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Cost to the Individual

Attribution

Original work: "Educators' guide to multimodal learning and Generative AI" — Tünde Varga-Atkins, Samuel Saunders, et al. (2024/25) — CC BY-NC 4.0
Adapted for UK Nursing Education by: Lincoln Gombedza, RN (LD)
Last Updated: December 2025

When using GenAI in nursing education, there are significant personal costs and responsibilities that both educators and students must consider.

Personal Accountability​

For Students​

Academic Integrity

  • Students must understand that using AI without proper attribution constitutes academic misconduct
  • The NMC Code emphasizes honesty and integrity - this extends to academic work
  • Using AI to complete assessments without disclosure undermines professional development

Clinical Competence

  • Over-reliance on AI for clinical reasoning can weaken critical thinking skills
  • Students must develop independent clinical judgment for patient safety
  • AI should supplement, not replace, clinical learning experiences

Professional Identity

  • Nursing requires empathy, compassion, and human connection
  • Excessive AI use may diminish development of these essential qualities
  • Students need authentic experiences to develop professional values

For Educators​

Pedagogical Responsibility

  • Educators must model responsible AI use
  • Clear guidance needed on when and how AI should be used
  • Responsibility to teach AI literacy alongside clinical skills

Assessment Design

  • Need to create AI-resilient assessments that measure authentic competence
  • Responsibility to ensure assessments align with NMC standards
  • Must balance innovation with academic rigor

Privacy and Data Protection​

Personal Information​

Student Data

  • Never input patient-identifiable information into public AI tools
  • Be cautious with personal student data
  • Comply with GDPR and university data protection policies

Clinical Scenarios

  • Anonymize all patient cases before using in AI prompts
  • Remove identifying details (names, dates, locations)
  • Consider institutional policies on data sharing

Digital Footprint​

Professional Reputation

  • Everything shared with AI tools may be stored and used for training
  • Consider long-term implications of AI interactions
  • Maintain professional standards in all AI communications

Cognitive Costs​

Critical Thinking​

Skill Atrophy

  • Over-reliance on AI can weaken problem-solving abilities
  • Students may lose confidence in their own clinical reasoning
  • Risk of becoming dependent on AI for basic tasks

Learning Depth

  • AI-generated summaries may reduce deep engagement with material
  • Students might miss nuanced understanding of complex concepts
  • Surface-level learning doesn't support clinical expertise

Metacognition​

Self-Awareness

  • Students need to recognize when they're relying too heavily on AI
  • Develop awareness of their own learning processes
  • Understand personal strengths and areas for growth

Time and Effort​

The Paradox of Efficiency​

Short-term vs. Long-term

  • AI may save time initially but can create dependency
  • Quick answers don't build lasting knowledge
  • Efficiency in learning doesn't always equal effectiveness

Prompt Engineering

  • Learning to use AI effectively requires time and skill
  • Poorly crafted prompts yield poor results
  • Need to invest in developing AI literacy

Emotional and Psychological Costs​

Anxiety and Uncertainty​

For Students

  • Confusion about when AI use is appropriate
  • Fear of being accused of cheating
  • Stress about keeping up with AI developments

For Educators

  • Pressure to integrate AI without adequate training
  • Uncertainty about detecting AI misuse
  • Concern about maintaining academic standards

Imposter Syndrome​

Attribution Confusion

  • Students may question which ideas are truly their own
  • Difficulty distinguishing between AI-assisted and independent work
  • Impact on professional confidence and identity

Financial Costs​

Subscription Services​

Premium AI Tools

  • Many advanced AI features require paid subscriptions
  • Creates equity issues between students with different financial means
  • Institutions may need to provide access to ensure fairness

Hidden Costs

  • Data usage for AI applications
  • Potential need for upgraded devices or software
  • Training and professional development expenses

Mitigation Strategies​

For Students​

  1. Set Boundaries

    • Define when AI use is appropriate for your learning
    • Use AI as a supplement, not a replacement
    • Maintain regular practice without AI assistance

  2. Practice Transparency

    • Always disclose AI use when required
    • Keep records of how AI was used in your work
    • Seek clarification when unsure about policies

  3. Develop Self-Awareness

    • Regularly assess your understanding without AI
    • Identify areas where you're becoming too dependent
    • Balance AI use with traditional learning methods

For Educators​

  1. Provide Clear Guidelines

    • Explicit policies on acceptable AI use
    • Examples of appropriate and inappropriate applications
    • Regular updates as technology evolves

  2. Model Responsible Use

    • Demonstrate ethical AI integration in teaching
    • Share your own AI learning journey
    • Acknowledge limitations and challenges

  3. Support Student Development

    • Teach AI literacy as a core skill
    • Create opportunities for AI-free practice
    • Foster critical evaluation of AI outputs

Nursing-Specific Considerations​

NMC Standards Alignment​

Platform 1: Being an accountable professional

  • Students must take responsibility for their own learning
  • AI use should enhance, not undermine, accountability
  • Professional judgment cannot be outsourced to AI

Platform 4: Providing and evaluating care

  • Clinical decision-making must remain human-centered
  • AI should inform, not replace, nursing assessment
  • Patient safety depends on independent critical thinking

Clinical Practice​

Placement Learning

  • AI cannot replace hands-on clinical experience
  • Students must develop practical skills independently
  • Mentors need guidance on supporting AI-literate students

Patient Interaction

  • Empathy and communication skills require human practice
  • AI cannot teach the art of nursing care
  • Authentic patient relationships are irreplaceable

Reflection Questions​

Consider these questions to evaluate your personal AI use:

  1. Accountability: Can you explain and justify every instance of AI use in your work?
  2. Learning: Is AI enhancing or replacing your learning process?
  3. Competence: Are you developing the clinical skills needed for safe practice?
  4. Integrity: Would you be comfortable disclosing your AI use to patients, mentors, or examiners?
  5. Balance: Are you maintaining skills that don't rely on AI?

Next: Explore Cost to the Environment to understand the sustainability implications of AI use.