The adaptation process included expert consensus and pilot testing before the measurement properties were assessed. The participants were evaluated as members of a convenience sample drawn from one university training programme, rather than through a study designed to test an intervention or its effects on care delivery. Factor analysis produced the five-part structure, while the scale achieved an internal-consistency value of 0.812, measured with McDonald’s omega.

Together, these results provide preliminary support for the adapted Spanish questionnaire as a potential resource for evaluating perceptions of respectful maternity care. The 41.1% variance result also shows that the five factors did not account for all observed variation in the questionnaire responses. Because the evidence comes from a preliminary evaluation in a convenience sample associated with one university programme, the results should not be treated as definitive confirmation that the instrument will perform similarly in other educational institutions, healthcare settings or Spanish-speaking populations.

The authors said the tool may be useful in training for ethical, communicative and woman-centred care competencies. That is a proposed educational application rather than a demonstrated clinical benefit. The reported analysis did not establish whether using the scale changes students’ behaviour, improves care during pregnancy, childbirth or the postpartum period, or affects maternal health.

The study also does not establish that any of the five factors causes an improvement in care outcomes. Its strongest supported findings are the adapted five-factor structure, the 41.1% share of total variance explained and the internal-consistency coefficient of 0.812, all presented by the researchers as preliminary evidence for the PCMR-E scale.

Subject of Research: Preliminary psychometric evaluation of a Spanish student perceptions of respectful maternity care scale

Article Title: The Spanish version of the Students’ Perceptions of Respectful Maternity Care scale: cultural adaptation and psychometric validation

Article References: Mejuto-Prego, M., & Mena-Tudela, D. (2026). The Spanish version of the Students’ Perceptions of Respectful Maternity Care scale: cultural adaptation and psychometric validation. BMC Nursing. https://doi.org/10.1186/s12912-026-05525-8

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05525-8

Keywords: respectful maternity care, Spanish adaptation, psychometric validation, nursing students, factor analysis, internal consistency, questionnaire, maternity care training, Spanish, version, Students, Perceptions

Researchers used an online survey and convenience sampling to recruit participants from a population of 2,097 nursing students, producing a response rate of 42.4%. Data were collected with a Student Information Form, the Free Time Management Scale and the Oxford Happiness Questionnaire. The investigators described the work as a cross-sectional, descriptive and correlational multicenter study. They used descriptive statistics, independent-samples t-tests, one-way ANOVA, Pearson correlation and hierarchical multiple regression to examine relationships in the sample.

According to the abstract, the mean Free Time Management Scale score was 3.56 ± 0.60, while the mean Oxford Happiness Questionnaire score was 3.68 ± 0.69. Students who participated in leisure activities and those who reported allocating sufficient time for leisure activities had significantly higher scores on both measures, with p-values below 0.05 for the reported comparisons. In the hierarchical regression, leisure time management remained positively associated with happiness after adjustment for control variables, with a standardized coefficient of β = 0.337 and p < 0.001. The final model accounted for 23.6% of the variance in happiness, and adding leisure time management increased the explained variance by 10.8 percentage points, ΔR² = 0.108, p < 0.001.

The study’s design limits the conclusions that can be drawn. Cross-sectional data cannot establish the temporal sequence between leisure time management and happiness or determine whether changes in one produce changes in the other. Convenience sampling, a 42.4% response rate and recruitment from only four universities also constrain how broadly the sample results may apply. The article’s authors characterized leisure time management as a potentially modifiable psychosocial resource, but causal effects and the effectiveness of any educational intervention cannot be established from these observational findings. They recommend longitudinal and experimental studies to clarify causal pathways. This report summarizes the supplied published abstract and does not independently assess the full study.

Subject of Research: Association between nursing students’ leisure time management and happiness in a four-university cross-sectional study

Article Title: Happiness levels of nursing students in relation to leisure time management: a multicenter study

Article References: Palloş, A., Özdemir Aydın, G., Yılmaz Coşkun, E., Özsaban, A., & Turan, N. (2026). Happiness levels of nursing students in relation to leisure time management: a multicenter study. BMC Nursing. https://doi.org/10.1186/s12912-026-05329-w

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05329-w

Keywords: nursing students, leisure time management, happiness, psychological well-being, cross-sectional study, multicenter study, Türkiye, hierarchical regression, levels, nursing, students, relation

The investigators used the Hamburg Nightmare Questionnaire to assess the type, frequency and components of nightmares. Depression, anxiety and stress symptoms were evaluated with the Depression, Anxiety, and Stress Scale-21. The study aimed to compare nightmare characteristics with the presence of depression, anxiety and stress symptoms among nursing students.

According to the abstract, students who reported nightmares once per week had symptom levels of 21.6% for depression, 29.0% for anxiety and 23.9% for stress. These figures were higher than the corresponding levels reported by students experiencing nightmares at other frequencies. The abstract also states that emotional involvement, physiological components and replicability were higher in nursing students with depression, anxiety and stress symptoms.

The results support an association between replicative nightmares and anxiety symptoms in this group of nursing students. The available evidence describes an observational association rather than establishing that nightmares cause depression, anxiety or stress. The published abstract does not provide details about participant recruitment, the distribution of students across nightmare-frequency categories, statistical uncertainty, potential confounding factors or other measures needed to assess the study’s broader limitations. The authors’ conclusion also calls for mental health professionals and nursing student mentors to consider the presence, type and components of nightmares when addressing students’ mental health, including possible psychopathology and suicidal behavior.

