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What would it cost farmers if Illinois banned glyphosate?

University of Illinois College of Agricultural, Consumer and Environmental Sciences

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A new analysis from the University of Illinois Urbana-Champaign and the Illinois Soybean Association finds that Illinois corn and soybean farmers could lose up to $609 million per year — representing a 3.6% revenue loss — if the state banned the weedkiller glyphosate.

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Credit: Jim Baltz, University of Illinois Urbana-Champaign

URBANA, Ill. — A new analysis from the University of Illinois Urbana-Champaign and the Illinois Soybean Association finds that Illinois corn and soybean farmers could lose up to $609 million per year — representing a 3.6% revenue loss — if the state banned the weedkiller glyphosate.

The estimate represents a realistic scenario in which farmers would replace glyphosate with more expensive and slightly less effective herbicide products, and accounts for modest yield losses. But the study’s authors say any yield loss, even equating to just 3.6% of a farmer’s bottom line, would be hard to bear.

“I don't know of any farmer who wants to take a revenue loss by any stretch of the imagination, and especially when we've got such tight margins right now,” said study co-author Aaron Hager, professor and faculty Extension specialist in the Department of Crop Sciences, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois. “Profits have been projected to be negative again this year for a lot of Illinois farmers, many of which may be on the verge of not being able to survive.”

The researchers became curious about economic impacts after glyphosate bans were introduced in past Illinois legislative sessions. Considering increasing public attention and court cases related to glyphosate, they recognized that another ban could be proposed at any time. Meanwhile, multiple other pesticide bans were proposed in Illinois earlier this year. The researchers say their analysis methods could be applied to other chemicals. 

“We actually discussed studying several different chemicals initially and landed on glyphosate,” said study co-author Corey Lacey, environmental policy manager at the Illinois Soybean Association. “We chose it because a glyphosate ban would probably have the biggest impact on farmers since it is one of the most used crop protection tools by corn and soybean farmers in Illinois. So a glyphosate ban is something that we really have to talk about and put some real numbers to.”

Estimating the loss

Lead author Sandy Dall’erba, founding director of CREATE (the center for Climate, Regional, Environmental And Trade Economics) and professor in the Department of Agricultural and Consumer Economics in ACES, took a quantitative approach to the analysis. 

He started by tallying the total usage and expenditures related to glyphosate in the state. To calculate potential revenue impacts under a ban, he relied on published estimates of corn and soybean yield losses with decreased glyphosate use. Then he considered alternative herbicides, measured their higher cost and lesser efficiency, and estimated the price increase these new options would experience in the event of a glyphosate ban. 

The results indicate that Illinois corn and soybean farmers could lose $300 to $609 million per year, representing a 1.8 to 3.6% revenue loss.

What’s missing

The analysis paints a picture of economic hardship for Illinois farmers, but the researchers acknowledge that it does not represent every consequence of a hypothetical glyphosate ban. For example, it doesn’t capture the potential human health and environmental impacts of shelving glyphosate, nor indirect costs related to using other crop protection tools.

“Our analysis is somewhat partial in the sense that it is only looking at one aspect — the economic impacts on the farmer. A complete assessment would also need to consider effects on the agrifood supply chain, public tax revenues, human health, and the environment before weighing the overall costs and benefits of a glyphosate ban,” Dall’erba said. 

Glyphosate is a key element in conservation tillage, used as the burn-down herbicide to remove standing vegetation before planting. Without it, fuel costs — and their associated greenhouse gas emissions — would likely rise under a hypothetical glyphosate ban. 

“Glyphosate allows farmers to adopt conservation practices like no-till on a scale that you can't accomplish in other ways,” Lacey said. “A glyphosate ban would likely result in more conventional tillage, which is going to have not just a conservation cost in terms of soil health and emissions, but a literal fuel cost since farmers would also be driving the tractor more in the field. That would lead to increased input costs that we didn't estimate here.”

