Problem-solving skills involve organizing and using information. This requires certain tendencies and prerequisites. This research aimed to study how learning motivation affects problem-solving. It also looked at critical thinking as a mediator. The focus was on students at Jiroft University of Medical Sciences, Iran, in 2024. The study was cross-sectional and involved 290 students from various fields at Jiroft University of Medical Sciences. It took place from January to May 2024. Data were gathered using standard questionnaires on learning motivation, problem-solving, and critical thinking. We analyzed the data with descriptive tests and structural equation modeling using Smart PLS3 and SPSS-23. The findings showed that learning motivation positively impacts problem-solving (p = 0.001, β = 0.52). It also boosts critical thinking (p < 0.001, β = 0.59). Moreover, critical thinking enhances problem-solving (p < 0.001, β = 0.63). Learning motivation improves problem-solving through critical thinking (p < 0.001). The results suggest that good learning motivation and critical thinking improve problem-solving. Therefore, we recommend that university leaders enhance learning motivation and offer training to boost critical thinking, leading to better problem-solving.
To examine the associations between Artificial intelligence (AI) dependence and critical thinking ability among nursing interns and to explore the potential mediating role of AI literacy. A convenience sampling method was used to select nursing interns recruited from multiple hospitals in Hunan, China between January and February 2026. A general information questionnaire, AI literacy scale, AI dependence scale, and critical thinking ability scale were used to conduct the online questionnaire survey. Data were analyzed using descriptive statistics, Pearson correlation analysis, and regression-based mediation analysis (PROCESS Model 4) with 5,000 bootstrap resamples. A total of 517 nursing interns were included in the final analysis. AI dependence was positively associated with AI literacy and critical thinking ability (all p < 0.001). After adjusting for covariates, AI literacy partially mediated the relationship between AI dependence and critical thinking ability. The indirect effect was significant [95%CI (0.399, 0.610)], and the model explained 52.0% of the variance in critical thinking ability. AI dependence was positively associated with critical thinking ability among nursing interns, both directly and indirectly through AI literacy. These findings suggest that integrating AI literacy training into nursing education may help optimize the educational benefits of AI.
In the context of educational digital transformation, AI precision feedback has emerged as a critical technological support for optimizing college students' cognitive development. As a key dimension of core competencies, thinking shaping ability directly impacts academic progress and lifelong learning capabilities. To elucidate the mechanism of AI precision feedback in shaping students' thinking shaping ability, this study conducted a mediation analysis with 1,079 college students using path analysis, Bootstrap sampling, and moderation testing. The research constructed a mediation model: "AI precision feedback → intrinsic value identification → thinking shaping ability," incorporating critical consciousness transformation as a moderating variable. Results revealed: (1) AI precision feedback significantly enhances thinking shaping ability (standardized coefficient = 0.561, p < 0.001); (2) Intrinsic value identification partially mediates this relationship [mediation effect = 0.153, accounting for 32.01% of total effect; 95% Bootstrap CI = (0.061, 0.284)]; (3) Critical consciousness transformation significantly moderates the relationship between intrinsic value identification and college students' thinking shaping ability (interaction ** p = 0.040), and the transformation of high critical consciousness can strengthen the promoting effect of intrinsic value identification on thinking shaping ability. This study enriches the theoretical framework for AI education and cognitive cultivation, providing empirical evidence and practical guidance for universities to optimize AI technology applications and precisely enhance students' cognitive literacy.
Motivational factors are widely recognized as central to students' engagement in cognitively demanding learning; however, the role of STEM career interest in the development of computational thinking during adolescence remains insufficiently understood. It is also unclear whether this association differs by gender. Grounded in Social Cognitive Career Theory, this study examined the association between STEM career interest and computational thinking among high school students and tested the moderating role of gender. Data were collected from 467 students (Mage = 16.05, SD = 1.20; 57.2% female) enrolled in public science high schools in Diyarbakır, Türkiye, using a descriptive correlational design. Participants completed the STEM Career Interest Scale and the Computational Thinking Skills Scale. Moderation analysis was conducted using PROCESS (Model 1) with 5,000 bootstrap resamples. STEM career interest was positively associated with computational thinking. Gender showed no significant main effect, and the interaction between STEM career interest and gender was not significant, indicating that the strength of this association was similar for female and male students. These findings suggest that, within academically selective STEM-focused environments, motivational orientations toward STEM are linked to computational thinking in comparable ways across genders. The results highlight the importance of supporting students' motivational engagement, alongside instructional practices, in fostering computational thinking during secondary education.