Subject of Research: Associations between nightmares and mental health symptoms among nursing students in southern Mexico

Article Title: Replicative, frequency and emotional component nightmares are associated with depression, anxiety, and stress in nursing students from southern Mexico

Article References: González-Castro, T. B., Genis Mendoza, A. D., López-Narváez, M. L., Tovilla-Zárate, C. A., García-Alejandro, B., Fresán, A., Peregrino-Bolaina, A., de la Rosa Pérez, H., Nicolini, H., & Hernández-Díaz, Y. (2026). Replicative, frequency and emotional component nightmares are associated with depression, anxiety, and stress in nursing students from southern Mexico. BMC Nursing. https://doi.org/10.1186/s12912-026-05341-0

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05341-0

Keywords: nightmares, nursing students, depression, anxiety, stress, mental health, cross-sectional association, BMC Nursing, Replicative, frequency, emotional, component

The survey was conducted from May through June 2026 using a general information questionnaire and the Large Language Model Dependence Scale. The researchers used latent profile analysis to classify students’ response patterns. Gaussian and Bayesian network analyses were then applied to characterize relationships among scale items, while computer-simulated perturbations assessed potential educational targets.

In the Gaussian network analysis, “Discomfort” was a central item overall and within the Functional-Dominant profile, whereas “Reliable results” was central in the Global-Dependent profile. The statistically upstream Bayesian nodes were “Work efficiency” and “Reluctant to start” overall; “Discomfort,” “Honesty,” and “Predictability” in the Functional-Dominant group; and “Excellent assistant” and “Discomfort” in the Global-Dependent group. These network results describe modeled relationships rather than causal effects.

The largest simulated increases and decreases were associated with “Reluctant to start” and “Discomfort” overall, “Spend more time” and “Boring tasks” in the Functional-Dominant group, and “Work efficiency” and “Excellent assistant” in the Global-Dependent group. The abstract describes these perturbations as candidate educational targets, not as tested interventions or demonstrated improvements. Because the available evidence is an abstract-level report, the study’s broader limitations, including sample representativeness and the implications of its cross-sectional design, cannot be evaluated in full from the supplied information.

Subject of Research: Large language model dependence profiles and candidate educational targets among nursing students at two Chinese universities

Article Title: Profiles and candidate educational targets of large language model dependence among Chinese nursing students: a cross-sectional study

Article References: Deng, Y., Liao, L., Wang, X., Wu, S., Chen, F., & Ye, Z. (2026). Profiles and candidate educational targets of large language model dependence among Chinese nursing students: a cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05370-9

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05370-9

Keywords: large language models, nursing students, dependence, cross-sectional survey, latent profile analysis, Bayesian networks, Gaussian networks, computer simulation, China, nursing education, Profiles, candidate

The survey was conducted from January 6 to January 16, 2025, among undergraduate nursing students at Hunan Medical College in Hunan Province, China. Participants were selected through convenience sampling, and electronic questionnaires were distributed through class WeChat groups by trained class leaders. Current nursing students were eligible, while students on leave and fourth-year nursing interns who were not on campus were excluded. Students reported their experiences with generative AI, educational interaction and self-regulated learning during the preceding semester.

Of the 1,573 questionnaires completed, 553 were removed because responses took less than 100 seconds, had no variation across items or followed repeating patterns that the researchers regarded as indicators of questionable response quality. The 1,020 retained responses included 469 first-year students, 334 second-year students and 217 third-year students. Their mean age was 19.09 years, with a standard deviation of 2.40. Women represented 83.2% of the analytical sample, and 98.8% of participants said they had begun using generative AI for course learning by 2024.

The students’ mean student–GAI interaction score was 14.80 with a standard deviation of 2.27. Mean educational interaction was 70.90 with a standard deviation of 8.15, and mean self-regulated learning was 56.00 with a standard deviation of 7.34. All three measures were positively correlated. Student–GAI interaction correlated with educational interaction at r = 0.378, with self-regulated learning at r = 0.236, and self-regulated learning correlated with educational interaction at r = 0.580; all three p values were below 0.01.

A regression model containing student–GAI interaction and self-regulated learning explained 39.8% of the variance in educational interaction, with an adjusted R² of 0.397. Both predictors showed positive associations with educational interaction. Student–GAI interaction had a standardized coefficient of β = 0.256, while self-regulated learning had a standardized coefficient of β = 0.520; both were significant at p < 0.001. Because the model was cross-sectional, these coefficients describe statistical relationships in the survey data rather than changes or causal effects over time.

Structural equation modeling estimated a direct path from student–GAI interaction to educational interaction with a standardized coefficient of 0.26. The standardized indirect path through self-regulated learning was 0.12. On the unstandardized scale, the total estimated association was 1.36, with a bias-corrected bootstrap 95% confidence interval of 1.14 to 1.57. The direct component was 0.92, with a 95% confidence interval of 0.72 to 1.11, while the indirect component through self-regulated learning was 0.44, with a 95% confidence interval of 0.32 to 0.57.

The indirect component accounted for 32.35% of the total estimated association, while the direct component accounted for 67.65%. The researchers therefore interpreted self-regulated learning as a partial statistical mediator. Their interpretation was specifically statistical: the survey cannot establish whether stronger AI interaction precedes stronger self-regulation, whether self-regulation supports educational interaction, or whether other variables influence all three. The mediation tests used 5,000 bootstrap samples, and the confidence interval for the indirect effect did not include zero.

The mediation pattern differed among the three components of educational interaction. Self-regulated learning accounted for 22.15% of the total estimated association with student-student interaction, 45.41% with student-teacher interaction and 41.54% with student-content interaction. The corresponding unstandardized indirect effects were 0.16, 0.17 and 0.11, each with a bootstrap confidence interval that excluded zero. Direct associations also remained significant: they were 0.56 for student-student interaction, 0.21 for student-teacher interaction and 0.15 for student-content interaction.