Whatever the unaccounted impact, the researchers say it’s clear their initial estimates are only the tip of an iceberg.

“What this work shows is that there can be significant financial consequences for something that looks fairly simple on paper,” Hager said.

The study, “Understanding the systemic impacts of a glyphosate ban on Illinois agriculture: Economic, agronomic, and community perspectives,” is published in Weed Technology [DOI: 10.1017/wet.2026.10133].  

Research in the College of ACES is made possible in part by Hatch funding from USDA’s National Institute of Food and Agriculture. This study was supported by the Illinois Soybean Association.

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Journal

Weed Technology

DOI

10.1017/wet.2026.10133 

 

New Model Rules mark meaningful step towards digital inheritance laws

University of Birmingham

European Law Institute approves Model Rules on Succession and Access to Digital Remains.

The European Law Institute (ELI) has approved its Model Rules on Succession and Access to Digital Remains, providing the world’s first comprehensive framework for dealing with digital assets and personal digital content after death.

The rules have been co-designed by Dr Edina Harbinja, Associate Professor in Law at the University of Birmingham, and are the first attempt to create a comprehensive model law governing digital succession.

The Model Rules address a huge gap and increasingly complex questions in European private and public law surrounding access to social media accounts, personal data, cryptocurrency and other digital assets when someone dies.

Intended to serve as a blueprint for national legislation and to inform future European policy initiatives, the ELI Model Rules are contributing to a coherent and future-proof framework for the management of digital remains.

Dr Edina Harbinja said: “When we die, we don’t just leave behind physical ‘real world’ property anymore. Our lives are so intertwined with the internet and digital world that now, when someone dies, they leave behind online accounts, cloud storage, social media profiles, digital wallets, creative works, and AI-enabled digital representations (also known as ‘deadbots’).

“But, as digital technology and platforms have accelerated at pace, our legal systems have struggled to keep up. There are urgent and fundamental questions about who may inherit, access, or manage these digital remains while respecting privacy, dignity and the wishes of the deceased that we do not currently have the answers to. Our new Model Rules, which have now been approved by the ELI, seek to address the chasm that exists in the law when it comes to our protection, assets and digital rights after death.”

The newly approved Model Rules offer an innovative and practical solution by recognising that not all digital remains and assets should be treated the same. Instead of forcing everything into traditional succession law or data protection law, the Rules establish a dual legal framework:

• Digital assets with economic value are transferred through the ordinary law of succession.

• Personal digital remains, closely connected to the deceased's identity, privacy, and dignity, are governed by a carefully safeguarded right of access rather than inheritance.

The Rules also address common occurrences where economic assets and personal data are intertwined. Dr Harbinja and her co-reporters introduce a structured process that protects privacy and gives effect to the deceased's wishes before digital assets are transferred to successors.

The Model Rules also provide practical guidance on issues that increasingly arise in modern estates, including ‘deadbots’, the responsibilities of online service providers, the protection of third-party privacy, and the handling of cross-border digital estates within the existing framework of European private international law.

Dr Harbinja added: “AI is a huge area of investment for governments all around the world, but it is also a topic that proposes challenges around regulation and the law when it comes to individual ownership and control. We are increasingly seeing celebrities sign deals with AI companies to use their likenesses and voices after they die, or trying to stop them from using them altogether.

“Without a clear legal framework, there is no way for people - not just celebrities - to meaningfully navigate the law so that people can have real control of their digital selves and likenesses after they die.”

Emily Deane TEP, Technical Counsel and Head of Government Affairs at STEP (Society of Trust and Estate Practitioners), which was part of the advisory committee and supported the project, said: “As succession planning evolves to reflect the realities of the digital age, clear legal frameworks are essential.

“The ELI Model Rules are a welcome and significant contribution to the international debate on digital inheritance, helping to address complex questions around ownership, access, privacy and personal autonomy after death. We hope they will provide a valuable foundation for future legislative and policy developments in this area.”