This review synthesizes the impact of Artificial Intelligence (AI) on nursing students' clinical competency, Higher-Order Thinking Skills (HOTS) and educational outcomes to differentiate between procedural efficiency and deep cognitive retention. Generative AI and Intelligent Tutoring Systems (ITS) offer personalized scaffolding. However, their comparative efficacy against conventional pedagogical approaches, such as face-to-face lectures and standard non-AI simulations, remains controversial, particularly regarding the potential trade-off between skill acquisition and cognitive depth. A systematic literature review guided by PRISMA 2020 guidelines. A comprehensive search across seven databases (PubMed, EBSCOhost, Scopus, ScienceDirect, ProQuest, IEEE Xplore, JSTOR) from 2015 to 2025 identified 14 eligible studies (7 RCTs, 7 Quasi-experiments) which were synthesized across East Asia, Europe and Africa. Quality was appraised using JBI tools, with the protocol registered in PROSPERO. Synthesis of 14 studies (n = 1107) reveals a critical divergence. AI interventions significantly improved psychomotor application, procedural skills and communication mechanics compared with traditional instructor-led teaching methods. However, findings on HOTS and retention were mixed; while GenAI enhanced inquiry-based problem solving, it occasionally compromised critical reflection and long-term knowledge retention compared with human-led instruction. Furthermore, a "gap in algorithmic empathy" was evident, with AI failing to effectively enhance cultural awareness. AI functions as a robust "pedagogical scaffold" for procedural simulation but risks inducing "cognitive offloading" if used passively. Educators must adopt a Hybrid-Scaffolded Model: leveraging AI for iterative drills while prioritizing human facilitation for deep cognitive consolidation, ethics and cultural safety.
Teacher-centered models in fundamental nursing education face issues including high student-instructor ratios and limited personalized feedback, hindering nursing students' clinical competency development. Peer-assisted learning with digital platforms is a promising solution. However, there remains a lack of research exploring the impact of structured digital platforms designed for peer practice in fundamental nursing education. This study aimed to evaluate the effectiveness of a structured digital platform for reciprocal peer practice in fundamental of nursing education. We conducted a quasi-experimental study involving 72 s-year undergraduate nursing students. The intervention group utilized reciprocal peer practice with the WeChat Mini Program, which was based on the BOPPPS teaching model (Bridge-in, Objectives, Pre-assessment, Participatory Learning, Post-assessment, Summary), while the control group participated in traditional group training in 3 weeks. Pre- and post-assessments were conducted using validated instruments. Data analysis was performed using SPSS 23.0, employing independent samples t-test and Mann-Whitney U test to compare the effects between the groups. The intervention group showed statistically significant improvements in the operational skills (Z = -3.566, p < 0.001). Additionally, participants in the intervention group showed improvements in the critical thinking (t = 2.386, p = 0.020). While both groups reported gains in self-efficacy, the intervention group exhibited a more pronounced improvement in self-efficacy (t = 3.152, p = 0.002) with reduced variability. The findings of this study highlight the potential for integrating digital tools for peer-assisted learning in nursing education, particularly within institutions facing faculty shortages or those seeking to modernize their pedagogical approaches.
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[This corrects the article DOI: 10.1371/journal.pone.0341294.].
