Unethical Use of Generative AI in Academic Work and Its Association With Academic Performance Among Undergraduate Nursing Students in KP Pakistan
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Background: The increasing integration of generative artificial intelligence (GenAI) into nursing education has raised concerns regarding academic integrity and educational outcomes. Evidence concerning unethical GenAI practices among Pakistani nursing students remains limited. Objective: To examine self-reported submission of AI-generated academic work as original content and its association with perceived lower grades among undergraduate nursing students in Khyber Pakhtunkhwa, Pakistan. Methods: An analytical cross-sectional study included 423 undergraduate nursing students recruited through convenience sampling from nursing colleges in Swabi, Khyber Pakhtunkhwa. Data were collected using a self-administered questionnaire and analyzed using IBM SPSS Statistics version 26.0. Descriptive statistics and Pearson's chi-square test were applied. Results: The mean participant age was 23.53 ± 1.90 years, and 74.7% were male. Most participants were enrolled in semester eight (61.9%). Among 422 valid responses, 181 students (42.9%) agreed or strongly agreed that they submitted AI-generated academic work as their own. A statistically significant association was observed between this practice and perceived lower grades when AI was used without adequate understanding (χ²(16) = 49.214, p < 0.001; Cramér's V = 0.171). Conclusion: Self-reported submission of AI-generated academic work was associated with perceived lower grades, although the association was relatively small. The cross-sectional findings do not establish causality or demonstrate changes in objectively measured academic performance.
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