Nursing students' experiences with AI-powered conversational and generative tools: A qualitative systematic review

BACKGROUND: AI-powered conversational and generative tools, such as ChatGPT and AI-supported simulations, are increasingly used in nursing education. AIM: To synthesize qualitative evidence on how undergraduate nursing students experience AI-powered conversational and generative tools in nursing education. METHODS: We conducted a qualitative systematic review using the Joanna Briggs Institute meta-aggregation approach. Seven databases were searched from 2020 to January 2026. Twenty-seven studies met the inclusion criteria. Findings were extracted, appraised using the JBI qualitative checklist, and synthesized into categories and overarching synthesized findings. RESULTS: Across 27 studies, 181 qualitative findings were aggregated into four synthesized findings. Students reported that AI enhanced conceptual understanding, clinical reasoning, and learning efficiency. AI tools also influenced emotional experiences, often increasing confidence and engagement, while sometimes causing frustration. Students reported both risks of dependency and the development of verification and self-regulation skills. Ethical concerns, particularly regarding academic integrity and the limits of AI in human-centered nursing care, were consistently emphasized. CONCLUSION: AI-powered tools are perceived by nursing students as valuable learning supports when integrated thoughtfully. However, clear guidance, AI literacy development, and strong emphasis on professional and ethical standards are essential. AI should complement, not replace, human-centered nursing education.