Suppressing retrieval of a memory when faced with a reminder has been shown to reduce the probability of that memory coming to mind in the future, a phenomenon known as suppression-induced forgetting (SIF). However, efforts to observe SIF have sometimes failed, leading some to question the robustness of the effect. To address this issue, we conducted a comprehensive meta-analysis of SIF within the think/no-think paradigm including several key methodological variants to the original design. Across 500 effects from 120 studies, we observed a consistent aggregate SIF effect (d ≈ 0.20-0.40) measured using either same probe (SIF ≈ 6%), independent probe (SIF ≈ 5%-6%), or recognition (SIF ≈ 2%-4%) tests. Notably, there was considerable methodological variability, and prediction intervals revealed substantial heterogeneity. Moderator analyses undertaken to explain this variability found SIF to be credibly larger when using (a) relatively more repetitions during the think/no-think phase within same probe data, (b) thought substitution instructions within same probe data (with the opposite observed for independent probe data), and (c) autobiographical memories (or future worries) as opposed to words or images. Results provide compelling evidence of the robustness of the SIF effect while also demonstrating limitations in the literature and areas of future interest. These findings not only reinforce theoretical claims about the role of inhibitory control in memory regulation but also provide empirically grounded recommendations for optimizing study design. As memory control is increasingly implicated in mental health and adaptive cognition, the present work establishes a foundation for future translational efforts and sets clear methodological benchmarks for the next generation of research into motivated forgetting. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Repetitive negative thinking may contribute to negative symptoms in psychosis. We report clinical outcomes from a pilot randomized clinical trial evaluating the feasibility and efficacy of group rumination-focused cognitive behavioural therapy (RFCBT) added to early outpatient care (OPUS) versus OPUS alone, i.e., treatment-as-usual (TAU). Young adults with schizophrenia spectrum disorders receiving OPUS care were randomized 1:1 to 13 weeks of group RFCBT plus OPUS or to TAU. Assessments were conducted at baseline and post-treatment. Feasibility was defined as ≥80% of participants completing ≥six sessions. The primary outcome was Brief Negative Symptom Scale (BNSS). Secondary outcomes were Perseverative Thinking Questionnaire (PTQ), Ruminative Responses Scale (RRS), Scale for the Assessment of Positive Symptoms (SAPS), Calgary Depression Scale for Schizophrenia (CDSS), Behavior Rating Inventory of Executive Function (BRIEF), and Social Functioning Scale (SFS). Between-group differences in change scores were tested with Welch t-tests. Fifty-nine participants were included, but one withdrew consent, meaning fifty-eight participants were analyzed intention-to-treat (RFCBT n=28, TAU n=30). The treatment was feasible with 82.14 % of participants in the RFCBT group completing ≥six sessions. Compared with TAU, RFCBT produced greater improvement in BNSS (between-group Δ -5.90; p=0.05; d=0.72). Repetitive negative thinking and rumination improved significantly: PTQ (Δ -8.35; p=0.016; d=0.89) and RRS (Δ -9.62; d=1.15; p=0.001). No significant between-group differences were observed for SAPS, CDSS, BRIEF, or SFS. Adding group RFCBT to OPUS was feasible and yielded large reductions in negative symptoms and repetitive negative thinking relative to TAU, supporting progression to a fully powered trial.
Creative choices often require quickly generating and evaluating possible actions under time pressure. However, it is still unclear whether creative continuation is expressed as a directed reconfiguration of whole-brain communication beyond undirected coupling or isolated regional responses. In this study, we identify directed, multiscale network signatures that separate creative from obvious action continuations in a naturalistic soccer decision task and measure how these patterns relate to creative decision skills. We estimated directed effective connectivity among 112 regions from whole-brain fMRI during Think (creative continuation) versus Video (obvious continuation) trials and tested condition effects using nonparametric permutation inference with family-wise error (FWE) control, and network organization was summarized using triad motifs and community structure, and related to Soccer Video Test scores (SVT). Twenty-two directed connections showed Think-Video differences at FWE α=0.05 in the 33 participants with usable data in both conditions. Think increased network description length (ρ=0.05: 6.20 vs 5.72; t32=6.23; PFWE=0.0001) and reduced feedforward-closure and convergent fan-in motifs (t32=-4.59 and -4.66; PFWE=0.0013). Across players, higher SVT scores predicted higher convergent fan-in motif counts (021U) (β=0.35 to 0.40; p=0.006 to 0.016; q≤0.047) and lower description length (β=-0.32 to -0.37;p=0.014 to 0.035; q≤0.047). Collectively, these findings demonstrate previously unresolved directed reweighting of local motifs and mesoscale organization during creative continuation, and provide a framework for mechanistic tests of creative expertise in real-world decisions.