The Model Rules combine legal certainty with respect for autonomy, dignity, and privacy. They are designed to support legislators, courts, legal practitioners, service providers, and citizens in addressing one of the defining legal challenges of the digital age.

ENDS

ICYMI

Meet ‘Likweli’: A new monkey species discovered in the Congo Basin

IMMEDIATELY ENDANGERED BY CIVIL WAR

Yale University

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An international team of scientists, including Yale researchers, has described a new Colobus monkey species inhabiting high forest canopies in the Democratic Republic of Congo (DRC). It is just the fifth new species of African monkey discovered in the past 75 years.

The species, Colobus congoensis, is a rare and cryptic monkey largely unknown even among people living within its range. But those who are familiar with the small, black monkeys — an arboreal creature marked by distinctive orange-cream patches around their mouths and noses — call them “Likweli,” which the researchers recommend remain the species’ common name.

The identification of Likweli as distinct from other Colobus monkey species is supported by evidence drawn from its physical traits, genetics, and vocalizations.  

“Our team evaluated multiple datasets that all reached the same conclusion: Likweli is a distinct species of Colobus monkey we haven’t seen before,” said Julia Arenson, a postdoctoral fellow in Yale’s Department of Anthropology and the Yale Institute for Biospheric Studies and coauthor of the study. “Discovering a primate species is exceptionally rare, especially from populations previously unknown to science.”

The documentation of the Likweli, she said, also highlights the importance of protecting the rich biodiversity of Lomami National Park, an 8,874-square-kilometer park known for its rare and endemic species.

In the past 75 years, only eight new ape and Old World monkey species from populations previously unknown to science have been discovered. Those include Lesula, a monkey species discovered in 2012 in the Congo Basin by a team that included several coauthors of the current study.

The latest discovery is described in an article published on July 15 in the journal PLOS One. For the study, Arenson and Eric Sargis, professor of anthropology in Yale’s Faculty of Arts and Sciences, collaborated with researchers from the Lukuru Wildlife Research Foundation and Lomami National Park in DRC, Florida Atlantic University, and Hunter College of the City University of New York. All research was conducted under the authorization of the Congolese Institute for Nature Conservation (ICCN), an agency of the DRC government.

John and Terese Hart, conservation biologists with the Lukuru Wildlife Research Foundation and curatorial affiliates at the Yale Peabody Museum, are coauthors of the study.

“The discovery and documentation of the Likweli never would have happened without our team of Congolese explorer naturalists,” said John Hart, the study’s lead author. “These field leaders recognized when they were in front of something they did not know. They put in the extra effort needed to document and confirm it. Their attentive fieldwork, covering hundreds of hours and thousands of kilometers of reconnaissance across trackless forest, produced some of the most remarkable information for this new find.”

From 2018 to 2022, the researchers recorded 114 observations of Likweli over a range of about 1,700 square kilometers in Lomami National Park and its buffer zone on highlands located between three tributaries of the Congo River: the Tshuapa, Lomami, and Lualaba. The monkeys, which were most frequently observed in small groups of about six individuals, are difficult to spot and photograph because they live high in dense forest canopy, the researchers noted.

“Only after 10 years of exploring the Lomami Forest did we have enough clear views and convincing photos to allow us to say that there was yet another new monkey,” said Terese Hart. “This primate was not only new – it was extremely rare and with a limited range.”

In addition, the researchers spoke with residents of 52 villages bordering or located within Likweli’s range. Residents in only eight villages reported knowledge of the species and could accurately describe it. Since people in the region typically have detailed knowledge of local flora and fauna, this supports the notion that Likweli is a cryptic species, the researchers said.

In April 2021, ICCN officers confiscated three deceased Likweli specimens from hunters within the Lomami National Park buffer zone. Those specimens — two adult females and one adult male — were acquired by the researchers with authorization from ICCN. The skins and skeletons are now housed in the Yale Peabody Museum’s mammalogy collection.