These results suggest that the self-regulatory pathway was most prominent in teacher-related and content-related interaction in the statistical model. For peer interaction, the direct component represented 77.85% of the total association, compared with 54.59% for student-teacher interaction and 58.46% for student-content interaction. The finding does not mean that AI replaces human contact or that self-regulation has no relevance to peer work. It instead shows how the measured associations were distributed across the three dimensions in this sample of nursing students.

Several technical features qualify the findings. The four-item Student–GAI Interaction Scale had a Cronbach’s alpha of 0.780, with a confirmatory-factor root mean square error of approximation of 0.066, comparative fit index of 0.992 and incremental fit index of 0.992. The 18-item Educational Interaction Scale had an alpha of 0.925 but weaker model fit, including a root mean square error of approximation of 0.099, comparative fit index of 0.872 and Tucker–Lewis index of 0.852. The 15-item self-regulated learning questionnaire had an alpha of 0.919 and a comparative fit index of 0.896.

The study has important limitations. It surveyed students at one Chinese medical university, limiting generalizability, and relied on self-reported measures that could be affected by social-desirability bias. The analysis did not adequately control for prior academic achievement, AI literacy, learning motivation, digital access, the frequency and purpose of AI use, platform type, task complexity, teacher-guided versus self-initiated use, course type, teacher support or institutional permissions. The authors also point out that a high level of AI interaction may reflect adaptive use, convenience, overreliance or course requirements, which were not distinguished. The findings are therefore promising associations from a cross-sectional study, not evidence that introducing generative AI necessarily improves nursing education.

Subject of Research: Cross-sectional mediation analysis of student–generative AI interaction, self-regulated learning and educational interaction among nursing students

Article Title: Generative artificial intelligence use and interpersonal educational interaction among nursing students: self-regulated learning as a statistical mediator

Article References: Li, J., Xu, E., Li, L., Huang, L., Pu, Y., & Huang, R. (2026). Generative artificial intelligence use and interpersonal educational interaction among nursing students: self-regulated learning as a statistical mediator. Frontiers in Psychology, 17, Article 1864535. https://doi.org/10.3389/fpsyg.2026.1864535

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1864535

Keywords: generative artificial intelligence, nursing education, nursing students, student–AI interaction, educational interaction, self-regulated learning, mediation analysis, cross-sectional survey, student-teacher interaction, student-content interaction, Generative, artificial

The participants were 197 men and 196 women with a reported mean age of 21.6 years and a standard deviation of 1.5 years. Fourth-year students formed the largest group, numbering 229, or 58.3%, while 164 students were in their third year. Most respondents, 358 or 91.1%, were enrolled in a regular bachelor of nursing program, and 35 were in a bridging program for people who already held nursing diplomas.

Only 35 respondents, or 8.9%, had worked in a healthcare setting before entering the bachelor’s program, while 15, or 3.8%, reported attending an extracurricular pain-management course. Prior use of a pain scale was much more common: 329 students, or 83.7%, said they had used one. Learning about pain across laboratories, simulation and clinical placements was reported by 260 students, or 66.2%.

< Researchers used the Knowledge and Attitudes Survey Regarding Pain, a tool developed in 1987 and updated in 2014, with the original authors approving an Arabic translation for the study. The translation process included recruitment of translators, forward translation, backward translation, consolidation by a committee and pilot testing.

Minor contextual changes included replacing acetaminophen with paracetamol and replacing a reference to the United States with Saudi Arabia. Ten nursing experts with pain-management expertise evaluated the content validity of the translated survey. The scale-level content validity index was 0.98, the universal-agreement scale-level index was 0.85, and the Arabic instrument’s Cronbach’s alpha was 0.70.

Scores below 50% were classified as poor, scores from 50% to 75% as fair, and scores above 75% as good. < Students performed relatively well on selected statements about opioids.

A total of 92.4% correctly identified the definition of drug or opioid analgesic addiction, 89.8% said subsequent opioid doses should be adjusted according to the patient’s response, and 88.8% recognized the need to assess analgesic effects to avoid over-analgesia and respiratory difficulty. Yet these strengths were not consistent across the survey: only 16 of its 41 questions were answered correctly by more than half of the participants. The lowest results involved routes and doses of opioid administration, expected respiratory effects, tolerance and dependence, and two clinical case scenarios.

The survey therefore captured a mixture of correct factual knowledge and substantial gaps in applying that knowledge. < Several responses differed from the correct answers recorded by the survey.

Three-quarters of students incorrectly believed that patients should be encouraged to endure pain as much as possible before receiving opioids. Ninety percent did not identify oral administration as the recommended method for morphine in persistent cancer pain, and 86% believed that clinically evident respiratory distress was likely when an intravenous morphine dose was increased. Only 44.3% chose the patient as the person most capable of assessing pain severity; 26% selected the nurse, 19% the physician and 5% the patient’s spouse or family member.

More than 80% regarded administration of sterile water as an effective test for determining whether pain was real. These findings describe students’ survey responses rather than their behavior in clinical care. <

The two case studies tested assessment and intervention decisions in patients of the same age who had undergone the same surgical procedure and reported the same pain score, but who displayed different outward behavior. In case study A, the patient was smiling and relaxed; in case study B, the patient was grimacing and uncomfortable. About 30% of participants correctly scored pain in each scenario.

