Mapping the evidence on generative artificial intelligence for higher-order thinking skills in nursing students: A scoping review.
TL;DR
The dual role of GenAI in HOTS development indicates that nursing education should integrate GenAI judiciously, and efforts should focus on improving the quality of human-AI collaboration, with particular attention to humanistic care, thereby helping students positively reshape their professional perceptions.
Abstract
Aim
This study aimed to map evidence regarding the role of generative artificial intelligence (GenAI) in developing higher-order thinking skills (HOTS) among nursing students.
Background
GenAI is revolutionizing medical education by enabling innovative pedagogical approaches and showing promise in cultivating HOTS. However, its implementation and evidence on its role in fostering HOTS in nursing students remain unclear.
Design
A scoping review.
Methods
The review was conducted in accordance with the PRISMA-ScR checklist and Arksey and O'Malley methodological framework. Searches were performed in October 2025 and updated in February 2026 across eight databases: PubMed, Ovid EMBASE, CINAHL, Web of Science, PsycINFO, Cochrane Library, Education Source and ERIC. Two reviewers independently screened the studies in a blinded manner. Seventeen articles were included. Data were analyzed using interpretive description to summarize study characteristics, followed by thematic analysis to identify relevant themes.
Results
Studies showed the dual role of GenAI in cultivating HOTS in nursing education. Three key themes were identified, including: (1) the paradoxical reconstruction of cognitive dynamics; (2) tensions and frictions at the human-AI interface; and (3) reshaping learning and professional identity in the AI era.
Conclusions
The dual role of GenAI in HOTS development indicates that nursing education should integrate GenAI judiciously. While GenAI offers potential benefits for HOTS development, it also introduces risks related to cognitive dependence and reduced critical engagement. Furthermore, efforts should focus on improving the quality of human-AI collaboration, with particular attention to humanistic care, thereby helping students positively reshape their professional perceptions.