Likweli are small, long tailed, and have black coats. Long, black hairs frame their foreheads and faces. Their small size, striking orange-cream patches on their faces, and white patches on their backsides underneath their tails distinguish them from Colobus satanas, its sister species and the only other Colobus monkey with all-black coats, the researchers said. Characteristics of its teeth and skull also differ from those of Colobus satanas, according to the study.

The researchers also compared Likweli vocalizations with those of other Colobus species. They found that its roars are similar to vocalizations of its sister species (Colobus satanas) in some ways but differ in sequence and frequency, among other aspects. 

Based on a genetic analysis, the researchers estimated that the most recent common ancestor of Colobus congoensis and Colobus satanas existed between about 4.7 and 5.8 million years ago, which represents the deepest split in lineages among Colobus monkeys, further suggesting that Likweli is a distinct species. 

The researchers note that the new species and its sister species, though very similar, inhabit ranges that are at least 1,200 kilometers apart, with the latter living to the west of the former.

Based on Likweli’s limited range and small population, coupled with the effects of increased hunting and human encroachment on the monkeys’ habitat, the researchers recommend that the species be designated as endangered.

“This is a rare discovery with significant conservation implications,” said Sargis, a curator of mammalogy and vertebrate paleontology at the Yale Peabody Museum and director of the Yale Institute for Biospheric Studies. “Our analyses provide strong evidence that this is a distinct new species that is endangered.

“Documenting new primate species like Likweli and Lesula illustrates the incredible biodiversity in this region and points to the importance of Lomami National Park and other conservation efforts in protecting that diversity.”

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Journal

PLOS One

Article Publication Date

15-Jul-2026

AI disagreement may shake patient trust in doctors

Penn State

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UNIVERSITY PARK, Pa. — Patient trust in medical professionals might hinge on what artificial intelligence (AI) has to say, according to a team led by Penn State researchers.

Using an AI chatbot roleplaying as a human doctor, the team identified how people perceive medical professionals when they think a “human” doctor consults an AI system for a second opinion during mental health consultations. They found that when the AI system agreed with the proxy doctor’s recommendation, patients viewed the professional’s assessment as more credible. But when the AI disagreed with the doctor’s assessment, patient perceptions of medical uncertainty and doctor laziness increased.

The researchers reported their findings in the June/July issue of the International Journal of Human-Computer Studies.

“Historically, when a doctor told a patient that they’re welcome to get a second opinion, they meant ‘go to another doctor’,” said S. Shyam Sundar, Evan Pugh University Professor and the James P. Jimirro Professor of Media Effects at Penn State. “But now in the same session, physicians can use an AI assistant to give a second opinion. We wondered how that might affect patients’ impressions of doctors. We found that perceptions of doctor credibility and medical certainty increase or decrease based on whether the AI assistant agrees or disagrees with the doctor’s diagnosis.”

Recruiting a team of human doctors to give tens or hundreds of patients a consistent experience in terms of clinical practice, communication style and interaction patterns in a controlled experimental setting is impractical, according to the researchers. So, they developed an AI-powered chatbot that could personalize conversations with patients, and gave it instructions to roleplay as a doctor named Dr. Alex.

Then the researchers recruited 135 adults in the United States and offered them an online therapy session with Dr. Alex to identify and discuss daily life stressors. Dr. Alex provided a brief mental health therapy session using the cognitive behavioral therapy (CBT) approach and concluded that CBT is a suitable approach for the patient. Dr. Alex also offered participants the option to get a second opinion from an AI assistant, CareBot. The assistant either agreed or disagreed with Dr. Alex’s recommendation.

After the session, participants answered questions about the doctor’s recommendation, their perceptions and trust in the doctor.

