直播预告：肠外营养安全管理

【直播预告】肠外营养安全管理（主讲人：宿桂霞，河北医科大学第四医院 ，原护理部主任），点击下方直接预约↓↓↓）

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ChatGPT is a state-of-the-art artificial intelligence (AI) chatbot developed by OpenAI, an American AI research laboratory (Taecharungroj, 2023). It is one of the most advanced chatbots currently available. ChatGPT utilises deep-learning techniques to generate natural language texts. It has been trained on a large corpus of online text data, such as books, news articles and websites (Kung et al., 2023). It generates text in response to a wide range of prompts, including questions, statements and requests for information. To use ChatGPT, users simply type in a prompt or question, and the chatbot responds based on its understanding of the language and context of the input. ChatGPT can understand context and carry on a conversation that is coherent and relevant to the topic at hand (Gilson et al., 2023). One of the key features of ChatGPT is its ability to generate human-like responses (Pavlik, 2023). Therefore, ChatGPT can be used to create writing, such as essays and stories, and to summarise literature (van Dis et al., 2023). Since the release of the ChatGPT service, the chatbot has attracted significant public attention and controversy because of its ability to generate contextually appropriate responses that mimic the tone and style of human language. In academia, scholars are concerned about the effects of ChatGPT on the writing of scientific papers (Flanagin et al., 2023; Thorp, 2023) and the chatbot's potential to be used to cheat on assignments and examinations (Flanagin et al., 2023).

ChatGPT是由美国人工智能研究实验室OpenAI开发的最先进的人工智能（AI）聊天机器人（Taecharungroj，2023）。它是目前最先进的聊天机器人之一。ChatGPT利用深度学习技术生成自然语言文本。它已经在诸如书籍、新闻文章和网站的在线文本数据的大型语料库上被训练（Kung等人，2023年）。它生成文本以响应各种提示，包括问题、声明和信息请求。要使用ChatGPT，用户只需键入提示或问题，聊天机器人就会根据对输入语言和上下文的理解做出响应。ChatGPT可以理解上下文并进行与手头的主题一致且相关的对话（Gilson等人，2023年）。ChatGPT的一个关键特性是它能够生成类似人类的响应（Pavlik，2023）。因此，ChatGPT可用于创建写作，如文章和故事，以及总结文学作品（货车Dis等人，2023年）。自ChatGPT服务发布以来，聊天机器人引起了公众的极大关注和争议，因为它能够生成模仿人类语言语气和风格的上下文适当的响应。在学术界，学者们关注ChatGPT对科学论文写作的影响（Flanagin等人，2023 ; Thorp，2023）以及聊天机器人被用于在作业和考试中作弊的潜力（Flanagin等人，2023年）。

While ChatGPT aims to provide accurate and informative responses based on existing data, the scope of the information that ChatGPT can provide is limited to what it has been trained on (Pavlik, 2023; Rudolph et al., 2023). Furthermore, it is possible that ChatGPT may provide incomplete or inaccurate information (Flanagin et al., 2023; Shen et al., 2023). This situation might create concerns because students who rely heavily on ChatGPT might develop a misunderstanding of a concept or topic, which could impair their ability to provide safe and effective care. Ultimately, the development and progression of the nursing profession could be affected.

虽然ChatGPT旨在根据现有数据提供准确和信息丰富的响应，但ChatGPT可以提供的信息范围仅限于它所接受的培训（Pavlik，2023 ;鲁道夫等人，2023年）。此外，ChatGPT可能提供不完整或不准确的信息（Flanagin等人，2023 ; Shen等人，2023年）。这种情况可能会引起担忧，因为严重依赖ChatGPT的学生可能会对概念或主题产生误解，这可能会损害他们提供安全有效护理的能力。最终，护理专业的发展和进步可能会受到影响。

The use of ChatGPT might affect nursing students' communication and interactions with educators and peers. Relying too heavily on ChatGPT in learning activities may cause students to disengage from their courses, educators and peers. Engaging with staff and peers is important for nursing students to develop interpersonal skills, which are essential for effective communication and building positive relationships with clients, caregivers and colleagues.

