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Measuring AI literacy in medical students: scale development and validation within a self-determination theory
Hung-Che Lin1,2, Chin-Sheng Lin3,4, Ching Sing Chai5
1Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan; Department of Otolaryngology, School of Medicine, College of Medicine, National Defense Medical University, Taipei, Taiwan.
Medical Education Online
|May 22, 2026
Summary
This study developed and validated the AI Literacy Scale for Medical Students (ALSMS) using self-determination theory (SDT). The scale measures AI literacy, crucial for healthcare professionals, and offers a framework for curriculum development.
Area of Science:
- Medical Education
- Artificial Intelligence in Healthcare
- Psychometrics
Background:
- Artificial intelligence (AI) integration in healthcare necessitates AI literacy for medical students.
- Existing AI literacy assessments lack validation and theoretical grounding in medical education.
- This study addresses the need for a validated AI literacy assessment within a theoretical framework.
Purpose of the Study:
- To develop and validate the AI Literacy Scale for Medical Students (ALSMS).
- To ground the assessment within the framework of Self-Determination Theory (SDT).
- To provide a psychometrically sound measure of AI literacy for medical trainees.
Main Methods:
- A split-sample validation design with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).
- Candidate facets were derived from existing instruments and organized according to SDT.
- EFA refined the first-order structure, and CFA validated the structure and compared models.
Main Results:
- EFA identified nine factors across SDT domains: competence, relatedness, and autonomy.
- CFA supported a correlated nine-factor structure with strong psychometric properties.
- Two theory-consistent models were identified, including one where ethics loaded on autonomy.
Conclusions:
- The ALSMS provides validity evidence for assessing medical students' AI literacy within an SDT framework.
- Findings emphasize integrating ethics into autonomy-supportive curricula.
- The ALSMS is potentially useful for curriculum design, advising, and evaluating AI literacy initiatives.
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