The research team found that agreement between Dr. Alex and the AI chatbot boosted patient confidence in the doctor’s recommendation. Disagreement had the opposite effect, increasing perceptions of medical uncertainty and doctor laziness. Anthropomorphism, or how human-like the AI-powered doctor seemed, also played a role in the observed outcomes. The positive effects of AI agreement and the negative effects of AI disagreement occur only when the doctor was perceived as more human-like.

The findings have important implications for services like telehealth and app-based and other online medical consultations, the researchers said.

“More than half of the participants in our study perceived the AI-simulated doctor as being human-like, demonstrating the capabilities of AI to replicate the professional behaviors of human doctors, at least from a conversational aspect,” said first author Cheng “Chris” Chen, assistant professor of emerging media and technology at Oregon State University who received her doctoral degree from Penn State. “This can bring challenges to doctors who provide online services where their true identity is not visible or clearly communicated. Patients may perceive AI as human or human as AI.”

The effect of AI disagreement on medical uncertainty was especially strong for individuals who believe that machines like AI are more accurate, objective and precise than humans, the researchers noted. These findings suggest that AI can have tremendous authority in planting seeds of doubt in patients’ minds, Sundar said.

The team also suggested strategies for communicating AI disagreement in ways that do not undermine patient trust in their physicians.

“A doctor can still communicate AI disagreement in implicit ways, like saying one of the tools they’re using has highlighted a few points that may be worth exploring a bit more closely, and offering to explore them together,” Chen said.

Explaining potential reasons for AI disagreement can help to reduce medical uncertainty and perceived laziness, Sundar added.

“Calling extra attention to the fact that there’s disagreement and showing that they’re on top of it can reduce the perception of laziness,” he said. “Then if the doctor can lend more nuance into why the medical uncertainty happened — like if the AI system is using data coming from a mostly white, Western sample, and the patient is non-Western, so the results might not apply to them — will communicate the doctor’s activeness.”

Other study co-authors include Yuan Sun, University of Florida, Gainesville; and Mengqi Liao, University of Georgia, who both received their doctoral degrees at Penn State.

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Journal

International Journal of Human-Computer Studies

DOI

10.1016/j.ijhcs.2026.103824 

Article Title

When AI Disagrees: The Effect of Second Opinion on Patients' Trust in Doctors

Boston University-led opinion piece highlights the need for public health leadership to build trustworthy AI in health

To realize AI’s promise for health, public health must help shape its future

Boston University

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From disease surveillance to clinical care, artificial intelligence is transforming health. As AI becomes more deeply embedded in decisions affecting population health, a new editorial argues that realizing AI’s full potential requires public health leadership alongside technical innovation.

Dr. Debbie Cheng, assistant dean of data science at Boston University School of Public Health, and lead author of a new peer-reviewed opinion piece published in American Journal of Public Health makes the case that public health leadership is essential to building trustworthy AI in health. Dr. Sandro Galea, dean of the Bursky School of Public Health at Washington University in St. Louis, and Dr. Madhu Mazumdar, director of the Institute for Healthcare Delivery Science at the Mount Sinai Health System in New York City, coauthored the article. 

"Public health is a field that has spent decades developing methods to evaluate interventions, monitor impacts, and address inequities," says Cheng, who is also a BU professor of biostatistics and a Hariri Institute Core Faculty member. "Those strengths are highly relevant to AI. It has enormous potential to improve population health, and the greatest opportunity comes when public health expertise helps shape it from the outset."

The editorial asserts that AI should be viewed not only as a technological innovation, but also as a public health opportunity. While AI developers have driven rapid advances, public health brings complementary expertise in understanding how innovations perform in real-world settings, affect different populations, and evolve over time. That perspective broadens how AI should be assessed, looking beyond technical performance to consider trustworthiness, equity, transparency, and population health impact.

The authors highlight examples showing why technical performance alone is not enough. Some AI systems used in dermatology have been shown to perform less accurately on darker skin tones, while other algorithms have underestimated illness severity among lower-income patients because they relied on healthcare costs as a proxy for medical need. Together, these examples illustrate why public health expertise is essential to ensuring AI systems are trustworthy, equitable, and effective across diverse populations.

