Agentic education · Learning science

Actionable companion · Self-regulation & metacognition

Learning with agency: Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination

AI-assisted editorial implementation guide, separate from the original research. Proposed actions are not claims or recommendations attributed to the source authors. No independent peer review of this guide is asserted.

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Evidence and context

Title and abstract screening; stage labels describe reported settings, not verified numerical ages. Design labels require full-text appraisal. Reported stage(s): Higher education. Health-professions learning must be distinguished from K–12 instruction.

Original authors’ abstract, reproduced under the linked source license:

There is a growing demand for comprehensive evaluations of the clinical learning quality of nursing education and the necessity to establish robust predictors and mediators for enhancing its outcomes within the context of mental health practice. This study is threefold: 1. Evaluating nursing students’ clinical learning quality before and after mental health nursing practice; 2. Establish if the grade of a theoretical course in mental health nursing and the student’s perception of their theoretical knowledge level predicts the grade of mental health nursing practice; 3. Explore how model learning opportunities, self-directed learning, safety, and nursing care quality mediate learning environment quality and tutorial strategies quality following mental health nursing practice. Using a before and after the study, 107 undergraduate nursing students at an Israeli university completed a questionnaire and the Clinical Learning Quality Evaluation Index tool to assess their perceptions of clinical learning quality before and after mental health nursing practice. The results showed a decline in students’ perceptions of tutorial strategy quality following mental health practical learning in clinical settings, with the theoretical course grade predicting the practical experience grade and underscoring the mediating role of learning opportunities between the learning environment and tutorial strategies. The study’s findings emphasize the importance of an adaptive learning environment and a solid theoretical foundation in fostering effective tutorial strategies and enhancing the overall learning outcomes for nursing students in mental health education.

What kind of evidence is this?

Intelligent tutoring & adaptive learning · Evidence synthesis

Stage: Higher education. Screening labels describe reported context and study-design language. They are not a risk-of-bias rating or proof of effectiveness for an age band.

Study methods · source passage

The study was conducted at an Israeli academic institution with a sample of 107 undergraduate nursing students. Inclusion criteria: Participants had to have successfully completed their theoretical clinical course, which is typically taken in a classroom setting at the end of the third year. Exclusion criteria: Participants who have not successfully completed the theoretical clinical course usually take it in a classroom setting at the end of the third year. The participants were selected through convenience sampling. A questionnaire was administered before and after the mental health practical learning unit. The pre-measurement reflects students’ perceptions before starting the mental health practice, while the post-measurement assesses their perceptions upon completing the practice. Consequently, comparing pre- and post-measurements offers valuable insights into the influence of students’ perceptions of tutorial strategy quality and other elements of clinical learning.

Limitations and uncertainty · source passage

The study has several limitations: Its reliance on a relatively small sample of undergraduate nursing students from a single Israeli institution may limit the generalizability of the findings to a broader population. Future research should include a larger, more diverse participant sample to ensure the representativeness of the results. Another limitation relates to the focus on mental health practice within nursing education, as the study’s findings may not fully reflect the experiences and challenges encountered in other specialty clinical nursing areas, such as which aspects of tutoring quality are being used and assessed. Incorporating a broader range of such areas could provide a more comprehensive understanding of the issue. An additional limitation is the study’s reliance on self-reported questionnaires to evaluate perceptions of learning quality, for the possibility of response bias and subjectivity. Future research could incorporate objective measures or observational methods to complement self-reported data, or use a complex mixed-method design [40] providing a more holistic understanding of clinical learning quality.

Design the system before the pilot

Document the learner model, mastery rule, hint sequence and adaptation signal. Compare adaptive routing with the same content in a non-adaptive sequence. Check whether early errors lead to persistent low-expectation pathways.

  • Use plan–attempt–check–reflect prompts and compare confidence with actual performance. Keep learner choice and reflection visible.
  • Use common rubrics, blind scoring where feasible and a fresh unaided reasoning task. Document permissible assistance and avoid treating AI-detector scores as proof of misconduct.

A 90-day district pilot

  1. Days 1–15 · Appraise. Have the curriculum lead and a teacher read the methods and limitations. Record the study design, sample, comparator, outcomes and evidence gaps. Define a local question that the study can help inform.
  2. Days 16–30 · Design. Choose one disciplinary task. Require a first attempt, a documented AI consultation, a critique of the output and an independent explanation. Align the comparison group and scoring rubric with the same objective. Name an accountable owner and set the baseline, success threshold and budget before implementation.
  3. Days 31–60 · Test. Start with a small voluntary cohort, preserve an accessible non-AI route and require teacher review. Use synthetic or de-identified examples; approve data handling and tool terms through district processes.
  4. Days 61–90 · Decide. Blind-score reasoning and accuracy on a new task without AI. Distinguish model examination scores, student perceptions and actual learner gains; only the last directly tests educational benefit. Compare with baseline, document uncertainty and stop or revise if learning worsens, access is unequal or critical errors persist.

The board decision brief

Report the learning problem, evidence quality, participating population, total cost including review time, measured benefit, errors, access differences and remaining uncertainties. Make a dated recommendation to stop, revise or expand. A positive perception survey alone does not establish learning improvement.

Attribution and reuse

Gizell Green; Sanaa Adawi. Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination. Nursing Reports (2024-05-10). https://doi.org/10.3390/nursrep14020086

Companion prepared 2026-10-30. Original authorship and DOI are preserved. The abstract is an attributed source extract; the implementation plan is new AI-assisted editorial material, offered under the same CC BY 4.0 license. This guide has not undergone independent peer review.