Nursing Students' Experiences with Large Language Models in Academic Writing: A Qualitative Systematic Review Based on the Technology Acceptance Model

In the quiet, often solitary work of academic writing, nursing students face a dual challenge: they must master a complex body of medical knowledge while learning to articulate it clearly in research papers and reports. For decades, the tools of this trade were dictionaries, libraries, and peer review. Today, a new force has entered the room. Large language models are computer programs trained on vast amounts of text that can read, write, and converse with a fluency that mimics human thought. These systems do not simply look up facts; they generate new sentences, summarize long documents, and offer explanations for difficult concepts. As these tools become more common in healthcare and education, a critical question arises: how do the students who will one day care for patients feel about using them to write their own work? Do they see them as helpful assistants, or as threats to their learning?

A team of researchers set out to answer this by gathering the voices of nursing students from around the world. They did not run a new experiment or survey a fresh group of people. Instead, they performed a careful synthesis of eleven existing studies that had already asked students about their experiences. By reading through these accounts, the researchers looked for common threads, grouping similar feelings and observations together to build a clearer picture of the whole. They organized their findings using a framework that helps explain why people adopt new technology, looking at whether students found the tools useful, easy to use, risky, or influenced by their surroundings. The result is a detailed map of the student experience, revealing a landscape where enthusiasm and caution walk hand in hand.

The students in these studies generally viewed these artificial intelligence tools with optimism. They described the technology as a powerful helper that could break down barriers in their work. When faced with dense medical literature written in a foreign language, the tools acted as translators and explainers, turning confusing paragraphs into clear summaries. Students reported that the programs could extract key ideas from long papers, helping them grasp the main arguments much faster than reading alone. In the actual writing process, the tools offered a steady hand for organizing thoughts, fixing grammar, and polishing sentences, which was especially valuable for those writing in a language that was not their first. Beyond the mechanics of writing, many students found a surprising source of comfort in the interaction. The process of writing a thesis can be isolating, and the constant availability of the tool provided a sense of companionship, offering immediate feedback and ideas when a student felt stuck or overwhelmed.

This positive reception was matched by a sense that the tools were incredibly easy to use. Students noted that they did not need special training or a background in computer science to operate them. The interface was intuitive, responding to natural language questions just as a person would. Because the tools were so accessible and responsive, students began to use them frequently, integrating them into their daily workflow. They turned to the programs for everything from brainstorming research topics to checking the structure of a draft. Over time, the tools became a normalized part of the academic routine, used almost every day by many students who felt they could not work as efficiently without them.

However, this reliance did not come without a sharp awareness of the risks. Even as students embraced the technology, they remained vigilant about its flaws. A major concern was the quality of the information the tools produced. Students reported that the programs sometimes made up facts, cited non-existent sources, or provided outdated medical guidelines. Because the tools are designed to sound confident, these errors could be difficult to spot, requiring students to double-check every piece of information carefully. There was also a worry that the tools lacked the specific depth needed for nursing. While they could handle general questions, they often struggled with the nuanced, specialized knowledge required for clinical assessments or patient care scenarios.

Perhaps the most profound concern was the fear that leaning too heavily on these tools might weaken the students' own minds. Many students worried that if the computer did the thinking for them, they would lose their ability to think critically, solve problems independently, or innovate. They recognized that the core of nursing is not just data processing but human connection. The ability to read a patient's subtle emotional cues, to offer genuine empathy, and to make complex clinical judgments based on a holistic view of a person are skills that a machine cannot replicate. Students expressed a firm belief that while the tools could assist with writing, they could never replace the human element of care or the critical thinking required to be a safe and effective nurse.

The decision to use these tools was also shaped by the world around the students. They were influenced by the rapid pace of technological change and the fact that their peers and mentors were already using them. Seeing others succeed with the help of artificial intelligence created a sense of pressure to keep up. At the same time, the rules governing these tools were often unclear. Some institutions banned their use in academic work, while others were still figuring out how to define what counted as academic misconduct. Students felt caught between the desire to use a helpful resource and the fear of violating ethical norms or compromising their originality. They also faced practical hurdles, such as the cost of premium versions of the software or the lack of reliable internet access in some areas, which limited who could use the tools effectively.

Ultimately, the students' willingness to use these tools was driven by a mix of hope and anxiety. On one hand, they saw the tools as a way to improve their work, reduce stress, and prepare for a future where technology is a standard part of healthcare. On the other hand, they felt a nagging fear that if they did not use these tools, they would fall behind their peers and lose their competitive edge. This created a complex motivation where the drive to use the technology was not always purely about seeing its value, but also about avoiding the disadvantage of being left out. The researchers concluded that while nursing students are generally positive about the potential of these tools, they are also acutely aware of the dangers. The path forward, they suggest, is not to reject the technology, but to teach students how to use it wisely, ensuring they understand its limits and never lose sight of the human skills that define their profession.