Beyond evaluating outcomes, Cheng says one of public health's most important contributions is asking critical questions early in the development process: Who benefits? Who might be left behind? What unintended consequences could emerge? Considering these kinds of questions up front, she says, can help ensure AI technologies improve health for everyone.

Cheng is already helping put those principles into practice at Boston University. As founding executive director of the Center for Health Data Science and director of strategy and partnerships for BU's AI Development Accelerator (AIDA), she works with members across the University community to support the responsible integration and adoption of AI in research, education, and administration.

"One of the things I value most about AIDA is the opportunity to bring a public health perspective into conversations about how AI is being adopted across the university," she says. “The best solutions emerge when people from different disciplines learn from one another.”

Looking ahead, Cheng hopes the editorial will encourage greater collaboration among public health researchers, clinicians, educators, and AI developers. One way to achieve that, she says, is by building communities of practice where experts from different disciplines can learn from one another and develop thoughtful approaches to integrating AI into their own work.

More broadly, the authors argue that realizing AI's promise for improving population health will require public health expertise to be embedded throughout the AI lifecycle — from development and implementation to evaluation and long-term governance.

"The future of AI in health will be strongest when technical innovation and public health leadership advance together," Cheng says. 

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Journal

American Journal of Public Health

DOI

10.2105/AJPH.2026.308559 

Method of Research

Commentary/editorial

Subject of Research

Not applicable

Article Title

Trustworthy Artificial Intelligence in Health Requires Public Health Leadership

Article Publication Date

12-Jul-2026

AI helps nurses stay one step ahead in chronic disease care, new review finds

A comprehensive review finds AI-powered nursing tools improve prediction of health risks and reduce unnecessary hospital use, while more research is needed on patients’ emotional well-being

JMIR Publications

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A comprehensive review finds AI-powered nursing tools improve prediction of health risks and reduce unnecessary hospital use, while more research is needed on patients’ emotional well-being.

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Credit: JMIR Publications

(Toronto, July 16, 2026) Artificial intelligence (AI) is helping nurses better predict health problems before they become emergencies, according to a new review of existing research published in JMIR Nursing. The study found that AI-based nursing interventions can improve the care of people living with chronic illnesses by identifying patients at greater risk of complications, reducing unplanned hospital visits, and potentially lowering health care costs.

The review, “Effectiveness of Artificial Intelligence–Based Nursing Interventions for Chronic Illness Care: Umbrella Review,” published by JMIR Publications, examined the evidence from eight high-quality systematic reviews. 

Lead author Jee Young Joo and colleagues found consistent evidence that AI can support nurses in making more informed, proactive decisions, particularly when caring for people with long-term conditions such as heart disease and diabetes.

Rather than replacing nurses, the findings suggest AI can serve as a clinical decision support tool by analyzing large amounts of patient information to identify warning signs that might otherwise be missed. Across the studies reviewed, machine learning was the most commonly used form of AI.

However, the authors note that there is not yet enough evidence to determine whether AI-based nursing interventions improve patients’ psychological or emotional well-being, highlighting an important gap for future research.

As health care systems face growing numbers of people living with chronic diseases, AI has the potential to become an important part of routine nursing practice. These findings provide guidance for health care leaders and educators looking to integrate AI into nursing care and training.

Original Article: 

Joo J, Liu M, Cho Y, Cho H. Effectiveness of Artificial Intelligence–Based Nursing Interventions for Chronic Illness Care: Umbrella Review. JMIR Nursing 2026;9:e97905
URL: https://nursing.jmir.org/2026/1/e97905
DOI: 10.2196/97905

About JMIR Publications

JMIR Publications is a leading independent open access publisher of digital health research and a champion of open science. With a focus on author advocacy and research amplification, JMIR Publications partners with researchers to advance their careers and maximize the impact of their work. As a technology organization with publishing at its core, we provide innovative tools and resources that go beyond traditional publishing, supporting researchers at every step of the dissemination process. Our portfolio features a range of peer-reviewed journals, including the renowned Journal of Medical Internet Research.

