GenAI for Assessment Preparation in Nursing
Institution: Dublin City University
Discipline: Nursing
Author: Amanda Drury
GenAI tool(s) used: ChatGPT and APO AI (discontinued)
Situation / Context
Subject Discipline: Nursing, Year 3, 140 students. Module: General Nursing 3A.
General Nursing 3A aims to enable students to develop a critical understanding of nursing assessment skills, and nursing management of physical and psychological problems in the context of acute and chronic health conditions.
The module assessment is summative, consisting of a written case study to describe the nursing assessment and care of a deteriorating patient in a hospital setting; examples of appropriate case studies included shock (e.g. septic, hypovolaemic, cardiogenic or anaphylactic shock), respiratory distress (e.g. due to exacerbation of a chronic breathing/lung condition), or a person living with a physical complication of cancer (e.g. pain, sepsis, dehydration).
The case study was to be based on a case the student had encountered in clinical practice. In year 3 of the programme, students will have completed 40 weeks of placement, with 26 weeks completed in the Summer, Autumn and Spring semesters preceding the delivery of this module.
Task / Goal
The first running of this Generative AI (GenAI) initiative took place in Spring 2023, following the public release of ChatGPT. The primary purpose of this initiative was to engage students in a critical exploration of academic integrity in the context of artificial intelligence.
The primary goal was to familiarise students with the practical and ethical considerations of artificial intelligence in academic writing. Additionally, this activity marked the beginning of a module redesign aligned with the principles of Universal Design for Learning (UDL).
UDL is an educational framework that promotes inclusivity by offering multiple ways for students to engage with content, process information, and demonstrate learning. It emphasizes three core principles: Multiple Means of Engagement, which seeks to capture and sustain students’ interest; Multiple Means of Representation, which ensures content is accessible through varied formats; and Multiple Means of Action and Expression, which offers students diverse ways to communicate their understanding.
In this case study, I examine how specific UDL principles guided the design and delivery of an AI-based learning activity that engaged students in evaluating a GenAI essay against the module assessment rubric. Through the targeted use of UDL principles, I aimed to foster critical thinking, support diverse learning preferences, and enhance students’ familiarity with academic standards. Specifically, I focused on engagement by leveraging students’ curiosity about AI and academic integrity, on representation by presenting content through various forms (AI essays, written, verbal and visual feedback), and on expression and action by allowing students to critique, discuss, and collaboratively revise the GenAI essays.
Actions / Implementation
Two GenAI chatbots, ChatGPT and APO AI (APO AI has now been discontinued) were prompted to write four essays related to the assignment brief using a single, low-level prompt in each tool:
- Prompt 1, Essay 1: “Tell me about ABCDE patient assessment.”
- Prompt 2, Essay 2: “Present a case study of an ABCDE patient assessment for someone with respiratory distress.”
Prior to class, students were given preparatory tasks to engage their interest and scaffold understanding:
- Revisit the Assignment Brief and give particular attention to the Assignment Rubric.
- Review each of the four GenAI essays, with awareness of the assignment brief.
- Share their evaluations of the four essays in three Mentimeter polls.
- In three words, what are your first impressions of the four essays.
- Please comment on 1-2 aspects of this draft essay that have been done particularly well.
- Please identify 1-2 aspects of this draft essay that the author could change to greatly improve their work.
Students examined the essays for content and structure, allowing them to connect the material to their own learning goals and to academic standards. This step engaged students by fostering curiosity about the role of GenAI in academic integrity and by highlighting the practical relevance of the assignment.
Prior to class, the feedback submitted by students in Mentimeter polls was uploaded to the online learning platform for students to review prior to class. During class, the poll results were presented and used to prompt initial discussion before proceeding to the in-class activities.
The use of the Mentimeter results as discussion prompts encouraged students to think critically about quality, clarity, and depth in the GenAI essays. An interrogation of the less common responses prompted students within the class to provide more detailed examples within the essays which could benefit from improvement. Members of the class highlighted examples where concepts were poorly explained or confusing, where information provided lacked sufficient detail, the lack of referencing and citation, and examples of spelling and grammatical inaccuracies.
Finally, students were asked to discuss how the essays could be improved based on a final Mentimeter poll. The discussions following each poll allowed students to expand on their points collaboratively, encouraging deeper engagement.
By addressing the essays’ strengths and weaknesses, this exercise supported students to articulate their observations and to identify specific improvements for the GenAI essays via written and verbal means.
The next stage of the in-class activity focused on students’ critical evaluation skills. Working in pairs, students were invited to evaluate one of the GenAI essays (Appendix 1), in relation to each point of the assignment feedback rubric. By assessing each rubric criterion, students practised structured critical thinking and reinforced their understanding of academic expectations, actively applying their knowledge and articulating their judgments and reasoning.
The class responses to the assignment rubric evaluation were discussed one by one and compared with the lecturer’s evaluation of the essay. During the discussion, an action plan was co-designed, to support editing and revision of the essay during class (Table 1).
|
Rubric Item |
Issues Identified |
|
1. Title & Introduction |
Title needs to reflect what the assignment is about |
|
2. Assessment & management of the case |
ABCDE has not been applied to a case. Limited information is provided about the ABCDE assessment and how specific issues are assessed (e.g. breath sounds, what might you be listening for?). No priorities for care evident. |
|
3. Conclusion |
There are no efforts to summarise key information from the assignment or case. There has been no effort to critically reflect on the care provided (e.g. what could have been done better/differently to achieve an earlier intervention or better outcome for this patient?) |
|
4. Referencing |
None of the module recommended reading is referenced. None of the references listed exist. There are no citations in the assignment. |
|
5. Presentation, grammar, punctuation, and spelling |
Formatting of the assignment is not acceptable. There are efforts to use paragraph structures, and there is a logical flow to the assignment, but it is not sufficiently detailed. There are some spelling errors. |
Table 1 Action Plan to Revise APO AI Essay 1
During the process of revising the essay, students prompted the lecturer on points to correct and strengthen the essay, focusing on presentation, formatting, spelling; titles, subsection headings; citation, checking references and verifying references; application of knowledge – differentiating between personal experience and scholarly evidence; writing concisely and critically, and introducing, concluding, and summarising the essay. This collaborative revision aligned with Multiple Means of Representation, Action, and Expression, as students were actively involved in translating feedback into specific revisions.
