The Mediating Role of AI Ethics Awareness Between AI Attitudes and AI Utilization: A Multisite Cross-Sectional Study...

To investigate the mediating role of nursing students' artificial intelligence (AI) ethics awareness between the association of attitudes toward AI technology and perceived AI utilization.

A paucity of studies exists about the role of AI ethics awareness between attitudes toward AI technology and perceived AI utilization, particularly among nursing students.

A multisite cross-sectional, correlational research participated by nursing students (n = 765) that were consecutively recruited from four nursing colleges (two private and two public owned) in Saudi Arabia. Three standardized self-report scales were utilized to collect data, and covariance-based structural equation modeling, using maximum likelihood estimation and bias-corrected bootstrap method, and mediation analyses were employed for data analyses.

The mean age of participants was 23.98 years old (SD = 4.40), and majority were females (78.90%), were second year students (33.85%), and had a mean grade point average of 4.16 (SD = 0.65). AI technology attitudes were positively associated with AI ethics awareness (β = 0.84, p = 0.001, and 95% CI = 0.76-0.94) and AI utilization (β = 0.55, p = 0.010, and 95% CI = 0.13-0.97). AI ethics awareness was positively associated with AI utilization (β = 0.41, p = 0.043, and95% CI = 0.01-0.84). Mediation analysis showed that AI technology attitudes were indirectly associated with AI utilization (β = 0.36, p = 0.013, and 95% CI = 0.05-0.68) via the mediation of AI ethics awareness. AI technology attitudes measured 72.05% of the R² of AI ethics awareness, while both AI ethics awareness and AI technology attitudes measured 87.94% of the R² of AI utilization.

Nursing students' AI technology attitudes and AI ethics awareness were positively associated with AI utilization, whereas AI ethics mediated between AI technology attitudes and AI utilization. Policymakers, nursing educational institutions, and educators could integrate AI ethics into nursing curricula to cultivate positive AI attitudes and responsible AI usage, preparing future nurses for an AI-integrated healthcare environment.

Nurse administrators in the nursing educational institutions and nurse managers in affiliated clinical training centers should provide a conducive learning environment (i.e., adequate resources, teaching/learning materials, and AI-trained staff) where students can learn AI-integrated technologies through practical or simulated activities.