ChatGPT的使用可能会影响护生与教育者和同伴的沟通和互动。在学习活动中过于依赖ChatGPT可能会导致学生脱离他们的课程，教育工作者和同龄人。与工作人员和同行的参与是重要的护理学生发展人际交往能力，这是必要的有效沟通和建立与客户，照顾者和同事的积极关系。

Another major concern is the possible negative influence of ChatGPT on nursing students' assignments due to the potential for academic dishonesty (O'Connor, 2022). Students may rely on ChatGPT to generate written assignments, such as essays, and submit these assignments as their own work. This action could be considered contract cheating or plagiarism, a form of dishonesty that violates the standards of nursing professionalism. The use of ChatGPT in nurse education may exacerbate equity problems. For example, if students have access to ChatGPT and use it to generate high-quality written assignments, they may have an unfair advantage over other students who do not have access to the chatbot, leading to inequalities in learning outcomes and opportunities (Cotton et al., 2023).

另一个主要问题是ChatGPT可能对护理学生的作业产生负面影响，因为可能存在学术欺诈行为（奥康纳，2022）。学生可以依靠ChatGPT生成书面作业，如论文，并将这些作业作为自己的工作提交。这种行为可以被认为是合同欺诈或剽窃，一种不诚实的形式，违反了护理专业标准。在护士教育中使用ChatGPT可能会加剧公平问题。例如，如果学生可以访问ChatGPT并使用它生成高质量的书面作业，那么他们可能会比其他没有访问聊天机器人的学生拥有不公平的优势，从而导致学习成果和机会的不平等（Cotton等人2023年）。

To deal with contract cheating involving ChatGPT, nurse educators play an important role in teaching their students about the importance of academic honesty, the value of critical thinking and the consequences of contract cheating (O'Connor, 2022). Nurse educators need to help students understand why contract cheating is wrong and how it undermines the integrity of the nursing profession. In addition, nurse educators should work with students to develop their writing and problem-solving skills. By providing guidance and feedback on assignments, nurse educators can help students build their competency and confidence in their ability to complete assignments independently. This will reduce the likelihood that students will feel the need to engage in contract cheating to complete their assignments.

Nurse educators should make good use of their academic judgement and experience to carefully review student work to detect instances of contract cheating. By being familiar with their students' writing styles, language use and patterns of thought, nurse educators can spot instances of work that seem out of character or inconsistent with students' previous work. If a particular work is significantly different in style or quality from a student's previous work, nurse educators can investigate further to determine whether contract cheating has occurred. However, AI-generated assignments can produce human-like responses, making it challenging to differentiate them from assignments produced by students. The volume of assignments that nurse educators need to grade can be overwhelming, making it difficult for them to thoroughly examine each assignment for signs of AI-generated content. This is particularly challenging in large classes or in institutions with limited resources. As AI technology continues to evolve, there is a need to develop more sophisticated software programmes to detect AI-generated written assignments.

护理教育工作者应充分利用自己的学术判断和经验，仔细审查学生的工作，以发现合同作弊的情况。通过熟悉学生的写作风格、语言使用和思维模式，护士教育工作者可以发现与学生以前的工作不符或不一致的工作实例。如果一个特定的工作是显着不同的风格或质量从学生以前的工作，护士教育工作者可以进一步调查，以确定是否发生了合同作弊。然而，人工智能生成的作业可以产生类似人类的反应，这使得将它们与学生生成的作业区分开来具有挑战性。护士教育工作者需要评分的作业量可能是压倒性的，这使得他们很难彻底检查每个作业是否有人工智能生成内容的迹象。这在大班或资源有限的机构中尤其具有挑战性。随着人工智能技术的不断发展，需要开发更复杂的软件程序来检测人工智能生成的书面作业。

Although ChatGPT might have potential negative impacts on nurse education, the opportunities it provides for this field should not be dismissed. When nursing students use ChatGPT critically and responsibly, it might enhance their learning process. ChatGPT can provide access to a large amount of information on nursing-related topics. Nursing students can interact with the chatbot to obtain self-directed answers to their questions and learn more about various nursing topics and concepts in an effective manner (Gilson et al., 2023; Nisar and Aslam, 2023). This can be particularly valuable in fields such as nursing, where students are required to quickly learn a large amount of complex information. ChatGPT offers greater accessibility to different learning materials and resources, as it can be accessed from any electronic device with an internet connection. ChatGPT enables students to access learning materials on their own terms and at their own pace, leading to a better learning experience.

