Effects of an AI-enhanced BOPPPS teaching model in nursing courses: a meta-analysis of randomized controlled trials

Aim To evaluate the effectiveness of an artificial intelligence (AI)–enhanced BOPPPS teaching model in nursing courses, with a focus on academic performance, self-directed learning ability, and teaching satisfaction. Design Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in accordance with PRISMA and registered in INPLASY (INPLASY202590123). Methods Chinese- and English-language databases were searched for eligible RCTs comparing AI-enhanced BOPPPS with traditional teaching (or BOPPPS alone). Data extraction and risk-of-bias assessment followed Cochrane guidance. Pooled analyses were performed using standardized mean difference (SMD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes, with heterogeneity assessed using I 2 . Results Four RCTs involving 459 nursing students were included. Academic performance showed a significant improvement in the AI-enhanced BOPPPS group (SMD = 1.06, 95% CI 0.63–1.48; p 0.05), with substantial heterogeneity. With substantial heterogeneity. Self-directed learning ability (3 studies; “excellent” category) was significantly improved in the AI-enhanced BOPPPS group (RR = 3.28, 95% CI 2.14–5.02; p 0.001) with no heterogeneity. Teaching satisfaction was also significantly higher with AI-enhanced BOPPPS (RR = 1.80, 95% CI 1.27–2.55; p 0.001), with low-to-moderate heterogeneity. Conclusion AI-enhanced BOPPPS teaching demonstrates consistent benefits in improving nursing students’ academic performance, self-directed learning ability and teaching satisfaction, these findings support the potential value of integrating AI into structured instructional design to enhance learning processes and student experience in nursing education. Systematic review registration https://inplasy.com/inplasy-2026-2-0026/ , Identifier: INPLASY202620026.