Contributor: Victoria Soltis-Jarrett
Will nurses consider Artificial Intelligence (AI) a pattern of ‘knowing’ in nursing in the future? I recently completed a course that required me to ensure that an online asynchronous graduate nursing course I will design meets the rigorous standards. I chose the asynchronous format of the course despite the availability of a synchronous one-day course option. I naively thought I would benefit from the online experience as an established nursing academic who took her qualifying exam as an R.N. with a pencil and paper. I aimed to explore the question: What is it like for an older learner to navigate a complex course? What knowledge will I use to navigate this course as a nurse? I realized I needed to take a philosophical approach to the daunting two weeks of modules ahead of me. The outcome of completing this course was surprising because it led me to consider whether AI would become a pattern of knowing in nursing. (What!?!) Here is what I think about this issue, and I would love to hear your thoughts.
Asynchronous learning has gained popularity, allowing almost everyone to access knowledge, which makes sense. AI for acquiring knowledge is also becoming increasingly popular. Although no guidelines specifically address AI’s authenticity, we have passed this signpost, and many have even received a “Get Out of Jail Free” card for using it without referencing it. Everyone seems mystified and intrigued by it. Is AI an authentic form of knowledge? Will we use AI as a source of knowing and understanding in nursing? I asked Duck AI these questions and learned its thoughts on the matter.
“While AI can produce authentic outputs, it does not possess authenticity in the human sense, as it lacks consciousness and personal experience. The implications of its use in various fields continue to be discussed”.
So, what is the relationship between AI and asynchronous learning? I’ve begun to believe that we, as a society, have rapidly ventured into uncharted territory. As a Nursologist, I must consider the implications of preparing nurses with certified asynchronous courses and reflect on how to approach AI to determine if they are connected. (Please stay with me as I explain further.) The quality standards for an asynchronous course have become very specific and regulated. Courses can be deemed ‘certified’ and considered high quality. Some schools of Nursing require faculty to place courses online and asynchronously. Is this the correct path to take for the future of nursing education?
By teaching courses asynchronously (wholly), do we prepare nurses to be like AI, mechanical, and machine-like? Not having that human interaction diminishes the ability of faculty to assess competency. On the flip side of this discussion, I wondered, “Can or will AI replace a nurse?”
I asked Duck AI for help. The answer:
“AI can support nurses by automating tasks, analyzing patient data, and assisting with diagnostics, but it cannot fully replace the compassionate care and critical thinking that human nurses offer. Nurses’ roles involve complex human interactions that AI cannot replicate”.
Because I have taught graduate nursing courses for Psychiatric-Mental Health Nurse Practitioners, I asked myself, “Can we teach nurses to interview patients within an asynchronous course? Can we teach nurses how to elicit their patients’ thoughts on suicide using compassion and genuineness? Can we teach nurses how to be empathetic?” All this information and skill without interacting with the student seems dangerous. Nursing schools depend on teaching these skills to a level of competency that prepares the graduate nursing student to be clinically competent and culturally sensitive. Can I achieve those skills by teaching them in asynchronous courses without face-to-face time? Of course, technology has advanced so that we can embed videos, podcasts, reading materials, and the professor’s voice online. But can we also interact with students solely through written comments, without witnessing and experiencing them as human beings in person? Can we ethically check them off as competent?
I took this idea further and wondered, “Can AI replace psychotherapy?” Duck AI answered,
“AI cannot fully replace psychotherapy because it lacks the essential human qualities needed for effective therapy, such as empathy and the ability to form deep interpersonal connections. While AI can assist mental health care, human therapists are still necessary for comprehensive support and understanding.”
My first thought is, “From whence did this information come?” I quickly surmised that if AI cannot be a ‘human nurse’, and psychotherapy cannot be replaced by AI, why would I teach students how to be a nurse through technology that does not interact in person? Asynchronous learning without human interaction cannot fully replace the personal or empirical knowing, nor any other patterns of knowing in nursing. It seems to me that it is vital for a Nursologist to consider how we teach nursing skills and whether we succumb to the requirements and pressure to teach ‘smarter’, larger in numbers, and across the globe. Some topics and areas of knowledge can be taught asynchronously and can be a part of nursing, but others cannot (in my opinion). Some topics can be taped, and the academic can observe the student’s level of competence through an online video. But this is not human interaction in real time.
As we charge ‘onward’ (in the words of Dr. Fawcett), I ask again, will AI become a pattern of knowing?
This website (Nursology.com) defines the fundamental patterns of knowing in nursing as empirical, personal, ethical, and aesthetic knowing (Carper, 1978). These patterns are meant to help nurses understand and address the diverse concerns they encounter in their practice. A fifth pattern, emancipatory knowing, has been added in recent years. In the original patterns, Carper states, “a philosophical discussion of patterns of knowing may appear to some as a somewhat idle, if not arbitrary and artificial, undertaking having little or no connection with the practical concerns and difficulties encountered in the day-to-day doing and teaching of nursing. But it represents a personal conviction that there is a need to examine the kinds of knowuting that provide the discipline with its particular perspectives and significance. Understanding four fundamental patterns of knowing makes possible an increased awareness of the complexity and diversity of nursing knowledge.” (page 21). (Link to this on the Nursology webpage.)