Only 5% selected the appropriate intervention involving 3 mg of intravenous morphine for the relaxed patient, and 8% selected it for the grimacing patient. The corresponding case-study responses produced some of the lowest correct-answer rates in the survey, indicating difficulty applying pain assessment and analgesic decisions even when the scenarios shared basic information. <

Survey performance was not significantly associated with gender, year of enrollment, type of nursing program, previous healthcare work, attendance at an extracurricular pain-management course, prior pain-scale use, learning context, or frequency of pain-scale use. Educational institution was the only demographic characteristic associated with performance in at least one analysis. A Kruskal–Wallis test found differences among the four universities when scores were treated as continuous.

Post hoc testing with Bonferroni correction showed that University A had significantly lower performance than Universities B and C. In robust linear regression, Universities B and C had higher continuous scores than the reference institution, while University D did not reach the conventional significance threshold. In the categorical logistic model, University C was associated with higher odds of a fair or good score than University A, but the corresponding categorical test across institutions had a p-value of 0.09.

< The findings extend earlier Saudi surveys that also reported low mean scores. The current study’s mean of 44% was similar to the approximately 42% reported in one earlier English-language survey and the 43% reported in another.

Those earlier investigations also identified language as a possible limitation for students whose first language was not English. By using an Arabic translation and recruiting senior male and female students from several institutions, the present survey addressed part of that concern and expanded the sample beyond the 150 participants in one earlier study. It did not test whether translation or any other methodological change improved learning, however, and the absence of a longitudinal or interventional design means that the causes of the low scores remain undetermined.

< The results provide a baseline for examining how pain management is incorporated into Saudi nursing programs. In the universities studied, pain management was addressed within selected subjects rather than as a discrete subject, using lectures, tutorials, simulation and clinical-placement experience.

The researchers recommended that educators and policymakers review curricula, resources and teaching methods, while suggesting particular attention to simulation, analgesic pharmacology, opioid administration and safety, patient-centered pain assessment, and communication with people experiencing pain. They also recommended broader studies involving additional institutions, practicing nurses and qualitative methods to investigate the factors associated with students’ low performance. These recommendations follow from the measured survey gaps, but the study did not implement or evaluate an educational intervention.

Several limitations constrain the interpretation of the findings. Because the study was cross-sectional, it can identify associations but cannot demonstrate causation. The sample came from only four purposively selected universities in one geographic region, so the results cannot be generalized to all Saudi nursing students.

Online self-reporting through the Knowledge and Attitudes Survey Regarding Pain may also introduce social-desirability bias, while the study’s recruitment and university selection were not described as nationally representative. The survey’s scoring system combines knowledge and attitudes, limiting the extent to which either can be isolated. Within those boundaries, the clearest reported findings are the low average score, the concentration of incorrect answers in pain assessment and opioid-related cases, and the absence of statistically significant relationships with most measured demographic and educational variables.

Subject of Research: Pain-management knowledge and attitudes among senior nursing students in northern Saudi Arabia

Article Title: Nursing Student's Knowledge of and Attitudes Towards Pain Management: A Cross‐Sectional Study

Article References: Alshehri, F. A., Levett‐Jones, T., Pich, J., & Alamri, A. S. (2026). Nursing Student's Knowledge of and Attitudes Towards Pain Management: A Cross‐Sectional Study. Nursing Open, 13(10), Article e70880. https://doi.org/10.1002/nop2.70880

Image Credits: AI Generated

DOI: 10.1002/nop2.70880

Keywords: pain management, nursing education, Saudi Arabia, nursing students, opioid safety, pain assessment, clinical decision-making, survey research, medical simulation, Nursing, Student's, Knowledge

The research, published in BMC Nursing, was led by Xiaoyan Zeng and Enru Lin, co-first authors from the School of Nursing at Fujian Medical University, together with colleagues including Rong Hu and Ying Wang. The team adopted a descriptive qualitative design, the methodological approach of choice when researchers want to capture participants’ experiences in their own terms while still producing a structured, analysable account. Rather than testing hypotheses or measuring variables, descriptive qualitative work asks open questions and lets patterns emerge from what participants say, making it particularly well suited to a concept like dignity, whose meaning varies between individuals and contexts.

Recruitment was deliberately broad. Using purposive sampling, the researchers enrolled 29 full-time undergraduate nursing students drawn from 15 universities across mainland China. Purposive sampling means participants were selected for their relevance to the research question rather than at random, ensuring the sample included students with varied educational and clinical experiences. Between September and December 2025, each student took part in an individual semi-structured online interview. Semi-structured interviews follow a flexible guide of open-ended questions, allowing participants to raise unexpected themes while ensuring every interview covers the core topic. Conducting the interviews online widened the geographic reach of the study and allowed students to speak from familiar surroundings, which can encourage candour on sensitive subjects such as perceived social status.

The interview data were analysed using Braun and Clarke’s thematic analysis, a widely used six-phase framework in which researchers immerse themselves in transcripts, code meaningful segments, and iteratively group codes into themes that capture something important about the dataset as a whole. The rigour of this approach depends on systematic coding and repeated comparison across the entire corpus, and it produces themes that are analytic summaries rather than simple topic labels. In this study, the process distilled hundreds of student statements into three overarching themes: external social valuation of nursing, appraisal of nursing’s professional value, and evolving professional dignity.

The first theme, external social valuation of nursing, describes how students’ sense of dignity was continuously calibrated against how society evaluates the profession. Students described encountering social attitudes that could either diminish or enhance their dignity. Where nursing was dismissed as subordinate work, an extension of medicine, or a fallback choice for those who could not enter other programmes, students reported feeling their chosen profession devalued, and with it their own sense of worth. Conversely, where nursing was recognised as skilled, caring, and indispensable, particularly in the wake of public health events that put nurses in the public eye, students described a corresponding lift in pride and confidence. The finding underscores that dignity is not generated solely inside the individual; it is partly on loan from the surrounding culture, and students are acutely sensitive to the exchange rate.

