Ethical awareness and attitudes toward artificial intelligence among undergraduate nursing students in Palestine: A...

Artificial intelligence is influencing healthcare delivery and nursing education; however, its responsible use requires awareness of privacy, accountability, patient safety, and human-centered communication. Evidence concerning ethical awareness among Palestinian undergraduate nursing students remains limited.

To assess ethical awareness and attitudes toward artificial intelligence among undergraduate nursing students in Palestine and identify factors associated with high ethical awareness.

A descriptive, analytical cross-sectional study was conducted among 276 undergraduate nursing students at Palestine Polytechnic University, Hebron, Palestine, during March and April 2025. Participants completed an anonymous self-administered questionnaire assessing sociodemographic characteristics, attitudes toward artificial intelligence, and ethical awareness. Ethical awareness was assessed using eight dichotomous items addressing ethical, legal, professional, and relational concerns. Descriptive statistics, independent-samples t tests, one-way analysis of variance, Pearson correlation, and binary logistic regression were applied.

Students demonstrated favorable views regarding the contribution of artificial intelligence to chronic disease management (87.4%), preventive healthcare (78.3%), and patient safety (73.4%). Nevertheless, ethical concerns were evident: 77.1% indicated that artificial intelligence could weaken provider-patient communication, 76.3% considered current legal regulation insufficient, and 66.2% recognized risks of reliance on artificial intelligence over human expertise. Female students reported higher ethical awareness than male students (4.08 ± 1.17 vs. 3.61 ± 1.26; p = .003), and ethical awareness differed by academic year (p = .006). Ethical awareness was positively correlated with attitudes toward artificial intelligence (r = .32, p < .001). Female gender, academic year, and favorable attitudes predicted high ethical awareness, whereas age was not significant.

Palestinian undergraduate nursing students expressed favorable attitudes toward artificial intelligence while recognizing ethical and professional risks. Integrating ethically grounded artificial intelligence education into nursing curricula may support safe, accountable, and patient-centered technology use.