Again, will AI become a pattern of knowing as we place nursing courses online asynchronously? I welcome your thoughts.
Source
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. ANS. Advances in nursing science, 1, 13–23.
About Victoria Soltis-Jarrett, PhD, PMHNP-BC, FAANP, FAAN
Victoria Soltis-Jarrett has been practicing as a nurse for over 40 years (as an RN, CNS, and NP) and has taught nursing knowledge in several countries. She has been privileged to work with a diverse group of students, faculty, and other health professionals who have been active co-participants for developing knowledge for the greater good.
That’s a good point. It lacks somehow to be referred the pattern of social political knowledge by Jill White 🙂
Thank you for this thoughtful and thought-provoking essay. I have come to think that there is a difference between source of information, pathway to knowing, and pattern of knowing. I prefer to consider AI as similar to a library – a source of information. As I think about it, it could also be an aspect of a pathway to knowing. But the pattern of knowing is wholly human – it’s a whole complex of how we access, how we choose, what we choose, and why we choose, and what we make of that information in context. I don’t think it is ethical to accept at face value and apply information provided by AI without careful human consideration. So today, I would respond that AI is not a pattern of knowing, but rather a valuable aid to coming to know. Who knows, tomorrow I may have come to know differently and respond differently. Maybe that’s the human part of it – learning and growing!
Victoria, Thank you for a provocative blog. I may be a dinosaur but I do not think that AI has any place in scholarly work. I agree with you completely that AI cannot “substitute” for the human to human aspects of teaching and doing nursology practice. If AI is used for scholarly work, it is crucial that content be checked VERY carefully for accuracy and that the AI use be cited. Otherwise, it is plagiarism, including when used to check references and such.
I do not regard AI as another pattern of knowing but instead, if used, a technique to improve writing (maybe!) and routine thinking (maybe!).
Thank you, Jacqui. I am also a dinosaur, and I find the indiscriminate use of AI in the asynchronous environment very troubling, and its use unethical in any environment for the most part. I am normally an early adopter of technology, especially when it makes my work easier – ethically.
We know that the use of AI increases cognitive debt and that AI cannot or must not replace human thought. It has no human elements. It decrements learning. It is too simple, hallucinates (I once saw an AI-generated report in which my male friend had somehow suddenly developed a uterus), only generates from past events, and is wildly inaccurate. It can steal our own intellectual property. AI has its place, but certainly not in courses where we do not ever “see” our students, or where we can actually assess them. I am content to use it only in formatting references – a non-human function.
Gracias por abrir la discusión.
Coincido totalmente con Fawcett, la IA es una herramienta como un cuaderno o calculadora. Amenos que las enfermeras sean autómatas, tecnócratas y su lógica se la dé un algoritmo cibernético y no la de una heurística, puede ser un patrón de conocimiento. La enfermería se distingue justamente por no ser ni autómata ni técnica, aún cuando en America Latina se haga lo contrario.En este sentido, una mala lectura de los patrones de conocimiento puede ser reduccionista, sobre todo en el contexto de LATAM, donde la enfermería se reduce a técnicas y procedimientos
Thanks, Victoria, for this provocative entry in the blog!
I’ve been thinking a lot about the use of generative AI in Nursing and Nursing Education. I use it almost everyday to assist me in my teaching, practice and management (I am Psychiatric and Mental Health Specialist Nurse and Adjunct Professor). In my experience, and I agree with Dr. Jacqueline Fawcett, AI cannot substitute and its use need to be checked. However, a tend to see AI as an assistant and a lever to every pattern of knowing:
– Aesthetic Knowing: in discussing with Gen AI, can I find more creative ways to see beyond what’s apparent? May I use AI to create symbols to deepen my conversation with a person?
– Ethical Knowing: I may submit all the regulations and codes to chat and use AI to discuss them and help me to reflect.
– Emancipatory and Sociopolitical Knowing: in a constant changing world, AI can help me to search the world and to listen to voices often overheard.
– Empiric Knowing: AI may help researchers to find gaps and inconsistencies in what we read. Sometimes we are biased and AI could help us asking some questions. Caution is required as AI cannot be considered responsible for the information and its accuracy.
– Personal and Spiritual Knowing: maybe one would think that this pattern needs to be free from AI. I am not sure. Although AI cannot replace our consciousness and our spirit, perhaps it can help to ask some serious and deep questions. If I save time from some bureaucracies and other redundancies in my daily work with the help of AI, can I be more human to the other person?
There are a lot of challenges and I am more than happy to discuss that!
( https://www.linkedin.com/in/tcasaleiro/ and tcasaleiro@esesfm.pt )