The second theme, appraisal of nursing’s professional value, shifts the focus from society’s gaze to the students’ own assessment of what nursing contributes. Students came to understand dignity through the meaningful nature of nursing work, the tangible difference nurses make to patients’ lives, and the professional respect that accrues with demonstrated clinical competence. In other words, dignity was not merely conferred from outside; it could be earned and internalised as students developed skills, witnessed recovery in patients they had cared for, and recognised the irreplaceable role of nursing within the health system. This internal appraisal acted as a counterweight to negative social attitudes, suggesting that professional value and social valuation operate through partly independent psychological pathways.

The third theme, evolving professional dignity, captures the developmental character of the phenomenon. Students’ perceptions were not fixed; they were continually reconsidered through nursing education and clinical exposure. Early in training, many students held impressions formed largely by media portrayals and family expectations. As they progressed through coursework and entered clinical placements, direct contact with real patients, practising nurses, and the realities of hospital work forced a renegotiation of what dignity in nursing meant to them personally. Some experiences consolidated their commitment; others exposed gaps between the profession’s ideals and its everyday conditions. The authors characterise students as occupying a vulnerable yet formative position, in which dignity and professional identity are actively taking shape and remain open to both damage and deliberate cultivation.

Why does this matter beyond the interview room? The research team argues that the development of professional dignity reflects a complex interplay of individual and contextual factors, with social recognition playing a central role. Dignity is linked in the wider nursing literature to professional identity, retention, and quality of care, and a workforce that enters practice with a diminished sense of professional worth may be more susceptible to burnout and attrition. For a profession already facing global shortages, understanding how the next generation constructs, or fails to construct, a durable sense of dignity is a workforce question as much as an educational one. The Chinese context adds particular interest, since nursing’s social standing varies considerably across countries and health systems, and the study provides a grounded account from one of the world’s largest nursing education systems.

The practical implications point squarely at nurse educators and clinical mentors. The authors conclude that these figures should recognise dignity formation as a developmental process and provide deliberate support to foster stronger professional dignity among students. In practice, that could mean explicitly addressing social stereotypes about nursing in the curriculum, creating structured opportunities for students to reflect on meaningful patient encounters, ensuring clinical mentors model respectful interprofessional behaviour, and designing placements where students can experience competence and its recognition firsthand. Because the study is qualitative, it does not quantify how common each experience is or test which interventions work; its contribution is a detailed, evidence-based map of the terrain that future quantitative and interventional research can now navigate.

The study was approved by the Biomedical Ethics Committee of Fujian Medical University, with approval dated January 17, 2024, and all participants provided written informed consent, with participation voluntary and withdrawal permitted at any time. It was funded by the Teaching Research Program for Undergraduate Education at Fujian Medical University and the Minjiang Education Leading Talents Program, with the funders having no role in the design, analysis, or publication decisions. Published open access on September 16, 2026, the research offers a timely reminder that professional dignity is not a fixed attribute that nursing students either possess or lack, but a living construct assembled from social signals, professional values, and lived experience, and one that educators can actively help to build.

Subject of Research: Undergraduate nursing students' perceptions of professional dignity

Article Title: Full-time undergraduate nursing students’ perceptions of professional dignity: a descriptive qualitative study of social attitudes, professional values, and self-identity

Article References: Zeng, X., Lin, E., Li, R., Hu, R., & Wang, Y. (2026). Full-time undergraduate nursing students’ perceptions of professional dignity: a descriptive qualitative study of social attitudes, professional values, and self-identity. BMC Nursing. https://doi.org/10.1186/s12912-026-05387-0

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05387-0

Keywords: nursing students, professional dignity, nursing education, qualitative research, professional identity, thematic analysis, social attitudes, clinical placements, nurse workforce, China, BMC Nursing, nursing ethics

The numbers tell a striking story. Only two relevant studies were published in 2019, but by 2025 that figure had climbed to 82, with almost two-thirds of all included studies, 64.6 percent, appearing in just the last two years of the review window. This surge tracks closely with the COVID-19 pandemic, which forced nursing schools worldwide to replace in-person clinical placements and simulation laboratories with digital alternatives almost overnight. What began as an emergency workaround, the review suggests, has hardened into a mainstream pedagogical approach that continues to accelerate even as campuses have fully reopened.

Geographically, the research boom is heavily concentrated. South Korea led the field, producing 21.2 percent of the included studies, followed by the United States at 18.7 percent, with China and Taiwan together contributing 11.1 percent. That East Asian dominance is one of the review’s most notable findings, and it cuts both ways: it reflects serious national investment in simulation-based training in the region, but it also raises questions about how well findings from these settings generalize to nursing programs in other countries, health systems, and cultural contexts. The authors flag this geographic concentration as a key constraint on the evidence base.

Technologically, the field is dominated by immersive experiences. Interactive immersive virtual reality, typically delivered through head-mounted displays that let students manipulate virtual instruments and interact with virtual patients, and 360-degree or 180-degree video-based virtual reality together accounted for 63.1 percent of the included studies. Screen-based virtual simulation, which runs on ordinary computers and requires no special hardware, made up 23.7 percent, while augmented reality, which overlays digital information onto the real world, accounted for a comparatively modest 4.0 percent. The distribution suggests that despite the cost and logistical burden of headsets, educators and researchers have gravitated toward the most immersive formats available, perhaps betting that presence and interactivity translate into deeper learning.

