This article describes the development and implementation of a culturally focused simulation about Amish preference for a non-conventional type of burn care.
Methodology:
Artificial intelligence (AI), specifically ChatGPT, was employed to create learning objectives, a clinical scenario involving an Amish man with chest burns, a detailed script, and debriefing tools aligned with INACSL Standards of Best Practice. This simulation was incorporated into course content on cultural competence for undergraduate nursing students.
Results:
Through an iterative refinement process, AI helped tailor the simulation content. Nursing students were engaged with cultural beliefs and practices, particularly the use of B&W ointment and burdock leaves in burn treatment.
Discussion:
The simulation promoted culturally sensitive communication and real-time adaptive feedback. While AI expedited content development, all material required expert validation. AI enhanced rather than replaced the instructional design process. Educators seeking to replicate this simulation may benefit from the cultural insights and methodology as described.
AlkhaqaniA. L. (2023). Potential benefits and challenges of ChatGPT in future nursing education. Maaen Journal for Medical Sciences, 2(2), 49–53. https://doi.org/10.55810/2789-9136.1020
2.
Amish Burn Study Group, KolaczN. M.JarochM. T.BearM. L.HessR. F. (2014). The effect of Burns & Wounds (B&W)/burdock leaf therapy on burn-injured Amish patients: A pilot study measuring pain levels, infection rates, and healing times. Journal of Holistic Nursing, 32(4), 327–340. https://doi.org/10.1177/0898010114525683
3.
BerozS. (2023). Simulation essentials for curriculum integration of next generation NCLEX. In JefferiesP. (Ed.), Clinical simulations in nursing education. Advanced concepts, trends, and opportunities (2nd ed., pp. 62–76). Wolters Kluwer.
4.
ChanM. M. K.WanA. W. H.CheungD. S. K.ChoiE. P. H.ChanE. A.YorkeJ.WangL. (2025). Integration of artificial intelligence in nursing simulation education: A scoping review. Nurse Educator, 50(4), 195–200. https://doi.org/10.1097/NNE.0000000000001851
5.
ChildsS. (2007). Exercise caution when making maple confections. Cornell Maple Bulletin 204.
6.
Del PinoF. J. P.ArroganteO.Simonelli-MunozA. J.Gallego-GómezJ. I.Jiménez-RodríguezD. (2022). Use of high-fidelity clinical simulation for the development of cultural competence of nursing students. Nurse Education Today, 116, 105465. https://doi.org/10.1016/j.nedt.2022.105465
DreifuerstK.BradleyC. S.JohnsonB. K. (2021). Debriefing: An essential component for learning in simulation pedagogy. In JeffriesP.R. (Ed.), Simulation in nursing education from conceptualization to evaluation (3rd ed., pp. 45–68). Wolters Kluwer.
9.
DreifuerstK.McDermottK.LoomisA.Young-BriceA. (2023). Debriefing, clinical judgement, clinical reasoning, and competence. In JeffriesP. (Ed.), Clinical simulations in nursing education. Advanced concepts, trends, and opportunities (2nd ed., pp. 62–76). Wolters Kluwer.
10.
FlurryM. D.HerringK. L.CarrL. W.HauckR. M.PotochnyJ. D. (2017). Salve and burdock: A safe, effective Amish remedy for treatment of traumatic wounds?Advances in Skin & Wound Care, 30(5), 213–217. https://doi.org/10.1097/01.ASW.0000515079.07160.e3
11.
GermainM. (2024). Artificial intelligence (AI) in human caring: Challenges and possibilities. Journal of Transcultural Nursing, 35(6), 398. https://doi.org/10.1177/1043659241289883
12.
HessR. (2018). Amish and Mennonite lay caregivers’ experiences using the B&W burdock leaf treatment on burns and wounds: A qualitative study. Journal of Amish and Plain Anabaptist Studies, 6(2), 144–159. https://doi.org/10.18061/1811/87098
HigashitsujiA.OtsukaT.WatanabeK. (2025). Impact of ChatGPT on case creation efficiency and learning quality in case-based learning for undergraduate nursing students. Teaching and Learning in Nursing, 20(1), e159–e166. https://doi.org/10.1016/j.teln.2024.10.002
15.