To learn more about JMIR Publications, please visit jmirpublications.com or connect with us via X, LinkedIn, YouTube, Facebook, and Instagram.

Head office: 130 Queens Quay East, Unit 1100, Toronto, ON, M5A 0P6 Canada

Media contact: communications@jmir.org

The content of this communication is licensed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, published by JMIR Publications, is properly cited.

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Journal

JMIR Nursing

DOI

10.2196/97905 

Method of Research

Systematic review

Subject of Research

People

Article Title

Effectiveness of Artificial Intelligence–Based Nursing Interventions for Chronic Illness Care: Umbrella Review

Article Publication Date

15-Jul-2026

Virtual–physical scenario simulation improves nursing students’ learning immersion in home visit training, but skill effects need further study

Virtual-reality simulation boosts immersion, but skill gains remain limited

Society of China University Journals

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Home visits are a core part of community nursing. For nursing students, they are not simply a checklist of health assessments. A home visit asks students to observe the family environment, recognize safety risks, communicate with patients and relatives, and turn classroom knowledge into practical care decisions.

Yet such situations are hard to recreate in a classroom. A real home may be cluttered. An older adult may hesitate, question the visitor, become impatient, or respond in unexpected ways. Traditional role-play can help students rehearse the process, but scripted scenarios may not fully capture the uncertainty of entering someone’s home as a nurse.

A study published in the Chinese Journal of Medical Education Research explored whether a virtual–physical integrated scenario simulation could bring students closer to that reality. Researchers from Peking Union Medical College School of Nursing, Beijing Xicheng District Desheng Community Health Center, and Beijing Fengtai District Fangzhuang Community Health Center tested the approach in undergraduate nursing education. They found that the new simulation model increased students’ learning immersion compared with conventional scenario simulation. However, the study did not show a clear short-term advantage in improving students’ home visit attitudes or skills.

The study involved 143 third-year undergraduate nursing students enrolled in 2022 and was conducted from March to April 2025. Students were assigned to either a virtual–physical integrated simulation group or a conventional simulation group. Both groups received the same theoretical teaching on home visits, followed by three hours of experimental teaching. A total of 128 students completed both pre- and post-teaching questionnaires, and 24 students from the virtual–physical group took part in semi-structured interviews.

The teaching task was the same for both groups. Students practiced preparing for a home visit, conducting inquiry and physical assessment, measuring rapid blood glucose, providing health education, and completing post-visit summary, feedback, and documentation. The difference lay in how the scenario was built.

In the conventional group, students worked in a standard laboratory, with classmates role-playing the home visit recipient and family member according to a prepared script. In the virtual–physical group, students trained in a smart eldercare laboratory. The setting combined multimedia equipment, LED displays, physical models, and a wireless smart elderly nursing simulation system. An intelligent simulator played the role of the older adult, while a student played the family member. The system supported AI-assisted inquiry, blood pressure and glucose measurement, and transitions between a community health center and a simulated home environment.

The main quantitative finding was about immersion. Students in the virtual–physical group had a higher total learning immersion score than those in the conventional group: 72.42±8.19 versus 69.44±8.41. The virtual–physical group also scored higher in emotional buy-in and learning experience. These results suggest that the integrated simulation helped students feel more engaged with the learning task.

The interviews help explain why. Many students said the intelligent simulator made the scenario feel more realistic. It could respond to questions, show impatience, ask follow-up questions, or display emotional changes. Some students felt that this made the interaction less predictable than a classmate reading from a script. Others said the simulated home environment, including details such as scattered objects or potential safety hazards, prompted them to observe the surroundings more carefully.

