Inclusive Leadership, Psychological Safety, AI Readiness, and Nurses' AI Literacy: A Longitudinal Study

To investigate the relationship between inclusive leadership and artificial intelligence (AI) literacy among nurses, with a specific emphasis on whether psychological safety and AI readiness mediate this relationship sequentially.

A longitudinal study was conducted between September 2025 and March 2026 with the use of a three-wave survey on 1334 clinical nurses. The selected hospitals were stratified by cluster random sampling at 10 tertiary hospitals in China. In T1, the level of inclusive leadership was measured, and in T2, the psychological safety as well as AI readiness was also tested. At T3, the AI literacy was assessed based on the tools that had been validated before. SPSS 25.0 and PROCESS 4.1 were used to test mediating effects.

All the important factors were positively correlated. The study also did not have any direct correlation between AI literacy and inclusive leadership. Nevertheless, it was passed through a number of indirect ways. The psychological safety (indirect effect = 0.258, 95% confidence interval [CI] [0.205, 0.315]) and the AI readiness (indirect effect = 0.082, 95% CI [0.051, 0.115]) were significant mediators in the relationship. Also, a sequential path was indicated by the data: as more inclusive leaders were observed to be, the more psychologically safe they became, which would then result in increased AI readiness, and finally, this resulted in AI literacy among nurses (indirect effect = 0.049, 95% CI [0.030, 0.070]).

The psychological safety and the AI readiness are two of the factors that can be used to explain why inclusive leadership is associated with the AI literacy among nurses. Our findings reveal that our study does not directly affect the AI literacy, but it affects how the nurse feels about the interpersonal relationship in the workplace as well as her ability to cope with the demands of the AI technology. That is, the impact of the inclusive leadership on the AI literacy of the nurses will be clearer when the nurses are psychologically safe and prepared to use the AI.

Our results can be used to determine that leadership behavior is a very important part of the organization, and it should provide open communication and learning in the workplace. The development of AI literacy will occur when the managers in the nursing field are able to establish psychological safety and enable nurses to have an increased level of confidence in the use of new technologies. These outcomes can also be enhanced through organizational initiatives like the education and skill building programs on AI.