Knowledge, attitudes, practices, and perceived barriers regarding artificial intelligence among undergraduate nursing students in Somalia: A cross-sectional study

Artificial intelligence (AI) is shaping healthcare delivery and nursing education, but evidence on AI readiness among nursing students in low-resource settings remains limited. Understanding students' knowledge, attitudes, practices, and perceived barriers is important for planning safe, ethical, and context-sensitive integration of AI into nursing curricula.

This study assessed knowledge, attitudes, practices, and perceived barriers regarding AI among undergraduate nursing students at SIMAD University, Somalia.

A descriptive cross-sectional study was conducted among 87 undergraduate nursing students between April and May 2026. Total population sampling was used to invite eligible students. Data were collected using a structured, self-administered questionnaire adapted from a validated instrument and analyzed using IBM SPSS Statistics, version 20. Internal consistency was strong, with Cronbach's alpha values of 0.82 for knowledge and exposure, 0.87 for attitude, and 0.95 for practice. Descriptive statistics summarized the data, while Mann-Whitney U and Kruskal-Wallis tests examined score differences across selected characteristics.

Most participants were female (83, 95.4%), and 31 (35.6%) were fourth-year students. Although 57 students (65.5%) were aware of healthcare applications of AI, deeper understanding was limited. Only 34 (39.1%) reported knowledge of basic AI concepts, and 22 (25.3%) understood machine learning and deep learning. Students held positive attitudes, with the strongest agreement concerning the need to understand ethical implications (mean 4.27, SD 0.68). AI was used mainly for research (mean 3.44, SD 0.88), idea generation, and assignments. Knowledge, attitude, and practice scores were significantly higher among students with previous AI-tool use and formal AI training.

Nursing students were receptive to AI and already used it academically, but formal preparation and technical knowledge remained limited. Structured AI literacy, ethical guidance, faculty development, and curriculum support are needed to promote responsible AI use in nursing education and digital health practice in Somalia and comparable low-resource settings.