Recalibrating the value of presence: A qualitative study on generative AI, attendance, and professional formation in...

Generative AI (genAI) is now embedded in higher education, yet its implications for undergraduate nursing students' decisions to attend voluntary on-campus learning alongside mandatory Clinical Learning Environment (CLE) activities remain underexplored, particularly in regulated clinical-hours contexts.

To explore how undergraduate nursing students use genAI for coursework and assessment preparation and how this use influences perceived necessity to attend lectures, tutorials, and CLEs, with attention to variation across year levels.

Exploratory-descriptive qualitative study conducted within a social-constructivist, interpretivist framework using applied thematic analysis.

Eighteen students from a metropolitan Australian Bachelor of Nursing program.

Semi-structured one-to-one interviews conducted on campus or via encrypted videoconference over one teaching period; audio-recorded and transcribed verbatim. Hybrid coding (sensitizing concepts and inductive expansion) with consensus meetings, reflexive memos, and member reflections. The study concluded based on analytical sufficiency rather than data saturation.

Four themes captured a developmental journey. (1) Instant Expertise: genAI served as an on-demand clinical coach that condensed pre-CLE preparation and reduced anxiety, while risking attentional drift from tacit cues. (2) Strategic Presence: students triaged attendance-CLE as non-negotiable; lectures/tutorials as negotiable-with a developmental pattern (Year 1 attendance to decode "why," Year 2 efficiency-driven selectivity, Year 3 targeted presence or deliberate reinvestment). (3) Relational Recalibration: facilitated dialogue and peer debate in smaller forums fostered judgement and professional identity; large didactic lectures offered less added value, making AI feel more responsive. (4) From Reliance to Reflexivity: senior students verified genAI against local protocols and ethical frameworks, foregrounding person-centered care and policy currency.

GenAI is transforming the emphasis from "seat time" to the "value of presence." Nursing programs should clearly define areas where in-person learning is essential, such as CLEs and facilitated case discussions, and incorporate genAI literacy and verification skills into their curricula. Future multi-site longitudinal research should investigate the outcomes of this innovative approach to presence.