Thinking Aloud with AI: Nursing Students’ Cognitive Processes Using GenAI for Clinical Reasoning

Project Lead: Charlene E. Ronquillo (Assistant Professor, Nursing)
Co-Leads: Rina Garcia Chua (Academic Integrity Program Manager, UBCO Library and Student Learning Hub); Lindsay Kennedy (Associate Professor of Teaching, Nursing); Lisa Moralejo (Associate Professor of Teaching, Nursing); Kathryn Sturgess (BSN Student, Nursing); Melanie Willson (Assistant Professor of Teaching, Nursing); Ryan Wilson (Assistant Professor of Teaching, Nursing)

Project Description

We aim to explore student motivations, characterize the nature of use, and identify impacts on critical thinking and complex clinical reasoning tasks that accompany the use of Generative AI (GenAI) in learning activities. In the context of high-stakes learning activities in undergraduate nursing education, we will investigate real-time cognitive interaction patterns and student perceptions of GenAI’s information accuracy and perceived influence on their critical thinking and potential deskilling (Lee et al., 2025; Topaz et al., 2025). Understandings of when, how, and what role GenAI tools play in student learning will offer insights into student-AI cognitive engagement and inform pedagogical strategies to ensure safe and responsible GenAI use.

Research Questions

  1. How do undergraduate nursing students interact with GenAI (ChatGPT) in real-time when developing care plans for complex clinical scenarios and responding to acute deterioration events?
  2. How do students identify and describe their own cognitive processes (e.g., information integration, identification of bias/errors) while using GenAI for tasks with potential clinical risk?
  3. How do students perceive GenAI’s influence on their critical thinking, decision-making, and the potential for deskilling?
  4. What strategies, if any, do students employ to mitigate risks associated with GenAI-generated information?