The methodological profile of the literature is equally revealing. Quasi-experimental designs were the most common study type at 27.8 percent, followed closely by randomized controlled trials at 22.7 percent. That nearly a quarter of the field consists of randomized trials is a point in its favor, since such designs are the gold standard for establishing causal effects. Yet the review also uncovered persistent weaknesses: small sample sizes, a scarcity of longitudinal follow-up that would show whether learning gains persist beyond the immediate post-test, and inconsistent outcome measures that make it difficult to compare results across studies or pool them in meta-analyses.

What are nursing educators actually measuring when they deploy these technologies? Three outcomes dominate the literature. Self-confidence and self-efficacy were assessed in 44.4 percent of studies, knowledge acquisition in 42.4 percent, and learner satisfaction in 39.4 percent. The review reports that favorable findings were commonly reported across these outcomes, meaning students generally emerged from virtual simulation feeling more capable, knowing more, and enjoying the experience. But the authors are careful to note an important limitation of their own work: this scoping review did not chart the direction or magnitude of effects, and no formal methodological quality appraisal was undertaken. In other words, the review maps where the field has been, not how strong the ground is.

That distinction matters for anyone hoping to draw practical conclusions. A scoping review, conducted here according to the Joanna Briggs Institute methodology and reported against the PRISMA-ScR checklist, is designed to chart the breadth of a literature rather than weigh the quality of individual studies. The team searched four major databases, PubMed, CINAHL via EBSCOhost, the Web of Science Core Collection, and Scopus, on 15 January 2026, with two reviewers independently screening records and extracting data and a third adjudicating disagreements. The protocol was retrospectively registered on the Open Science Framework, and the authors published their complete data extraction matrix, covering all 198 studies, as supplementary material, an unusually transparent move that allows other researchers to scrutinize and reuse the dataset.

The technical breadth captured in the review also hints at where the field is heading. Beyond the headline categories of virtual, augmented, and mixed reality, the included studies span a wide range of nursing education domains, from fundamental clinical procedures to complex scenario-based decision making. The authors standardized heterogeneous labels from the original papers into consistent categories for technology type, delivery format, outcome measures, sample-size bands, and educational domain, a data harmonization effort documented in their supplementary files. This kind of infrastructure matters because a literature growing this fast risks fragmenting into incompatible silos of terminology and measurement unless someone takes the time to build a common map.

The review’s conclusions are measured but pointed. Virtual simulation has been implemented across a broad range of nursing education contexts, and the mapped studies predominantly reported positive learning outcomes. However, the authors identify four constraints that warrant attention: limited longitudinal follow-up, geographic concentration in East Asia, small samples, and inconsistent outcome measures. Their prescription is standardized, multi-site research, ideally with agreed-upon instruments and designs that follow students long enough to show whether virtual simulation produces durable clinical competence rather than a temporary boost in test scores or confidence.

For nursing schools weighing investment in headsets, simulation software, and faculty training, the review offers both encouragement and caution. The sheer volume of recent research, and the consistency of positive findings on confidence, knowledge, and satisfaction, suggests that virtual simulation is no passing fad but a durable fixture of clinical education, one that proved its worth when the pandemic severed students from real wards. At the same time, the field’s reliance on small, short-term, regionally concentrated studies means that the boldest claims about virtual simulation, that it can replace or even surpass traditional clinical experience, still outrun the evidence. The next phase of this research story, the authors imply, will be less about proving that the technology can engage students and more about demonstrating, with rigorous and comparable methods, that it makes them better nurses.

Subject of Research: Use of virtual simulation technologies in nursing education

Article Title: Virtual simulation in nursing education: a scoping review

Article References: Dong, H., Zhou, C., Xing, L., & Li, D. (2026). Virtual simulation in nursing education: a scoping review. BMC Nursing, 25(1), Article 780. https://doi.org/10.1186/s12912-026-05295-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05295-3

Keywords: virtual simulation, nursing education, virtual reality, augmented reality, scoping review, nursing students, educational technology, simulation-based training, COVID-19, clinical education, self-efficacy, knowledge acquisition

The World Health Organization defines self-medication as the selection and use of medicines by individuals to treat symptoms they have recognized themselves, or the intermittent reuse of a prescribed drug for a chronic condition, all without professional oversight. When practiced responsibly for minor ailments, it can relieve pressure on overstretched health systems and support personal autonomy. But irresponsible self-medication carries serious consequences: misdiagnosis, delayed treatment of serious disease, adverse drug reactions, and—perhaps most dangerously—the acceleration of antimicrobial resistance, which the WHO ranks among the gravest threats to global health. A 2022 systematic review cited in the study put the worldwide prevalence of self-medication at up to 67 percent, with Southeast Asia topping the table at 74 percent, and prior research has found rates approaching 97 percent among health sciences students, far above the general population.

Vietnam presents a particularly fertile environment for the practice. Roughly half the population bought at least one medicine or supplement in the preceding three months according to recent national data, and antibiotics can reportedly be purchased without a prescription at 97 percent of community pharmacies. Earlier Vietnamese studies among university-level health students reported six-month self-medication rates ranging from 32 percent among pharmacy students to 52.7 percent among health sciences students who relied on personal experience. Yet the country’s associate-degree pharmacy and nursing students—the backbone of the primary healthcare workforce in rural and provincial facilities—had never been systematically compared within a single institution.

The research team, working from November to December 2025, surveyed essentially the entire final-year cohort: 365 eligible students, of whom 363 provided valid responses, a 99.5 percent response rate. The sample comprised 223 pharmacy students and 140 nursing students, nearly all aged 20 to 25 and predominantly female. The questionnaire, adapted from a validated instrument developed in Penang, Malaysia, went through a rigorous six-stage translation and cross-cultural adaptation process, including independent forward and back translation, expert committee review, pretesting, and a pilot with 30 separate students. Reliability was high: the knowledge section scored 0.85 on the Kuder–Richardson 20 coefficient and the attitude scale reached a Cronbach’s alpha of 0.92, both comfortably above the conventional 0.70 threshold.