虽然ChatGPT可能对护士教育产生潜在的负面影响，但它为这一领域提供的机会不应被忽视。当护理专业的学生批判性和负责任地使用ChatGPT时，它可能会增强他们的学习过程。ChatGPT可以提供对护理相关主题的大量信息的访问。护理学生可以与聊天机器人进行交互，以获得对其问题的自我指导答案，并以有效的方式了解更多关于各种护理主题和概念的信息（Gilson等人，2023 ; Nisar和Aslam，2023）。这在护理等领域特别有价值，因为学生需要快速学习大量复杂的信息。ChatGPT为不同的学习材料和资源提供了更大的可访问性，因为它可以从任何具有互联网连接的电子设备访问。ChatGPT使学生能够按照自己的条件和自己的节奏访问学习材料，从而获得更好的学习体验。

The use of ChatGPT has the potential to facilitate continuing nurse education. Given that ChatGPT can provide a large amount of information quickly (Pavlik, 2023), nurses can use the chatbot to engage in continuous education and training, which is essential for keeping up with the rapidly evolving field of healthcare and nursing. Nurses can access up-to-date information about new nursing interventions and technologies as well as emerging trends in nursing practice. ChatGPT can be integrated into various applications and websites to provide quick and accurate responses to students' queries and requests. This can help improve students' satisfaction by reducing wait times and providing immediate assistance. The model can also reduce the amount of time nurse educators need to spend answering the same questions repeatedly.

ChatGPT的使用有可能促进护士继续教育。鉴于ChatGPT可以快速提供大量信息（Pavlik，2023），护士可以使用聊天机器人进行持续教育和培训，这对于跟上快速发展的医疗保健和护理领域至关重要。护士可以访问有关新的护理干预措施和技术以及护理实践中的新兴趋势的最新信息。ChatGPT可以集成到各种应用程序和网站中，为学生的查询和请求提供快速准确的响应。这可以通过减少等待时间和提供即时帮助来帮助提高学生的满意度。该模型还可以减少护士教育者需要重复回答相同问题的时间。

It is not realistic or feasible to ban students' use of ChatGPT in a technology-savvy era. Nurse educators should instead view ChatGPT and other AI chatbots as tools to supplement traditional teaching approaches. Nurse educators should first equip themselves with good knowledge about ChatGPT and its potential applications in nurse education. They should be provided with training sessions that cover the basics of ChatGPT, its capabilities, its strengths and limitations, how it can improve teaching effectiveness and its potential issues, such as plagiarism and contract cheating. The training should cover strategies for detecting and preventing plagiarism and contract cheating involving ChatGPT. A platform should be established to foster collaboration among nurse educators to share their experiences and best practices in addressing the use of ChatGPT in nurse education. This can include regular meetings or workshops to discuss emerging issues and brainstorm solutions (Mhlanga, 2023).

在一个技术盛行的时代，禁止学生使用ChatGPT并不现实，也不可行。护士教育工作者应该将ChatGPT和其他AI聊天机器人视为补充传统教学方法的工具。护士教育工作者应首先对ChatGPT及其在护士教育中的潜在应用有良好的了解。他们应该提供培训课程，涵盖ChatGPT的基础知识，它的功能，它的优势和局限性，它如何提高教学效率及其潜在的问题，如剽窃和合同作弊。培训应涵盖检测和防止涉及ChatGPT的剽窃和合同欺诈的策略。应建立一个平台，以促进护士教育者之间的合作，分享他们的经验和最佳做法，解决在护士教育中使用ChatGPT。这可以包括定期会议或研讨会，以讨论新出现的问题和集思广益的解决方案（Mhlanga，2023）。

Nurse educators should teach students when it is appropriate to use ChatGPT, how to critically appraise the contents generated by it and how to avoid over-reliance on it (Mhlanga, 2023). Nurse educators should help students develop critical and independent thinking skills to evaluate the validity, appropriateness and relevance of the information provided by ChatGPT. For example, they can teach students to consider potential biases and cross-validate information using reputable sources. Nursing students should be encouraged to use multiple sources of information, such as textbooks, academic journals and clinical protocols and guidelines, in addition to ChatGPT as human-driven verification processes are indispensable (van Dis et al., 2023).