This Perspective explores and calls for the integration of Indigenous knowledge systems within sustainability science to address urgent environmental, social, and economic challenges. Insights emerged from a collaborative workshop held in Baawaating (Algoma District, Ontario, Canada) with knowledge holders, practitioners, scholars, and community leaders, including members from the Ketegaunseebee (Garden River) and Batchewana First Nations. The paper examines how Indigenous ways of being, thinking, and knowing can enrich sustainability research. This work focuses on mapping parallels and distinctions between Indigenous and other sustainability practices with regard to the planet, the land, and relationships. It explores systems thinking, circularity, and Two-Eyed Seeing as a way to reimagine human-land relationships through place-based knowledge and stewardship. We stress the importance of embedding purpose and intention in scientific inquiry and propose examples such as ceremonial practices, seven-generational thinking, and relational accountability. The Perspective calls for a paradigm shift beyond Western-centric and reductionist approaches, which lead to endless economic growth, toward holistic, interconnected, and intentional frameworks that respect Indigenous worldviews. A series of concrete calls to action urge sustainability researchers to integrate Indigenous knowledge respectfully, foster long-term collaborative relationships, and adopt regenerative and relational approaches in their scholarship. This will contribute to restoring the balance needed among cultures and between humanity and the natural world. Collectively, as sustainability scholars, we want to see meaningful change and encourage a paradigm shift: to embrace inclusive, holistic approaches that contribute to impactful, results-oriented actions that restore health to our world. You can do this through being advocates for change to promote reconciliation, strengthen intercultural relationships, and support greater well-being for all, and, in doing so, protect the planet by reducing ecological harm.
Given theoretical and methodological criticisms surrounding coping strategies, this study examines coping profiles and differences between mothers and fathers at the time of their child's autism diagnosis. Multi-group confirmatory factor analyses (MG-CFAs) were conducted to improve construct validity of the French Ways of Coping Checklist-Revised in 554 parents in France and to test measurement invariance between mothers and fathers. Linear mixed models were performed to examine parental status (mother vs. father) differences in coping strategies. Dyadic latent profile analysis (LPA) was used to identify distinct coping profiles and the R3STEP approach to examine differences in latent profile membership by parental status. MG-CFAs supported four coping dimensions (problem solving-positive reappraisal, seeking social support, wishful thinking, and self-blame) and demonstrated configural and metric invariances, with partial scalar invariance between mothers and fathers. Fathers reported a significantly lower use of all coping strategies except wishful thinking. LPA identified three coping profiles -Varied Coping, Adaptive-Dominant Coping, and Maladaptive-Dominant Coping-with no significant differences in latent profile membership between mothers and fathers. In both parents, coping profiles differed by anxiety symptoms; additionally, maternal profiles were associated with socio-economic status, stress levels, and the child's internalizing difficulties, and paternal profiles with depressive symptoms. These findings provide a more nuanced understanding of mother-father differences in coping among parents of autistic children and underscore the need for tailored, profile-based interventions in clinical practice and future research.
Diabetic foot ulcers represent a significant clinical challenge requiring comprehensive knowledge of classification systems and surgical intervention strategies. The BOPPPS (Bridge-in, Objective, Pre-assessment, Participatory learning, Post-assessment, Summary) teaching model has gained increasing attention in medical education, yet its effectiveness in vascular surgery residency training remains underexplored. This study aimed to evaluate the effectiveness of the BOPPPS teaching model in standardized training for vascular surgery residents regarding diabetic foot Wagner classification and surgical intervention strategies. This retrospective cohort study included 196 vascular surgery residents who underwent standardized training at the Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University from January 2023 to December 2024. Based on their training rotation schedule, residents were allocated to either an experimental group (n = 98) receiving BOPPPS-based instruction or a control group (n = 98) receiving traditional teaching methods. Primary outcomes included theoretical examination scores, clinical skill assessment (Mini-CEX and DOPS), self-directed learning readiness (SDLRS), critical thinking disposition (CTDI-CV), and teaching satisfaction. The experimental group demonstrated significantly higher theoretical examination scores (82.47 ± 8.63 vs. 74.85 ± 9.21, p < 0.001) and Mini-CEX scores (7.84 ± 1.12 vs. 6.93 ± 1.28, p < 0.001) compared to the control group. DOPS scores for wound debridement (8.12 ± 0.95 vs. 7.23 ± 1.18, p < 0.001), vascular assessment (7.96 ± 1.08 vs. 7.14 ± 1.25, p < 0.001), and amputation level determination (7.78 ± 1.15 vs. 6.89 ± 1.32, p < 0.001) were significantly improved in the BOPPPS group. Self-directed learning readiness scores increased significantly in the experimental group (168.52 ± 18.74 vs. 153.28 ± 21.36, p < 0.001), and critical thinking disposition scores were notably higher (292.84 ± 28.65 vs. 271.35 ± 31.42, p < 0.001). Teaching satisfaction rates reached 94.9% in the experimental group versus 78.6% in the control group (p < 0.001). The BOPPPS teaching model significantly enhances the effectiveness of standardized training for vascular surgery residents in diabetic foot management, improving theoretical knowledge, clinical competence, self-directed learning ability, and critical thinking disposition.
