ChatGPT-Supported Transcultural Nursing Education and Nursing Students’ Cultural Awareness and Competence: A Preliminary One-Group Pretest–Posttest Study

In the daily work of a nurse, the most critical tool is not always a stethoscope or a syringe, but the ability to understand the person lying in the bed. Patients come from every corner of the world, carrying beliefs, values, and traditions that shape how they experience illness and healing. When a nurse fails to recognize these differences, care can become confusing, ineffective, or even harmful. To address this, nursing schools teach a concept called cultural competence. This is the ability to provide care that respects a patient's background, requiring a nurse to first understand their own biases before they can truly connect with someone from a different culture. As classrooms and hospitals become more diverse, educators are constantly searching for new ways to teach these soft skills, which are just as vital as medical knowledge. Recently, a new kind of helper has entered the conversation: artificial intelligence. While these computer programs can generate vast amounts of text, they are not perfect; they can sometimes offer oversimplified or biased views of culture. The question for modern educators is whether these tools can be used safely to help students learn, or if they will only reinforce stereotypes.

A team of researchers in Turkey recently set out to test this idea with a group of nursing students. They wanted to see if a specific type of classroom course, which used an artificial intelligence chatbot as a learning partner, could actually improve how aware and skilled students felt when dealing with patients from different cultures. The study took place at a public university between February and June 2024. Twenty-eight undergraduate nursing students, roughly half of whom were from Turkey and half from other countries, volunteered to participate. The researchers did not just hand the students a computer and tell them to chat; they designed a careful, structured lesson plan where the technology played a specific, limited role.

The course was built around a simple but rigorous process. The students were divided into small groups, mixing local and international students to encourage natural conversation. Each group was assigned a topic related to caring for people from different cultural backgrounds. First, they used a chatbot to brainstorm ideas, expand on concepts, and find examples. However, the rules were strict: the students could not simply copy what the computer wrote. They were required to find at least ten scientific articles to verify and refine the information the chatbot provided. This step was crucial. It forced the students to treat the artificial intelligence not as an authority, but as a starting point for inquiry. They had to check the facts, look for bias, and ensure the content was accurate before presenting it to the class.

Once the material was prepared, the groups took turns presenting their findings while the rest of the class acted as a questioning audience. This created a dynamic environment where students had to defend their ideas and engage in deep discussion. Throughout the term, the instructors acted as guides rather than lecturers, helping the students spot any cultural stereotypes that might have slipped into the computer's suggestions. The students were also encouraged to link what they learned in the classroom to their real-world experiences in hospitals, sharing stories about how they had handled culturally sensitive situations during their clinical practice. To measure the results, the researchers asked the students to fill out surveys about their cultural awareness and skills before the course began and again after it ended.

The results showed a clear positive shift in the students' learning. After the course, the students scored significantly higher on measures of cultural awareness. They felt more comfortable interacting with people from different backgrounds, were better at recognizing their own cultural assumptions, and had a stronger grasp of how to handle clinical situations involving diverse patients. Their overall cultural competence also improved, with specific gains in the skills they could use and the knowledge they had acquired. However, one area did not change significantly: cultural sensitivity. This aspect, which involves deep-seated attitudes, moral responsiveness, and an emotional openness to difference, did not show a measurable increase after just one course. The researchers suggest that while students can quickly learn facts and skills, developing a genuine, heartfelt sensitivity to cultural differences may take longer and require more repeated, intense experiences than a single semester can provide.

It is important to understand what this study does and does not prove. The researchers were careful to note that they could not say the artificial intelligence alone caused these improvements. The course was a mix of many things: peer discussion, real-world hospital practice, and the use of the chatbot. The study design, which involved only one group of students taking a test before and after, means the researchers cannot rule out that the improvement came from simply talking to each other or gaining more clinical experience. They cannot say for certain that the chatbot was the magic ingredient. Instead, the findings suggest that using artificial intelligence as a tool within a carefully supervised, evidence-based lesson plan is a promising approach. It appears that when students are taught to question the computer, verify its answers with real science, and discuss the results with peers, the technology can support learning without replacing the human elements of education.

The study also highlights a necessary caution. The researchers found that if the chatbot is used without guidance, it risks producing simplified or stereotyped views of culture. The success of this project relied heavily on the instructors who moderated the discussions and the students who were trained to double-check the computer's output. The findings suggest that artificial intelligence can be a useful starting point for student curiosity, but it must be embedded in a learning environment that prioritizes critical thinking and human connection. For nursing education, this means that while new tools can help organize information and spark ideas, they should never replace the need for direct interaction, reflection, and the guidance of experienced teachers. The path to becoming a culturally competent nurse remains a human journey, one that technology can support but not complete on its own.