护士教育工作者应该教学生什么时候适合使用ChatGPT，如何批判性地评估它产生的内容，以及如何避免过度依赖它（Mhlanga，2023）。护士教育工作者应帮助学生培养批判性和独立思考能力，以评估ChatGPT提供的信息的有效性，适当性和相关性。例如，他们可以教学生考虑潜在的偏见和交叉验证信息使用信誉良好的来源。应鼓励护理专业学生使用多种信息来源，如教科书、学术期刊和临床方案和指南，除ChatGPT外，因为人为驱动的验证过程是不可或缺的（货车Dis et al. 2023年）。

Nurse educators should explain the limitations of ChatGPT to students. For example, the chatbot cannot provide clinical judgements or consider a client's individual factors. The responses generated by ChatGPT may not be appropriate or relevant to the specific context of a student's enquiry. Students should be taught to consider the context of their questions and to evaluate whether the responses generated by ChatGPT are relevant and appropriate. Importantly, the chatbot cannot replace a human's clinical reasoning or humanistic care and compassion.

护士教育工作者应该向学生解释ChatGPT的局限性。例如，聊天机器人无法提供临床判断或考虑客户的个人因素。ChatGPT生成的回复可能不适合或与学生查询的特定上下文不相关。应该教学生考虑他们的问题的背景，并评估ChatGPT生成的答案是否相关和适当。重要的是，聊天机器人不能取代人类的临床推理或人文关怀和同情心。

To avoid nursing students' over-reliance on ChatGPT and encourage them to acquire their own critical thinking skills, independent thought and clinical reasoning skills, nurse educators can design assignments that teach students to think critically, creatively and independently. For instance, case studies that require students to develop comprehensive nursing care plans for people with complex health issues can be considered. Care plans should be based on up-to-date research evidence, textbooks and clinical guidelines.

为了避免护理学生过度依赖ChatGPT，并鼓励他们获得自己的批判性思维技能，独立思考和临床推理技能，护士教育工作者可以设计作业，教学生批判性，创造性和独立思考。例如，可以考虑要求学生为有复杂健康问题的人制定全面护理计划的案例研究。护理计划应基于最新的研究证据、教科书和临床指南。

Nurse educators might make good use of ChatGPT to foster students' critical thinking. For example, students could be asked to develop a clinical protocol or care plan based on information provided by ChatGPT. At the same time, students need to use reputable sources, such as peer-reviewed research articles and existing clinical guidelines, to cross-validate or challenge the content generated by ChatGPT. The students should further discuss the validity, appropriateness and relevance of the contents and how they will translate the clinical protocol or care plan generated by ChatGPT into their clinical practice.

护理教育工作者可以很好地利用ChatGPT培养学生的批判性思维。例如，可以要求学生根据ChatGPT提供的信息制定临床协议或护理计划。同时，学生需要使用有信誉的来源，例如同行评审的研究文章和现有的临床指南，来交叉验证或挑战ChatGPT生成的内容。学生应进一步讨论内容的有效性，适当性和相关性，以及如何将ChatGPT生成的临床协议或护理计划转化为临床实践。

Reflective practice-based essays can help reduce reliance on ChatGPT in nurse education. Rather than asking students to write an essay on a specific topic, reflective writing encourages nursing students to critically analyse their own experiences and consider ways in which they can improve their future practice. By reflecting on their own experiences, nursing students can develop a deeper understanding of the clinical context and their knowledge and gain insights that may not be available through the ChatGPT system.

反思性的实践论文可以帮助减少护士教育中对ChatGPT的依赖。而不是要求学生写一篇关于特定主题的文章，反思性写作鼓励护理专业的学生批判性地分析自己的经验，并考虑如何提高他们未来的实践。通过反思自己的经验，护生可以更深入地了解临床背景和他们的知识，并获得通过ChatGPT系统可能无法获得的见解。

Supplementing written assignments with oral presentations can also reduce reliance on ChatGPT. Oral presentations require students to communicate their ideas in a clear and concise manner. By presenting their ideas to their peers and teachers, students can receive feedback and engage in discussion to further develop their understanding of a specific topic. In addition to written assignments, nurse educators can incorporate a variety of interactive and experiential learning activities into the nursing curriculum to actively engage students, help them develop their critical thinking skills, and avoid over-reliance on ChatGPT. Simulations can create realistic scenarios in which students can apply their clinical reasoning skills and decision-making abilities in a safe and controlled environment. Group discussions and classroom debates can encourage students to share their own perspectives and engage in collaborative learning. Discussions and debates can help students develop their critical thinking skills by challenging other classmates and analyzing and evaluating different viewpoints.

