Understanding surgeon adoption of artificial intelligence surgical technology: integrating UTAUT-TOE model

Artificial intelligence (AI) has become a transformative technology in surgical practice, revolutionizing modern healthcare and offering advancements in precision, efficiency, and patient outcomes. Despite its potential, the integration of AI technologies into surgical practice raises important professional and organizational barriers, as well as ethical concerns that must be addressed to ensure successful and morally sound integration. This research employs mixed-methods of 19 qualitative in-depth interviews with surgeons and hospital administrators, and a quantitative survey of 224 healthcare professionals across surgical specialties to investigate the acceptance of AI-enhanced surgical systems (AISS). The insights from study 1 informed the subsequent quantitative investigation in study 2, which adopts a dual-lens framework integrating the unified theory of acceptance and use of technology (UTAUT) and the technology-organization-environment (TOE). This novel approach enables examination of acceptance factors across individual and organizational levels. The findings from study 1 revealed three key themes shaping AISS acceptance, including performance, organizational, and environmental factors. Study 2 confirmed positive associations between attitude toward AISS and eight factors: performance expectancy, effort expectancy, relative advantage, compatibility, facilitating conditions, management support, social influence, and competitive pressure. Relative advantage emerged as the strongest predictor. Conversely, firm size and government pressure had significant negative effects. This research emphasizes the interdependence of individual and organizational factors influencing acceptance of AI in healthcare. It offers a roadmap for stakeholders to navigate technological integration, aligning with the objectives of the Healthy China 2030 initiative and Sustainable Development Goal 3 (SDG3): good health and well-being.