CHATBOT USE ON NURSING STUDENTS

THE EFFECT OF CHATBOT USE ON NURSING STUDENTS' CONCEPT MAP CONSTRUCTION SKILLS: A RANDOMIZED CONTROLLED STUDY

Concept maps are visual tools that help students organize information and understand how ideas are related to each other. Although concept mapping is widely used in nursing education, many nursing students find it difficult to create effective concept maps. Recently, artificial intelligence tools such as ChatGPT have begun to be used in education and may help support students during learning activities. However, it is not yet clear whether using chatbots improves students' ability to create concept maps. This study aimed to examine whether using a chatbot (ChatGPT) helps nursing students develop better concept map construction skills. The study was conducted as a randomized controlled trial with second-year nursing students taking a surgical nursing course during the 2024-2025 spring semester. A total of 108 students were randomly assigned to either an intervention group or a control group. All students received the same theoretical education about postoperative care of cardiac surgery patients from the same instructor. Students in the intervention group received brief training on how to use ChatGPT and were allowed to use the chatbot while creating case-based concept maps. Students in the control group created concept maps using only textbooks and course materials. Students' knowledge, concept map quality, and attitudes toward concept mapping were evaluated. The results showed no significant difference between the two groups in terms of postoperative care knowledge or overall concept map scores. However, students who used ChatGPT had more positive attitudes toward concept mapping. Students also reported that the chatbot helped them understand complex information more easily and supported them during the concept map creation process.In conclusion, using a chatbot did not improve concept map performance scores, but it had a positive effect on students' attitudes and learning experiences. Chatbot-assisted learning may be a useful supportive tool in nursing education. Further studies with larger groups of students and longer follow-up periods are needed to better understand its effects on learning outcomes.

Study Overview

• Status: Completed
• Conditions: to Examine the Effect of Chatbot Use on Nursing Students
• Intervention / Treatment: Behavioral: Chatbot-assisted concept mapping; Behavioral: Traditional concept mapping -Control Group

• Study Type: Interventional
• Enrollment (Actual): 108
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Izmir, Turkey (Türkiye)
    • Dokuz Eylul University,

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• -Taking the surgical nursing course for the first time

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Chatbot-assisted concept mapping; Students in this group received standard theoretical instruction on postoperative nursing care of cardiac surgery patients and, in addition, participated in a 15-minute training session on the use of ChatGPT and effective prompt techniques. During case-based learning activities, students were instructed to use the chatbot as a supportive tool while constructing concept maps.	Behavioral: Chatbot-assisted concept mapping; In this study, pre-test and post-test assessments were administered to students in both the intervention and control groups. Data were collected using the Student Information Form, Concept Map Evaluation Checklist, Attitude Toward Concept Mapping Scale, and a postoperative nursing care knowledge test. Students in the intervention group received training on ChatGPT use and prompt formulation and utilized the chatbot during the creation of case-based concept maps. The control group completed the same concept mapping activities using traditional learning resources without chatbot support.
Active Comparator: Control group; Students in this group received the same theoretical instruction on postoperative nursing care of cardiac surgery patients as the intervention group. They constructed case-based concept maps using textbooks, lecture notes, and course materials only, without the use of any chatbot or artificial intelligence-based tools.	Behavioral: Traditional concept mapping -Control Group; Students in the control group received the same theoretical instruction on postoperative nursing care of cardiac surgery patients. They constructed case-based concept maps using textbooks, lecture notes, and course materials only, without the use of any chatbot or artificial intelligence-based tools.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Concept Map Construction Skill	Concept Map Assessment Keys: Concept Map Assessment Keys are one of the tools used to evaluate concept maps. In this assessment tool, the student is evaluated on identifying a concept related to the topic and establishing meaningful connections between them, with 1 point awarded for each meaningful relationship/connection found. Another item evaluated is whether the student follows a hierarchical order according to priority when moving from general concepts/elements to more specific concepts, with 5 points awarded for each hierarchy established by the student. The student is awarded 10 points for each cross-connection established when moving from one concept section/group to another with a hierarchically meaningful connection.	Baseline (post-test), after the intervention - assessed once immediately after to the intervention.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attitude Toward the Concept Mapping Method	Attitude Scale Towards the Concept Map: This will be used to assess the attitudes of all groups towards the concept map method prior to the initiative. It is a 5-point Likert-type scale developed to determine individuals' attitudes towards the concept map method. The scale consists of a total of 23 items and has a two-factor structure. The first factor consists of positive attitude items and contains 13 items. The second factor consists of negative attitude items and contains 10 items. Items on the scale are scored from 1 to 5. For positive items, the response "Strongly Agree" receives the highest score (5), while the response "Strongly Disagree" receives the lowest score (1). For negative items, the scoring is reversed; the response "Strongly Agree" receives the lowest score (1), while the response "Strongly Disagree" receives the highest score (5). As the total score obtained from the scale increases, the individual's attitude towards the concept mapping method is considered more po	After the intervention - assessed once immediately after the intervention.
Knowledge Level of Postoperative Nursing Care in Cardiac Surgery	Cardiac Surgery Patient Nursing Care Knowledge Test: Prepared to measure student nurses' knowledge levels regarding post-cardiac surgery patient care. The test covers topics such as methods for maintaining the stability of patients after sternotomy, signs of cardiac tamponade, and the most commonly used graft types in coronary artery bypass grafting surgery. Additionally, postoperative care processes such as the importance of early mobilization, practices that support sternum healing, and the purpose of using compression stockings are also addressed in the test questions. Furthermore, the knowledge level regarding critical issues such as patient groups at risk of wound infection, appropriate mobilization planning, and nursing interventions to prevent pulmonary complications is assessed, and the aim is to increase nurses' awareness of these processes (Durmaz Edeer & Kankaya, 2025). Five experts were consulted for content validity for the knowledge test. Based on the evaluations obtaine	Baseline (pre-test), before the intervention - assessed once immediately prior to the intervention.
Students' Perceptions of Chatbot Use in Concept Mapping	Qualitative data were collected from students in the intervention group using two open-ended questions exploring their opinions on the role of chatbot use in the learning process and its contribution to concept map construction. Responses were analyzed using thematic analysis.	Post intervention immediately

Collaborators and Investigators

• Sponsor: Dokuz Eylul University

Study record dates

Study Major Dates

• Study Start (Actual): March 19, 2025
• Primary Completion (Actual): April 14, 2025
• Study Completion (Actual): April 14, 2025

Study Registration Dates

• First Submitted: December 16, 2025
• First Submitted That Met QC Criteria: December 16, 2025
• First Posted (Actual): December 30, 2025

Study Record Updates

• Last Update Posted (Actual): December 30, 2025
• Last Update Submitted That Met QC Criteria: December 16, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Nurse education, Concept mapping, Nursing Students, Artificial Intelligence, Qualitative, Randomized controlled study
• Other Study ID Numbers: 9662

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No