Metacognitive theory suggests that maladaptive beliefs about thinking are associated with the cognitive attentional syndrome (CAS), which is characterized by repetitive negative thinking and heightened threat monitoring. This study examined a dual-mediation model in which rumination and anxiety sensitivity were tested simultaneously as mediators of the relationship between metacognitive beliefs and sleep quality in a nonclinical sample. A total of 346 Iranian adults (18-60 years) completed validated self-report measures of metacognitive beliefs, rumination, anxiety sensitivity, and sleep quality. Structural equation modeling (SEM) with bias-corrected bootstrapping (2,000 resamples) was used to test the hypothesized model. The model demonstrated acceptable fit to the data (CFI = 0.96, RMSEA = 0.074). Metacognitive beliefs were not significantly associated with sleep quality after including the mediators. However, significant indirect effects were observed through rumination (β = 0.32, 95% CI [0.20, 0.40]) and anxiety sensitivity (β = 0.28, 95% CI [0.17, 0.37]). The model explained 50% of the variance in sleep quality. The findings indicate that metacognitive beliefs are statistically associated with poorer sleep quality indirectly through rumination and anxiety sensitivity in a community sample. These results support the value of examining transdiagnostic cognitive-emotional processes in sleep research. Due to the cross-sectional design and reliance on self-report measures, causal inferences cannot be drawn. Future longitudinal and experimental studies are needed to clarify the temporal relationships and clinical utility of these pathways.
The green and digital transitions are reshaping the global economy, requiring new human capital paradigms that move beyond technical skills and instrumental, metric-driven models. This paper reimagines human capital development through the Daoist classic Zhuangzi, which critiques rigid categorization and promotes spontaneity, perspectival flexibility, and harmony with change. Rather than viewing human capital as a fixed set of skills, Zhuangzi offers a model focused on adaptability, ethical humility, and intuitive responsiveness. Through a structured hermeneutic analysis of the text, we derive a conceptual framework organized around five core capacities: adaptive learning, ethical humility, embodied and intuitive skill, relational attunement, and frugality-oriented judgment, which are positioned as foundational to an enhanced intellectual capital framework that prioritizes dynamic, relational, and sustainability-oriented capabilities. These traits align with systems thinking, participatory governance, and frugal innovation in green and digital contexts. The paper proposes a Zhuangzi-inspired framework for education and policy, emphasizing metacognitive awareness, narrative pedagogy, and the integration of philosophical inquiry into technical training. Zhuangzi, far from being a historical curiosity, serves as a vital guide in modern discussions on sustainability, automation, and human development. It encourages a shift from control-based models to those grounded in trust, simplicity, and ethical awareness. Daoist thought provides a philosophical compass for fostering a more resilient, humane, and context-responsive approach to human capital. Through an illustrative application on digital environmental monitoring, the paper demonstrates how the framework reframes competence as cultivated responsiveness rather than technical control. By connecting ancient philosophy with modern sustainability challenges, and directly engaging with intellectual capital theory, this paper positions Zhuangzi as a key resource in reshaping human capital toward wisdom-oriented adaptability.
This study investigates how emotional intelligence mediates the link between future temporal orientation and depressive symptoms in university students and explores whether physical activity moderates this connection. Data were collected from 1,014 undergraduate students (490 males and 524 females) across three universities in Fujian Province, China, between 1 March and 5 July 2024. Participants were selected via random sampling and completed the Future Time Perspective Scale, Emotional Intelligence Scale, Physical Activity Rating Scale, and Epidemiologic Studies Depression Scale. Statistical analyses included Pearson's correlation, linear regression, and moderated mediation analysis (PROCESS Model 7) using SPSS 22.0. (1) Future time perspective significantly and negatively predicted depression (β = -0.32, p < 0.001). (2) Emotional intelligence partially mediated the association between future time perspective and depression (indirect effect = -0.11, SE = 0.02, 95% CI [-0.15, -0.08]). (3) Physical exercise moderated the first-stage path of the mediation model (FTP → EI). Simple slope analyses showed that the FTP-EI association was significant at both low (M - 1 SD) and high (M + 1 SD) levels of physical exercise, but was stronger at high physical exercise (simple slope: β = 0.41, p < 0.01) than at low physical exercise (simple slope: β = 0.25, p < 0.01). Future time perspective influences depression both directly and indirectly through emotional intelligence. Additionally, physical exercise enhances the predictive effect of future time perspective on emotional intelligence, suggesting that active individuals exhibit a stronger link between future-oriented thinking and emotion regulation.
