Knowledge, attitudes, and practices toward AI technology (ChatGPT) among nursing students at Palestinian universities

52.6% of students cited lack of interest as a main factor contributing to the decrease in AI practices in Palestine.

“A lack of appropriate training (56.2%) and a lack of interest (52.6%) were the main factors contributing to the decrease in AI practices in Palestine”

48.3% of students agreed that AI would be a burden.

“With respect to whether AI would be a burden, the students were largely divided, with 48.3% agreeing”

24.3% of students recognized providing medication reminders as a potential use of ChatGPT in patient care.

“Providing medication reminders | 74 | 24.3”

30.6% of students had received training or education related to ChatGPT.

“Yes | 93 | 30.6”

27.6% of students were very familiar with ChatGPT.

“Very familiar | 84 | 27.6”

56.2% of students cited lack of appropriate training as a main factor contributing to the decrease in AI practices in Palestine.

“A lack of appropriate training (56.2%) and a lack of interest (52.6%) were the main factors contributing to the decrease in AI practices in Palestine”

53.3% of respondents were aware of AI's uses in the medical field.

“While somewhat more than half of the respondents (53.3%) were aware of AI's uses in the medical field”

69.4% of students had no formal education or training related to ChatGPT.

“No | 211 | 69.4”

13.8% of students disagreed that AI was crucial to the medical field.

“The small minority (13.8%) of them who disagreed”

23.4% of students were not at all familiar with ChatGPT.

“Not at all familiar | 71 | 23.4”

51.7% of respondents agreed that AI might replace healthcare providers.

“AI might replace healthcare providers, according to 51.7% of respondents”

49.7% of students said they had not learned about AI in college.

“nearly half (49.7%) said they had not.”

82.9% of students felt that AI was crucial to the medical field.

“The majority of the students (82.9%) felt that AI was crucial to the medical field.”

46.7% of respondents did not know about AI's uses in the medical field.

“a percentage (46.7%) did not.”

84.5% of nursing students at Palestinian universities knew what AI was.

“A total of 84.5% of the participants knew what AI was.”

41.8% of students said they had learned about AI in college.

“Fewer than half of the students (41.8%) said they had learned about AI in college”

49.0% of students were somewhat familiar with ChatGPT.

“Somewhat familiar | 149 | 49.0”

21.4% of students disagreed that AI helps with disease severity assessment and early diagnosis.

“A total of 21.4% disagreed”

72.3% of students agreed that AI helps with disease severity assessment and early diagnosis.

“The majority (72.3%) agreed that AI helps with disease severity assessment and early diagnosis.”

15.1% of students recognized offering emotional support as a potential use of ChatGPT in patient care.

“Offering emotional support | 46 | 15.1”

79% of students were in favor of AI being included in nursing and specialized training programs.

“The majority of the students (79%) were in favor of AI being included in nursing and specialized training programs.”

• Also stated in: § Results · plain

  “79% supported the integration of AI into nursing curricula and specialized training programs”

62.2% of students felt that AI could increase diagnostic errors.

“the majority (62.2%), who felt that AI could increase diagnostic errors.”

19.1% of students disagreed that AI had to be included in hospitals and health centers.

“19.1% disagreed”

35.9% of students recognized answering patient questions as a potential use of ChatGPT in patient care.

“Answering patient questions | 109 | 35.9”

43% of respondents disagreed that AI might replace healthcare providers.

“but 43% disagreed.”

15.4% of respondents were unclear or did not know what AI was.

“A total of 15.4% of the respondents were unclear or did not know what AI was.”

28.6% of students disagreed that AI could increase diagnostic errors.

“Nevertheless, 28.6% disagreed”

72.4% of participants expressed optimism that AI can enhance the learning process.

“A majority (72.4%) expressed optimism about the potential application of AI in education by believing that it can enhance the learning process.”

21.7% of students recognized conducting initial assessments as a potential use of ChatGPT in patient care.

“Conducting initial assessments | 66 | 21.7”

47.4% of participants were either uncertain or did not know about machine learning and deep learning.

“a notable percentage (47.4%) were either uncertain or did not know.”

40.5% of students disagreed that AI would be a burden.

“and 40.5% disagreeing.”

Approximately 28% of participants expressed uncertainty about AI's potential in education.

“Even still, approximately 28% expressed uncertainty”

75.4% of students thought that AI had to be included in hospitals and health centers.

“The majority (75.4%) thought that AI had to be included in hospitals and health centers”

52.6% of participants were aware of machine learning and deep learning.

“Although slightly more than half (52.6%) of the participants were aware of machine learning and deep learning”

Among nursing students (n=304), 75.4% agreed that the introduction of artificial intelligence is necessary in hospitals and health centers.

“Do you think the introduction of artificial intelligence is necessary in hospitals and health centers? | 229 | 75.4 | 17 | 5.6 | 58 | 19.1”

Among nursing students (n=304), 62.8% did not feel comfortable using ChatGPT for patient care.