The instrument measured four domains. Ten binary items assessed knowledge of drug interactions, contraindications, and safe-use principles, scored against the modified Bloom’s cutoff in which 80 percent or higher counts as good. Ten five-point Likert items gauged attitudes, operationalized as the propensity to self-medicate—so a higher score signals a stronger inclination toward the behavior, not a safer mindset. Nine further items captured actual practice over the preceding six months, including where students obtained medicines, what they treated, and why. Statistical analysis combined chi-squared and Mann–Whitney U tests with multivariable logistic regression, controlling for multicollinearity and verified for calibration with the Hosmer–Lemeshow test.

The knowledge results were broadly reassuring. Overall, 80.1 percent of students demonstrated good knowledge, with pharmacy students outperforming nursing students, 84.3 percent to 73.2 percent. Pharmacy students scored significantly higher on drug–alcohol interactions, drug–food interactions, and contraindications in children, reflecting the deeper pharmacology content of their curriculum. But a troubling detail lurked in the data: 61.7 percent of all students admitted having previously discontinued a medicine without consulting a healthcare professional—a habit with direct relevance to antimicrobial resistance and treatment failure, and one that was equally common in both disciplines.

Attitudes told a different story. Nearly 80 percent of students showed a moderate propensity toward self-medication, and 12.3 percent showed a high propensity. Nursing students were 5.5 times more likely than pharmacy students to fall into the high-propensity category, 24.6 percent versus 4.5 percent, despite scoring similarly on knowledge. Encouragingly, most students rejected the notion that professional training is unnecessary for safe self-medication, and majorities declined to recommend self-medication to others or to claim they could self-treat many diseases simply because of their health sciences background. Married students also expressed more caution than their single peers.

Practice data revealed what the researchers call a pharmacy–nursing paradox. Pharmacy students, armed with better knowledge and more cautious attitudes, nonetheless self-medicated more often: 61.0 percent versus 40.0 percent among nursing students. They cited emergency situations more frequently as a justification and self-treated gastrointestinal complaints—abdominal pain, diarrhea, constipation—at substantially higher rates. Nursing students, by contrast, leaned on prior treatment experience and the internet for information, and showed a striking reliance on unconventional supply channels: 46.2 percent of nursing students who self-medicated obtained medicines online, and 26.9 percent bought them at supermarkets, compared with 5.1 percent and 1.5 percent respectively among pharmacy students. The authors flag this as a pharmaceutical-law literacy gap, particularly urgent given Vietnam’s new e-commerce provisions under Law No. 44/2024/QH15.

The multivariable regression, fitted on 299 complete cases, distilled the picture into three independent predictors of self-medication. Being a nursing student roughly halved the odds compared with pharmacy students, an adjusted odds ratio of 0.43. Each one-point increase in the attitude score—greater propensity toward self-medication—raised the odds by 5 percent. And students with a grade point average between 2.00 and 2.49 faced nearly four times the odds of self-medicating compared with those in the excellent range, a finding that remained stable across sensitivity analyses including a Firth penalized-likelihood model. Knowledge score, notably, was not significant in any model, and the weak bivariate correlation between knowledge and attitudes dissolved after adjustment. The authors interpret this through the lens of the Theory of Planned Behavior: attitudes and internalized professional norms, not factual recall, drive behavior. Nursing training, with its emphasis on following medical orders, may itself act as a protective barrier, while pharmacological depth may breed a subtle overconfidence among pharmacy students—a hypothesis the cross-sectional design cannot confirm.

The implications reach beyond one college. Because knowledge alone demonstrably fails to shape safe behavior, the authors argue that health professional curricula should embed attitude-oriented interventions that stress the limits of professional competence and the clinical risks of unsupervised medication use, including arbitrary discontinuation. Nursing programs need explicit content on pharmaceutical law and online medicine purchasing; regulators, meanwhile, should strengthen Good Pharmacy Practice inspections and publish lists of licensed e-pharmacies. The study also positions cumulative GPA as a potentially modifiable risk marker worth screening for targeted support. Its limitations are real—single-institution scope, self-reported data vulnerable to recall and social desirability bias, and no capacity for causal inference—but the message is hard to dismiss. In a region where antibiotics sit behind no prescription counter, the people who will soon staff the front line of primary care are learning, before graduation, that knowing the risks of self-medication and acting on them are two very different skills.

Subject of Research: Self-medication knowledge, attitudes, and practices among Vietnamese healthcare college students

Article Title: Knowledge, attitudes, and practices regarding self-medication among healthcare college students in Vietnam: a cross-sectional study

Article References: Vo-Ho, T.-D., Vo, H. B. T., Huynh, H. V., Le, P.-Y. T., Nguyen, N.-N. T., & Vo, T. Q. (2026). Knowledge, attitudes, and practices regarding self-medication among healthcare college students in Vietnam: a cross-sectional study. Pharmacia, 73, Article e204360. https://doi.org/10.3897/pharmacia.73.e204360

Image Credits: AI Generated

DOI: 10.3897/pharmacia.73.e204360

Keywords: self-medication, Vietnam, pharmacy students, nursing students, knowledge attitudes practices, antimicrobial resistance, cross-sectional study, health sciences education, over-the-counter medicines, pharmacology training, Binh Duong Medical College, drug safety

The study, published in BMC Medical Education, recruited ninety-one first-semester undergraduate students from the dental programme at Karolinska Institutet and the nursing programme at Sophiahemmet University in Stockholm. Participants completed a detailed survey that captured sociodemographic information, their estimated daily screen use broken down by purpose, and a battery of twelve self-report instruments covering everything from anxiety and depression to sleep quality, physical activity, fear of missing out, and jaw pain. Self-perceived academic performance was measured with the Academic Performance Scale and treated as a continuous score rather than a crude pass-fail category, allowing the researchers to detect subtle associations that binary outcomes would have obscured.

