The effects of artificial intelligence ethics awareness, digital literacy, and metacognition on nursing students’ attitudes toward artificial intelligence

Abstract

Artificial intelligence (AI) is rapidly transforming healthcare, raising new ethical challenges related to patient rights, transparency, and fairness. Nursing students must therefore develop competencies not only in digital and cognitive skills but also in AI ethics awareness to ensure responsible adoption of these technologies. A descriptive correlational study was conducted with 121 nursing students in South Korea. Validated instruments measured AI ethics awareness, digital literacy, metacognition, and attitudes toward AI. Data were analyzed using t-tests, ANOVA, Pearson’s correlation, and multiple regression. AI ethics awareness (β = 0.30, p < .001) and digital literacy (β = 0.38, p < .001) were significant predictors of attitudes toward AI, jointly explaining 31.8% of the variance. Higher levels of ethical awareness and digital competence were associated with more positive perceptions of AI. The findings highlight the ethical and educational importance of preparing healthcare professionals to navigate AI responsibly. Embedding ethical principles such as autonomy, justice, and accountability into nursing and healthcare curricula, as well as into institutional and national standards, will be crucial for protecting patient rights and promoting fairness in AI-driven healthcare.

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