INACSL Standards Committee., MillerC.DeckersC.JonesM.Wells-BeedeE.McGeeE. (2021). Healthcare simulation standards of best practiceTM outcomes and objectives. Clinical Simulation in Nursing, 58, 40–44. https://doi.org/10.1016/j.ecns.2021.08.013
16.
JeffriesP.RogersB. (2021). The NLN Jeffries simulation theory. In JeffriesP.R. (Ed.), Simulation in nursing education from conceptualization to evaluation (3rd ed., pp. 19–30). Wolters Kluwer.
17.
JohnsonB.ZulkoskyK.O’ReganS. (2023). Observer roles: Their purpose, power, and value to health care simulation. In JefferiesP. (Ed.), Clinical simulations in nursing education. Advanced concepts, trends, and opportunities (2nd ed., pp. 146–162). Wolters Kluwer.
18.
JungS. (2023). Challenges for future directions for artificial intelligence integrated nursing simulation education. Korean Journal of Women Health Nursing, 29(3), 239–242. https://doi.org/10.4069/kjwhn.2023.09.06.1
19.
KeimJ. W. (1999). Comfort for the burned and wounded. Philosophical Publishing.
20.
KochA.RitzM.MorrowA.GrierK.McMillian-BohlerJ. M. (2021). Role-play simulation to teach nursing students how to provide culturally sensitive care to transgender patients. Nurse Education in Practice, 54, 103123. https://doi.org/10.1016/j.nepr.2021.103123
21.
LomisK.JeffriesP.PalattaA.SageM.SheikhJ.SheperisC.WhelanA. (2021). Artificial intelligence for health professions educators (NAM Perspectives, Discussion Paper). National Academy of Medicine. https://doi.org/10.31478/202109a
22.
MarjaS. L.SuviA. (2021). Cultural competence learning of health care students using simulation pedagogy: An integrative review. Nurse Education in Practice, 52, 1–8. https://doi.org/10.1016/j.nepr.2021.103044
23.
MarkeyK.DoodyoKingstonL.MoloneyM.MurphyL. (2021). Cultural competence development: The importance of incorporating culturally responsive simulation in nurse education. Nurse Education in Practice, 52, 1–8. https://doi.org/10.1016/j.nepr.2021.103021
SarikahyaS. D.ÖzbayÖ.TorpuşK.UstaG.ÖzbayS. Ç. (2025). The impact of ChatGPT on nursing education: A qualitative study based on the experiences of faculty members. Nurse Education Today, 152, 106755. https://doi.org/10.1016/j.nedt.2025.106755
29.
SniderM.KelleherJ.BrumbaughJ. T.AballayA.DuncanC. L. (2023). Descriptive analysis of current burn care for plain communities in Ohio and Pennsylvania: A qualitative study of strengths and needs in a hospital community partnership. Journal of Burn Care & Research, 44(4), 936–944. https://doi.org/10.1093/jbcr/irac141
30.
Tristate Burn Care Team, & HessR. (2023). Oil therapy massage as complementary care of burns and wounds. Journal of Amish and Plain Anabaptist Studies, 11(2), 201–210. https://doi.org/10.62192/japas.v11i2n09
31.
WeberC.CornemanA.Dal CinA. (2021). Amish burn treatment meets a major trauma centre: Success with cooperation. Plastic Surgery Case Studies, 7, 1–5. https://doi.org/10.1177/2513826X211019577
32.
WhitefordE.AbdessalamS. (2021). Burdock leaf and B&W ointment: A natural and suitable alternative to negative pressure wound therapy and skin grafting in the treatment of traumatic crush injury post-surgical debridement. Journal of Pediatric Surgery Case Reports, 65, 101751. https://doi.org/10.1016/j.epsc.2020.101751
33.
WyssL.DonnenwirthJ. A.RossR.HessR. F. (2022). Educating nursing students about female genital cutting/mutilation using a standardized patient in a virtual dramatization simulation. Journal of Transcultural Nursing, 33(5), 652–658. https://doi.org/10.1177/10436596221107599
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
