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Nursing students taught with AI-enhanced lessons scored higher in a four-trial review

Study title: Effects of an AI-enhanced BOPPPS teaching model in nursing courses: a meta-analysis of randomized controlled trials

Evidence type
Systematic review or meta-analysis
Sample
n = 459
Sources
1 sourcePeer-reviewed
Published
2 min read
Truvace record
TRV-2026-2815cite or check it

Study title: Effects of an AI-enhanced BOPPPS teaching model in nursing courses: a meta-analysis of randomized controlled trials

A systematic review and meta-analysis pooled four randomized controlled trials of 459 nursing students in China-linked courses. It compared BOPPPS, a six-phase lesson structure, enhanced with AI against traditional teaching or BOPPPS alone. Academic performance improved in the AI group (SMD 1.06, 95% CI 0.63–1.48).

Read the study abstract

Aim To evaluate the effectiveness of an artificial intelligence (AI)–enhanced BOPPPS teaching model in nursing courses, with a focus on academic performance, self-directed learning ability, and teaching satisfaction. Design Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in accordance with PRISMA and registered in INPLASY (INPLASY202590123). Methods Chinese- and English-language databases were searched for eligible RCTs comparing AI-enhanced BOPPPS with traditional teaching (…

The gain

A meta-analysis of four randomized trials with 459 nursing students found AI-enhanced BOPPPS teaching raised academic performance (SMD 1.06) and tripled the odds of an 'excellent' self-directed learning rating (RR 3.28) versus traditional teaching.

In brief

Students in the AI-enhanced groups were more likely to be rated 'excellent' in self-directed learning (RR 3.28) and 'very satisfied' with teaching (RR 1.80, 95% CI 1.27–2.55). The authors say this suggests value lies in learning processes and student experience rather than test scores alone.

The evidence base is small. Heterogeneity in the academic performance result was substantial (I² = 72.8%), and the AI tools varied from ChatGPT-assisted teaching to a 5G smart classroom, so the pooled effect cannot be tied to one kind of AI.

Main points

  1. The review searched PubMed, Web of Science, Embase, the Cochrane Library, CNKI, WanFang and VIP through October 14, 2025, and was registered with INPLASY.
  2. Four RCTs were included, with 219 students in intervention groups and 212 in control groups taught by conventional teacher-centered lecturing.
  3. Three studies reported academic performance, with a pooled SMD of 1.06 and heterogeneity of 72.8%.
  4. Three studies reported self-directed learning; the share rated 'excellent' was 3.28 times higher with AI, with no heterogeneity (I² = 0.0%).
  5. Three studies reported satisfaction; 'very satisfied' ratings were 1.80 times as likely, with I² of 37.4%.
  6. Two trials did not adequately report or implement blinding of participants and personnel, and most did not describe allocation concealment.

What the review found when it combined the studies

These are the review’s own pooled results, copied from its abstract. Truvace did not recalculate them.

  • Proportion of nursing students rated excellent in self-directed learning with AI-enhanced BOPPPS versus control

    Risk ratio 3.28 (95% CI 2.14 to 5.02)

    459 people · search to October 14, 2025

    The review’s own words
    The meta-analysis showed that the proportion of students rated as “excellent” in self-directed learning ability was significantly higher in the intervention group than in the control group (RR = 3.28, 95% CI: 2.14–5.02; p < 0.001), indicating that the AI-enhanced BOPPPS model substantially improved students’ self-directed learning ability.

  • Nursing students' academic performance with AI-enhanced BOPPPS teaching compared with traditional teaching

    SMD 1.06 (95% CI 0.63 to 1.48)

    459 people · search to October 14, 2025

    The review’s own words
    The meta-analysis showed a statistically significant improvement in academic performance in the AI-enhanced BOPPPS group compared with the control group (SMD = 1.06, 95% CI: 0.63–1.48; p = 0.025).

  • Proportion of nursing students very satisfied with teaching, AI-enhanced BOPPPS versus control

    Risk ratio 1.80 (95% CI 1.27 to 2.55)

    459 people · search to October 14, 2025

    The review’s own words
    The meta-analysis showed that the AI-enhanced BOPPPS model significantly increased teaching satisfaction compared with the control condition (RR = 1.80, 95% CI: 1.27–2.55; p < 0.001), indicating a substantial improvement.

Code checks every number above against the review’s text before it is shown. The short labels are an AI model’s reading of that text, so the review’s own sentence sits under each one. A pooled figure is only as strong as the studies behind it. How Truvace uses pooled results

The full story

The included trials covered different AI approaches. One used an AI-enhanced BOPPPS model, another a BOPPPS-based 5G smart classroom, and two used ChatGPT-assisted BOPPPS. Courses included neurosurgery, thoracic nursing and pathophysiology, and outcomes ranged from theory scores to internship performance.

Risk-of-bias review rated the trials as low risk overall, with complete outcome data and no selective reporting. Randomization procedures were often unclear, and blinding of participants was a problem in two trials, which the authors say may have introduced observer bias.

The authors attribute the variable academic results to differences in AI implementation, course type, assessment format and student baselines. They call for standardized AI components, multicenter trials and long-term follow-up on clinical competence.

Sources

1 on file
  1. Frontiers in Medicinedoi:10.3389/fmed.2026.1767911
    Peer-reviewed2026-02-18

Talk it over

Four questions to start onWho gets this benefit, and who was left out of the study or story?

Start with a question

Nursing students taught with AI-enhanced lessons scored higher in a four-trial reviewhttps://truvace.com/item/effects-of-an-ai-enhanced-boppps-teaching-model-in-nursing-courses-a-meta-analys

  1. Who gets this benefit, and who was left out of the study or story?

    The gain A meta-analysis of four randomized trials with 459 nursing students found AI-enhanced BOPPPS teaching raised academic performance (SMD 1.06) and tripled the odds of an 'excellent' self-directed learning rating (RR 3.28) versus traditional teaching.

    Answer in the thread

  2. How do we know? What can this kind of evidence show, and what can’t it?

    The evidence This rests on a systematic review or meta-analysis with a sample of 459, from Frontiers in Medicine.

    Answer in the thread

  3. What does it leave open? What else would you want to know before acting on it?

    The record’s own caveat The review included only four mostly single-center trials with short-term interventions and no standardized way of integrating AI, and blinding was inadequate in some trials.

    Answer in the thread

  4. Have you seen AI used this way where you study, work or live? Did it go the same way?

    Answer in the thread

The questions are the same on every record. The details under them are taken from this record as written.

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