When Machines Decide: Exploring How Trust in AI Shapes the Relationship Between Clinical Decision Support Systems and...

Area of Science:

• Clinical Informatics
• Nursing Science
• Artificial Intelligence in Healthcare

Background:

• Artificial intelligence (AI)-based Clinical Decision Support Systems (AI-CDSS) are increasingly used in intensive care units (ICUs) to aid nurses in critical decision-making.
• While AI-CDSS aim to improve accuracy and patient outcomes, concerns exist regarding potential emotional consequences for nurses, such as decision regret.
• Trust in AI is hypothesized to influence nurses' emotional responses and acceptance of AI-guided decisions.

Purpose of the Study:

• To investigate the relationship between nurses' reliance on AI-CDSS, their experience of decision regret, and their level of trust in AI.
• To specifically examine the moderating role of trust in AI within the association between AI-CDSS reliance and decision regret.

Main Methods:

• A cross-sectional correlational study was conducted with 250 intensive care unit (ICU) nurses.
• Validated instruments, including the Healthcare Systems Usability Scale (HSUS), Decision Regret Scale (DRS), and Trust in AI Scale, were administered.
• Statistical analyses included descriptive statistics, Pearson's correlations, multiple linear regression, and moderation analysis.

Main Results:

• Nurses reported moderate levels of AI-CDSS reliance, decision regret, and trust in AI.
• AI-CDSS reliance showed a significant negative correlation with decision regret (r = -0.42, p < 0.01) and a positive correlation with trust in AI (r = 0.51, p < 0.01).
• Both AI-CDSS reliance (β = -0.36) and trust in AI (β = -0.24) were significant predictors of reduced decision regret (R² = 0.27, p < 0.001), with trust moderating this relationship.

Conclusions:

• Higher reliance on AI-CDSS is associated with decreased decision regret among ICU nurses, especially when trust in AI is high.
• Trust in AI plays a crucial role in enhancing nurses' emotional acceptance of AI tools and facilitating their effective integration into clinical practice.
• Developing and fostering trust in AI-CDSS is essential for mitigating the emotional impact on nurses and optimizing decision-making processes in critical care settings.