Outcomes
While no formal evaluation was conducted, comparing the responses of the pre-class Mentimeter polls with the discussion and outcomes of in-class activities provided insights into the effectiveness of this initiative.
During discussions of Mentimeter poll results, students’ reflections on the GenAI essays provided qualitative data that highlighted both strengths and areas for growth in their understanding of academic writing. The iterative dialogue around rubric-based assessment revealed an improvement in students’ critical analysis skills, as they moved from general impressions (“informative,” “structured”) to critique of the depth, clarity, and citation practices within the essay. This process, grounded in UDL principles, fostered a learning environment where students felt encouraged to actively participate, question, and refine academic writing.
There were three key outcomes of this activity, highlighting the impact of integrating UDL principles in fostering engagement, critical thinking, and self-assessment:
- Students’ enhanced understanding of self-assessment and assessor-based assessment: Students gained hands-on experience in applying the module assessment criteria to a worked example, generated via an AI chatbot. Through the discussion and subsequent in-class activities, students deepened their understanding of assessment processes. The Mentimeter polls and discussions provided an informal means to gauge students’ evolving understanding as they critically analysed the strengths and weaknesses of the essay, making them more aware of the standards expected in their own assignment submissions. Observations during these discussions suggest that students became more comfortable with assessment, developing a stronger sense of how to evaluate their work in line with academic expectations.
- Creation of an action plan for essay revision: Providing feedback on rubric items to improve the essay gave students a practical framework which students could adapt to support self-assessment and revision of their essays. The collaborative nature of this task, coupled with instructor feedback, provided a structured approach to refining the GenAI essay, leading to the co-designed action plan to revise the GenAI essay.
- Development of a module-specific phrase bank: As students discussed the structuring of academic writing, including assignment purpose, rationale, and case study summaries, a list of phrases were developed by the lecturer to support students in articulating key sections of their work. This module-specific phrase bank became a shared resource, supporting students in clearly expressing their ideas and aligning their language with academic standards. The phrase bank may also serve as a scaffold for future assignments, promoting consistency and confidence in writing.
Reflections
This initiative underscores the potential and limitations of GenAI in undergraduate academic writing for assessment. The pre-class activities highlighted common misconceptions among students about the reliability of GenAI. Information derived from the Mentimeter polls provided important information to modify in-class activities, prompting more in-depth discussion regarding shortcomings in GenAI for academic writing, and risks to academic integrity.
Through the in-class activities to assess and revise the GenAI essay, students began to recognise that while GenAI could be a useful tool to begin outlining a written assignment, the information generated would not be suitable for final submission and required students to apply their understanding and theoretical knowledge of concepts to enhance the quality of the essay and ensure it meets the standards of assessment. The development of the action plan and phase bank serve as useful tools which students can adapt for use within this and other modules to enhance skillsets related to critical thinking, proofreading, and revision.
In future iterations of this module, I plan to integrate GenAI tools further in teaching through two key activities:
- Students will disclose and critically assess their use of GenAI in assignments: The assessment will require students to generate the essay initially in a GenAI chatbot, and will be asked to submit the version generated, alongside the prompts used to prepare the initial essay. In the final assignment, students will be asked to include a brief critical commentary of the essay produced by the chatbot and provide an outline of the specific revisions made to the essay, including the readings, evidence and information which informed the revisions.
- GenAI case studies for in-class use: During classes, case studies are critical to support students’ application of theoretical knowledge to practical cases. I will begin to integrate GenAI case studies for use during class. Students will be asked to prompt the chatbot on the assessment and management of a GenAI case study; the chatbot will tell the students the outcomes of their actions, and students will be facilitated in class to discuss and critique the outcomes of case management within the chatbot.
By integrating UDL principles, this initiative cultivated a flexible, inclusive learning environment that bolstered students’ capacity for self-assessment, critical engagement, and academic confidence.
The activity’s outcomes indicate that students were more prepared to approach assignments with an evaluative mindset, equipped with a practical toolkit to enhance their work and align it with academic standards. For others who might consider adapting this activity within teaching and learning, careful scaffolding of the process, including structured mechanisms for student feedback before, during and after the activity is essential to ensuring the success of the activity, and allowing real-time alterations in the lesson plan to clarify and address the issues raised by students during the activity.
Polls are available on request from author.
Digital Resources:
Author Biography
Dr Amanda Drury is an Associate Professor in General Nursing in the School of Nursing, Psychotherapy and Community Health, Dublin City University, Ireland. She holds a PhD, MSc in Cancer Care and Postgraduate Diploma in Education from Trinity College Dublin. Her research and teaching interests focuses on the health and well-being of people affected by cancer and chronic diseases. She has expertise in the development and evaluation of education programmes, most recently as the principal investigator of the Advanced Breast Cancer for Nurses (ABC4Nurses) programme.