Students also described the experience as more challenging. In conventional role-play, classmates may unintentionally guide or remind each other. In the virtual–physical setting, the simulator had its own response logic. That forced students to listen, adapt, and solve problems more actively. For a teaching activity designed to prepare students for real home visits, this kind of uncertainty may be educationally valuable.

But the same study also cautions against assuming that a more immersive experience automatically produces stronger skills. After teaching, the conventional group showed a small improvement in home visit skill scores compared with before teaching. However, there was no significant difference between the two groups in post-teaching home visit skill scores. The virtual–physical group scored 60.60±6.85, while the conventional group scored 60.89±6.62. The total home visit attitude-skill scores and related dimensions also did not show a clear advantage for the virtual–physical group.

The authors suggest several possible explanations. Home visit skills require repeated practice and feedback. In this study, the experimental teaching lasted only three hours, which may not have been enough time for measurable skill gains to emerge. Students in the virtual–physical group also had to learn how to interact with the smart simulation system. Its novelty and complexity may have drawn some attention away from the core home visit skills being practiced.

Technical limitations also affected the experience. In interviews, students reported delays in system responses, imperfect speech recognition, the need to press buttons during interaction, and occasional breakdowns in conversational flow. Some students felt that conventional role-play, despite being less technologically advanced, allowed more natural and warmer human interaction. The study therefore shows both promise and friction: smart simulation can make training more realistic, but the technology still needs to become smoother and easier to use.

This distinction matters for nursing education. Technology should not be adopted simply because it is new or visually impressive. In home visit teaching, the goal is to help students build observation, communication, assessment, and decision-making abilities. Virtual–physical simulation may support those goals by creating richer and less predictable scenarios, but it requires careful instructional design. Teachers need to keep the learning objectives clear, guide students’ attention to core skills, and provide timely feedback after the simulation.

The study’s findings should also be interpreted with caution. The sample came from a single institution and was relatively small. The home visit attitude-skill questionnaire was designed by the research team and requires further validation. The novelty of the simulation technology may also have influenced students’ learning experience, creating a possible Hawthorne effect. The authors call for larger, multicenter studies using standardized tools and allowing students time to become familiar with the technology before its educational effects are evaluated.

Even with these limits, the study offers a useful lesson for digital transformation in nursing education. Smart simulation can help students feel more present in a home visit scenario. It can expose them to messier communication and environmental details than conventional role-play may provide. But immersion is only the beginning. The next question is how to turn that engagement into durable nursing competence.

Article information：

Article Title: 虚实结合情景模拟在家庭访视教学中的应用效果研究

English Title: Study on the application effects of virtual-reality integrated scenario simulation in home visit teaching

Journal: Chinese Journal of Medical Education Research

DOI: 10.3760/cma.j.cn116021-20251129-02253

Authors: Li Xiaoxue, Zhang Zheng, Wang Lingyun, Wang Li, Guo Aimin

Chinese Journal of Medical Education Research is a monthly peer-reviewed journal sponsored by the Chinese Medical Association and hosted by Chongqing Medical University, under the supervision of the China Association for Science and Technology.
Launched in 2002, the journal publishes research and practice-oriented studies on medical education, with a focus on teaching reform, clinical teaching, curriculum development, residency training, graduate education, nursing education, educational technology, and international medical education. It also features themed columns and special issues on emerging topics and institutional innovations in medical education.
The journal is recognized as a Source Journal for Chinese Scientific and Technical Papers and Citations and is included in the Chinese Science and Technology Core Journals. It is indexed in Wanfang Data, Index Copernicus, the WHO Western Pacific Region Index Medicus, and Ulrich’s Periodicals Directory.

Journal page: http://yxjyts.alljournals.ac.cn/homeNav?lang=zh

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DOI

10.3760/cma.j.cn116021-20251129-02253 

Method of Research

Case study

Subject of Research

People

Article Title

Study on the application effects of virtual-reality integrated scenario simulation in home visit teaching