用口头报告补充书面作业也可以减少对ChatGPT的依赖。口头报告要求学生以清晰简洁的方式表达自己的观点。通过向同学和老师展示他们的想法，学生可以获得反馈并参与讨论，以进一步发展他们对特定主题的理解。除了书面作业外，护士教育工作者还可以将各种互动和体验式学习活动纳入护理课程，以积极吸引学生，帮助他们培养批判性思维能力，并避免过度依赖ChatGPT。模拟可以创建逼真的场景，学生可以在安全和受控的环境中应用他们的临床推理技能和决策能力。小组讨论和课堂辩论可以鼓励学生分享自己的观点并参与协作学习。讨论和辩论可以帮助学生通过挑战其他同学，分析和评估不同的观点来培养他们的批判性思维能力。

Students should be taught how to use ChatGPT appropriately to enhance their discussions and debates. For example, ChatGPT can be used to provide additional information and perspectives related to the topics being discussed. This can enrich the associated discussion and debate by contributing different viewpoints and sources of information that may not have been considered by the students.

应该教学生如何适当地使用ChatGPT来加强他们的讨论和辩论。例如，ChatGPT可用于提供与正在讨论的主题相关的其他信息和观点。这可以通过贡献学生可能没有考虑的不同观点和信息来源来丰富相关的讨论和辩论。

With the consent of students, nurse educators can review the ChatGPT conversation logs provided by the students. By reviewing the conversation logs, nurse educators might be able to identify common misconceptions or knowledge gaps that students have about a topic. This information can be used to improve teaching materials and strategies. However, nurse educators should not pressure students to disclose their conversation logs with ChatGPT. Nurse educators should respect the privacy and autonomy of students. While it can be useful for nurse educators to review the conversation logs to understand their learning process and identify areas where they may need more guidance, it is ultimately the student's decision to share their conversation logs.

经学生同意，护士教育者可以查看学生提供的ChatGPT对话日志。通过审查对话日志，护士教育工作者可能能够确定常见的误解或知识差距，学生对一个主题。这些信息可用于改进教学材料和策略。然而，护士教育工作者不应该向学生施加压力，要求他们披露与ChatGPT的对话日志。护士教育者应尊重学生的隐私和自主权。虽然护士教育工作者查看对话日志以了解他们的学习过程并确定他们可能需要更多指导的领域可能是有用的，但最终由学生决定是否共享他们的对话日志。

While there is certainly potential for ChatGPT to enhance the teaching and learning experience, there are also concerns about its impact on students' critical thinking and clinical reasoning skills. To understand the impacts of ChatGPT on nurse education, more empirical research is needed to investigate: (i) the impact of ChatGPT on student learning outcomes, such as critical thinking, clinical reasoning and knowledge acquisition; (ii) the role of ChatGPT in nurse educators' teaching and how it affects their workload, teaching practices and student engagement; and (iii) the ethical considerations and implications of using ChatGPT in nurse education.

虽然ChatGPT肯定有潜力增强教学和学习体验，但也有人担心它对学生的批判性思维和临床推理能力的影响。为了了解ChatGPT对护士教育的影响，需要进行更多的实证研究来调查：（i）ChatGPT对学生学习成果的影响，例如批判性思维、临床推理和知识获取;（ii）ChatGPT在护士教育工作者教学中的作用，以及它如何影响他们的工作量、教学实践和学生参与度;和（iii）在护士教育中使用ChatGPT的伦理考虑和影响。

The use of ChatGPT and other related AI technology in nurse education is expected to continue to grow as technology advances and students and educators will become more comfortable with its use. However, it is important to note that while AI technology can enhance teaching and learning, it should not replace human interaction and support. Nurse educators and students should be mindful of the limitations of AI technology and ensure that it is used in conjunction with other teaching methods to provide holistic nurse education.

随着技术的进步，ChatGPT和其他相关人工智能技术在护士教育中的使用预计将继续增长，学生和教育工作者将对其使用更加舒适。然而，重要的是要注意，虽然人工智能技术可以增强教学和学习，但它不应该取代人类的互动和支持。护士教育工作者和学生应注意人工智能技术的局限性，并确保将其与其他教学方法结合使用，以提供整体护士教育。

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