This study examined, using a laboratory paradigm, whether activating thought-fusion beliefs has an immediate effect on obsessive-compulsive-like symptoms, namely discomfort and behavioral responses to neutral intrusive thoughts, independent of cognitive self-consciousness, and assessed its clinical specificity. A 2 (group, patients with OCD vs. healthy control) × 3 (experimental condition, thought-fusion beliefs plus cognitive self-consciousness vs. cognitive self-consciousness alone vs. control) mixed-design experiment was conducted (n = 108). Variables were manipulated using a fake electroencephalogram (EEG) and verbal instructions. Primary outcome measures were the frequency of intrusions related to target thoughts (water or drinking) and the discomfort associated with these intrusions. Secondary outcomes included effort to control intrusions and time spent thinking about them. Data were analyzed using covariance and generalized linear models, controlling for anxiety and depression. A significant group × condition interaction was found for discomfort associated with intrusions. Within the patient group, Condition 1 produced significantly greater discomfort than Condition 2 and the control condition, with Condition 2 also exceeding the control condition. For intrusion frequency, only a main effect of condition was observed, with both experimental conditions exceeding the control condition. Significant group × condition interactions were also found for both secondary measures, with the pattern (Condition 1 > Condition 2 > Control) most pronounced in the patient group. Under controlled conditions with standardised stimuli, thought-fusion beliefs independently and specifically amplify distress associated with intrusive thoughts in patients with OCD and increase control-related responses.
Newborn screening (NBS), a mandated public health intervention, allows the identification of babies with potentially life-threatening disorders and facilitates disease diagnosis and management before the onset of symptoms. While NBS saves lives, the process can be fraught with anxiety and unanswered questions from parents or guardians of newborns, especially as they wait for an appointment with a clinician. This study aimed to describe the development and testing of an educational chatbot (NBSchat) to address the emotional support and information needs of parents of newborns identified with sickle cell trait via NBS. NBSchat, a fully scripted (ie, rule-based) chatbot, was developed by a multidisciplinary team and evaluated through a sequential multiple methods study, including interviews and a survey. To inform chatbot design, we conducted semistructured interviews with 11 adults-5 clinicians who work with parents of infants identified with sickle cell trait through NBS and 6 parents of infants aged 12 months or less-using the critical incident technique and think-aloud tasks while using a prototype of NBSchat. Transcripts underwent thematic analysis. In a survey, 250 parents of infants aged 12 months or less without abnormal NBS results were shown a mock newborn screening result letter and then interacted with NBSchat, after which they self-reported emotional and attitudinal outcomes before and after the simulated exposure. Feedback from interviews confirmed that parents are distressed by trait results and actively seek information and reassurance. Thematic analysis indicated that NBSchat provided reliable, accurate information that parents wanted and had the potential to reduce negative emotions (eg, provide relief and reduce stress). Key strengths included addressing an immediate health concern and offering reassurance. The results of the postintervention survey indicated that, compared to pre-exposure scores, participants reported significantly lower negative emotions (mean 7.0 [SD 3.2] vs 5.8 [SD 3.2] out of 12; mean difference -1.2, 95% CI -1.57 to -0.83; P<.001), improved positive emotions (reflected by a decrease in the reverse-coded positive emotion score; mean 8.6 [SD 4.2] vs 7.8 [SD 4] out of 16; mean difference -0.8, 95% CI -1.27 to -0.37; P<.001), and reduced uncertainty (mean 6.5 [SD 3] vs 5.5 [SD 3.4] out of 12; mean difference -1, 95% CI -1.42 to -0.58; P<.001). Parents noted that NBSchat provided immediate reassurance and was convenient to access. They further reported that the predefined, structured questions in the script helped guide their learning and understanding. Overall, participants who interacted with NBSchat found it to be acceptable, with improved emotional measures after its use. Future research will investigate the outcomes of using the chatbot and its implementation in a pragmatic randomized controlled trial.