Chatbot-Centered Integration of Simulation and Artificial Intelligence in Nursing Education: A Narrative Review

Abstract

Nursing education is at the center of a rapidly transforming digital learning ecosystem, with the integration of artificial intelligence (AI), chatbots and simulation technologies. These innovations have the potential to strengthen clinical reasoning skills, increase student engagement, objectify assessment processes and support the retention of learning outcomes. However, effective and safe integration requires consideration of pedagogical alignment, ethical responsibilities, data security, algorithmic bias and human oversight. This study synthesises the extant evidence and proposes an integrated 'chatbot-centered integration model' for use in nursing education. The model synthesises Socratic questioning, gamified problem solving, simulation, virtual/augmented reality, and learning analytics within a unified framework, adopting a chatbot orchestrator role that facilitates pre-briefing, in-scenario counselling and debriefing stages. This synthesis is grounded in constructivism, situational learning, and pedagogical agents theory. The role of digital tools such as chatbots, simulations and artificial intelligence in nursing education is steadily increasing, as is their impact on students. These tools have numerous positive and negative impacts depending on the type and variety of use, and their effects are multidimensional.

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