AI-Supported Standardized Patients to Strengthen Early Clinical Judgment in Nursing Students

Background: Early clinical judgment is essential for Next Generation NCLEX readiness, yet opportunities to apply reasoning are limited in early-semester nursing courses. Method: First-semester accelerated baccalaureate nursing students participated in a scaffolded instructional sequence incorporating didactic instruction, AI-assisted review, an AI-supported standardized patient, guided application, and debriefing. Self-rated confidence was measured pre–post ( N = 81), and examination performance was compared with a historical cohort. Results: Confidence increased from 2.0 to 4.0 (95% CI [1.72, 2.28]), t(80) = 15.42, p < .001, d = 1.59. Mean examination scores were higher in the intervention cohort (87%) than in the historical cohort (81%), t(187.55) = 6.51, p < .001, d = 0.94. Conclusion: A scaffolded instructional sequence incorporating an AI-supported standardized patient was associated with greater confidence and improved examination performance. Further research should examine effects on clinical judgment using validated measures.