The Nursing and Midwifery Council (NMC), in conversations with other health regulators, is currently considering the use of artificial intelligence (AI). Concerns have been raised that ChatGPT, a generative AI tool, is being used by nurses to complete their reflections as part of the revalidation process. This echoes considerations for colleagues delivering higher education programmes.
A Google search delivered the following description of ChatGPT:
‘… a natural language processing chatbot driven by generative AI that allows you to have human-like conversations to complete various tasks. For example, the AI tool can answer questions and assist you with tasks such as composing emails, essays, and code.’
Spector (2023), in her discussions with Sanford education scholars who undertook research with students, reported that the launch of ChatGPT AI chatbots has triggered an alarm for many educators, who worry about students using the technology to cheat by passing off its writing as their own. However, the research found that AI was not in fact increasing the frequency of cheating.
Spector reflected that research shows that cheating is generally a symptom of other issues, and often a deeper, systemic problem. It was also found that, when students feel respected and valued, they are more likely to engage in learning and act with integrity. The discussions concluded that, although AI can be misused and has limitations, AI literacy could be considered as a powerful tool that can be a great asset.
AI is not going away and, along with addressing the deeper reasons why students cheat, it is clearly important that students are taught how to understand and think critically about this technology.
Nurses on the NMC register are part of a profession with nationally recognised standards set by law. The NMC states that, to determine that someone is capable of safe and effective practice, they must have the skills, knowledge, character and health to work in their profession. Nurses, midwives and nursing associates who are seeking to join or rejoin the register or renew their registration through revalidation must make declarations about their health and character.
The requirements of ‘good character’, as outlined in the NMC (2019) guidance, requires consideration of any:
- Criminal proceedings
- Findings by another regulatory body (including health and social care)
- Conduct that may amount to a breach of the requirements of the Code.
Nurses are asked to affirm the following character declaration in their application (NMC, 2019):
‘Do you declare that you are of good character which enables you to practise safely and effectively?’
At the most serious end of the scale, if a nurse is found to have deliberate intention to mislead in their application to join or renew a place on the NMC register, this could result in the possibility that a case of fraudulent entry to the register could be opened, investigated and progressed to a hearing.
The Health and Care Professions Council (HCPC) (2024) has published its view on AI and information for education providers, recommending three key areas that education providers should consider when responding to developments in this area:
- Academic integrity
- Supporting staff and learners to become AI literate
- Emerging technology within practice.
The HCPC also signposts us to QAA (the Quality Assurance Agency for Higher Education) (2024), which has developed an impressive range of advice resources relating to AI and the ways in which it can be used as a positive tool, while maintaining academic standards.
So, is using ChatGPT cheating? In terms of revalidation, a consideration for us all professionally is that, even if a registrant is using AI to generate or support writing up of reflections, the reflective discussion will be face to face, with the registrant articulating their reflections and learning directly with another registrant, so there should be triangulation of their reflections and learning. The confirmer should be assuring that the reflective discussion has taken place.
It is inevitable that new technologies will be embraced by colleagues, so triangulation of the activity to evidence the reflection and learning is key. There is also a need for the NMC to work with education providers to consider how AI is embraced as a tool for learning for students on NMC-approved programmes. As highlighted by Spector (2023), getting support from a parent, colleague or tutor has not historically been seen as cheating. We therefore need to embrace the technology and consider the potential to support learning and the context in which it has been utilised.