The analytical design is where the study becomes genuinely interesting. Rather than simply correlating total screen hours with grades, the team ran a hierarchical linear regression, a statistical technique that adds explanatory variables in successive blocks so that each block’s unique contribution can be isolated. Demographic variables went in first, followed by total screen time, then purpose-specific screen use, and finally a composite measure of psychological symptom burden together with screening status for temporomandibular disorders, a family of conditions affecting the jaw joint and chewing muscles that was assessed with a validated three-question screening tool.

The results upended the conventional narrative. Total screen time was unrelated to academic performance in every analysis the researchers conducted. When purpose-specific use was added to the model, it explained an additional 19.0 percent of the variance in performance beyond total duration, a highly significant contribution. Strikingly, when the order was reversed and total duration was entered after purpose, it added only 2.2 percent of explained variance and failed to reach statistical significance. In other words, once you know what a student is doing on their devices, knowing how long they spend on them tells you almost nothing extra.

Within the full model, which accounted for roughly a third of the variance in self-perceived performance, three factors emerged as significant. Academic screen use, time spent on screens for study purposes, was positively associated with performance, carrying a standardized coefficient of 0.426. Work-related screen use showed the opposite pattern, with a negative association, and psychological symptom burden was also negatively associated with performance. Students carrying heavier loads of depressive, anxious, and stress-related symptoms reported poorer academic performance regardless of how many hours they spent in front of a display.

The health findings added a further layer. Students who rated their academic performance lower also reported poorer health-related quality of life in five of the eight domains measured by the RAND-36, a widely used health survey covering physical functioning, role limitations, energy, emotional wellbeing, social functioning, pain, and general health. The lower-performing group was also more likely to screen positive for temporomandibular disorders, although this jaw-related association did not survive statistical adjustment for oral parafunctional behaviors, habits such as teeth clenching and grinding that the researchers measured with the Oral Behavior Checklist. That statistical nuance suggests the apparent link between jaw problems and academic self-assessment may be mediated by these unconscious oral habits rather than the disorder itself.

Why should purpose matter so much more than duration? The answer likely lies in what different types of screen use actually demand from the brain and body. Academic screen use is, by definition, aligned with the outcome being measured, so a positive association is almost tautological: students who study more, even if that studying happens on a laptop or tablet, tend to feel they are performing better. Work-related screen use, by contrast, may compete directly with study time and recovery time, fragmenting attention and adding fatigue without contributing to academic mastery. And psychological symptom burden is a well-established correlate of academic difficulty, capable of degrading concentration, memory, and motivation independently of any digital behavior.

The study’s methodology deserves attention for its statistical discipline. The researchers used the Holm-Bonferroni procedure to control the family-wise error rate within families of outcomes, a correction that reduces the risk of false positives when many comparisons are made simultaneously. They also reported effect sizes alongside significance tests and compared groups using appropriate non-parametric and parametric tests depending on the distribution of the data. This level of rigor matters in a field, screen-time research, that has been criticized for producing noisy, contradictory findings driven by small effects and uncorrected multiple comparisons. The Swedish team’s willingness to report that total screen time simply did not matter, even after building a model specifically designed to detect such an effect, lends credibility to the positive findings that did emerge.

Several caveats temper the conclusions. The study is cross-sectional, meaning it captures a single moment in time and cannot establish whether screen use patterns cause differences in academic performance or merely accompany them. The sample is modest in size and drawn from two health-science programmes at elite Swedish institutions, so the findings may not generalize to students in other disciplines or countries. And the key outcome is self-perceived performance rather than objective measures such as examination scores, raising the possibility that students’ self-assessments are shaped by the same psychological factors that appear in the model. The authors themselves frame the work as exploratory, a word that signals hypothesis generation rather than definitive proof.

Even with those limitations, the implications are hard to ignore. If the study holds up in larger and longitudinal samples, the widespread practice of setting screen-time limits as a blunt instrument may be misguided, particularly for university students whose academic lives are now inseparable from digital devices. A student spending seven hours a day on screens, most of it reading course material and writing assignments, may be in a far healthier position than one spending three hours scrolling through work-related messages and social feeds while battling anxiety. The message from Stockholm is not that screens are harmless, but that the question we should be asking has changed: not how much, but what for, and at what psychological cost. For students, educators, and the growing industry of digital wellbeing tools, that reframing could reshape how screen habits are assessed and managed in the years ahead.

Subject of Research: The relationship between screen use, health status, and self-perceived academic performance in Swedish dental and nursing students

Article Title: Screen use, health status, and self-perceived academic performance among Swedish dental and nursing students: an exploratory cross-sectional survey study

Article References: Christidis, N., Lärfars, M., Khattar, P., Markus, D., Canales, G. D. L. T., & Christidis, M. (2026). Screen use, health status, and self-perceived academic performance among Swedish dental and nursing students: an exploratory cross-sectional survey study. BMC Medical Education, 26(1), Article 1508. https://doi.org/10.1186/s12909-026-10445-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10445-x

Keywords: screen time, academic performance, dental students, nursing students, mental health, temporomandibular disorders, digital media use, RAND-36, psychological symptoms, Karolinska Institutet, cross-sectional study, medical education