The effect of chatbot-supported instruction on nursing students' history-taking questioning skills and stress level: A randomized controlled study

Background: Comprehensive history-taking is crucial for patient assessment, prioritisation of care, and planning of care. While direct instruction methods effectively explain history-taking processes and components, they provide insufficient opportunities for practice, necessitating the implementation of supplementary teaching strategies. Objective: This study aimed to examine the effects of AI chatbot-supported history-taking training on nursing students' questioning skills and clinical stress levels. Methods: This randomized controlled study with pretest-posttest was conducted with 82 “first-year” nursing students. The students were randomly assigned to either an intervention (n = 41) or a control (n = 41) group. The intervention group underwent history-taking using the traditional teaching method (theoretical training, watching a video, and clinical practice) plus an artificial intelligence (AI) chatbot; the students in the control group were trained only with the traditional method. Results: The intervention group demonstrated significantly superior performance in two specific components: history of present illness and review of systems (p < 0.05). Clinical stress levels showed mixed results, with significant differences in Challenge and Benefit subscales but no difference in overall stress scores between groups. Conclusion: Chatbot-based history-taking instruction is efficacious in improving students' history-taking questioning skills in specific components of history-taking, but not in clinical stress.