Artificial intelligence literacy among Chinese junior college nursing students: A self-determination theory–based structural equation modeling study

Abstract

<title>Abstract</title> Background Artificial intelligence (AI) is rapidly transforming nursing education and clinical practice. However, AI literacy (AIL) among nursing students, particularly in China, remains underexplored, and little is known about how educational and psychological factors jointly shape AIL. Objective Guided by self-determination theory, this study examined how the learning environment, self-directed learning ability, self-efficacy and intrinsic learning motivation are associated with AIL among Chinese junior college nursing students. Design: Multi-centre cross-sectional survey. Methods An online questionnaire survey was administered to nursing students from six junior colleges in Anhui Province, China, between October and December 2024. AIL was assessed using the AI Literacy Ability Measurement Scale, and the learning environment, self-directed learning ability, self-efficacy and intrinsic learning motivation were measured with validated Chinese scales. Data were analysed using descriptive statistics, correlation analysis and structural equation modelling with bootstrapping. Results A total of 1,563 questionnaires were analysed (response rate 97.8%). The mean AIL score was 120.0 ± 25.64, indicating a moderately high level. Students scored lower on AI skills than on ethical awareness. AIL showed significant positive correlations with the learning environment (r = 0.663, p &lt; 0.001), self-directed learning ability (r = 0.683, p &lt; 0.001), self-efficacy (r = 0.517, p &lt; 0.001) and intrinsic learning motivation (r = 0.592, p &lt; 0.001). The final structural equation model demonstrated acceptable fit. The learning environment (β = 0.355, p &lt; 0.001) and self-directed learning ability (β = 0.288, p = 0.001) had significant direct effects on AIL and small but significant indirect effects via intrinsic learning motivation. Self-efficacy was associated with AIL indirectly through intrinsic learning motivation (indirect β = 0.052, p = 0.001), whereas its direct path was not significant (β = 0.032, p = 0.303). Conclusions AIL among Chinese junior college nursing students was at a moderately high level, with practical AI skills lagging behind ethical awareness. A supportive learning environment and strong self-directed learning ability were key correlates of AIL, partly through enhancing intrinsic learning motivation. Educational interventions should improve the learning environment, foster students' self-directed learning abilities and cultivate intrinsic motivation to promote AIL in nursing education.

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