“Among the students, 62.8% did not feel comfortable using ChatGPT for patient care, whereas 37.2% did.”

There was no significant change in attitude toward AI depending on where you live (p = 0.486).

“There is no significant change in attitude depending on where you live (p = 0.486).”

Among nursing students (n=304), 25% answered No to having applied AI technology in any field.

“Have you ever applied AI technology in any field? | 178 | 58.6 | 58.6 | 76 | 25.0 | 50 | 16.4”

Among nursing students (n=304), 82.9% agreed that AI is essential in the medical field.

“Do you believe AI is essential in medical field? | 252 | 82.9 | 10 | 3.3 | 42 | 13.8”

Among nursing students (n=304), 57.9% said that patients would not be open to communicating via ChatGPT.

“Most respondents (57.9%) said that patients would not be open to communicating via the ChatGPT.”

Among nursing students (n=304), 75% agreed that budget should be allocated for AI to be used in hospitals and health centers.

“Do you believe budget should be allocated for AI to be used in hospitals and health centers? | 228 | 75 | 16 | 5.3 | 60 | 19.7”

Among nursing students (n=304), 45% cited lack of financial resources as a reason for reduced practice of AI in Palestine.

“According to you what might be the reason for reduced practice of AI in Palestine? | Lack of financial resources | Lack of financial resources | Lack of financial resources | Lack of financial resources | 137 | 45”

Among nursing students (n=304), 52.6% cited lack of interest as a reason for reduced practice of AI in Palestine.

“According to you what might be the reason for reduced practice of AI in Palestine? | Lack of interest | Lack of interest | Lack of interest | Lack of interest | 160 | 52.6”

58.6% of students had used AI in their coursework.

“While 58.6% had used AI in their coursework”

Among nursing students (n=304), 72.3% agreed that AI aids practitioners in early diagnosis and assessment of severity of disease.

“Do you think that AI aids practitioner in early diagnosis and assessment of severity of disease?* | 220 | 72.3 | 19 | 6.3 | 65 | 21.4”

Among nursing students (n=304), 51.7% agreed that AI will replace health care providers in the future.

“Do you believe that AI will replace health care providers in future? | 157 | 51.7 | 16 | 5.3 | 131 | 43”

Among nursing students (n=304), 24.7% found AI difficult to apply.

“While more than half (54.3%) considered AI simple to use, 24.7% found it difficult, possibly as a result of difficulties with comprehension or application.”

26.3% of students considered perception of technological advancement as a factor contributing to the decrease in AI practices in Palestine.

“The perception of technological advancement (26.3%) was considered less significant than other criteria”

Among nursing students (n=304), 79% agreed that AI should be included in the curriculum in nursing school as well as specialist training.

“Do you think AI should be included in curriculum in nursing school as well as specialist training? | 240 | 79 | 13 | 4.3 | 51 | 16.7”

Among nursing students (n=304), 47.7% were uncertain about using ChatGPT in their practice.

“A total of 47.7% of them, or nearly half, were uncertain about using the ChatGPT in their practice.”

Among nursing students (n=304), 48.3% agreed that AI would be a burden for practitioners.

“Do you believe AI would be a burden for practitioner? | 147 | 48.3 | 34 | 11.2 | 123 | 40.5”

There were no significant differences in AI knowledge by living place.

“The results of an ANOVA revealed that third-year students aged 23–27 years had high levels of AI knowledge, but there were no significant differences in terms of where they attended university and lived.”

Among nursing students (n=304), 19.1% were excited about incorporating ChatGPT into their practice.

“Only 19.1% of the students were excited, whereas 23% were anxious.”

Among nursing students (n=304), 46% cited lack of curriculum as a reason for reduced practice of AI in Palestine.

“According to you what might be the reason for reduced practice of AI in Palestine? | Lack of curriculum | Lack of curriculum | Lack of curriculum | Lack of curriculum | 140 | 46”

Of 75 classified responses about ChatGPT use in nursing practice, 39 were positive experiences.

“Good Occurrences (n = 39): ChatGPT is”

Among nursing students (n=304), 68.1% reported feeling either extremely comfortable or comfortable using technology.

“The majority of the students (68.1%) reported feeling either extremely comfortable or comfortable using technology.”

Among nursing students (n=304), 54.3% considered AI simple to use.

“While more than half (54.3%) considered AI simple to use, 24.7% found it difficult, possibly as a result of difficulties with comprehension or application.”

ANOVA revealed that third-year students aged 23-27 years had high levels of AI knowledge.

“The results of an ANOVA revealed that third-year students aged 23–27 years had high levels of AI knowledge, but there were no significant differences in terms of where they attended university and lived.”

There were significant differences between males and females in AI knowledge (p < 0.05) on some items.

“With respect to artificial intelligence and its applications in the medical field, there were significant differences between males and females in terms of female sex (p < 0.05).”

Among nursing students (n=304), 62.2% agreed that AI would increase the percentage of errors in diagnosis.

“Do you believe AI would increase the percentage of errors in diagnosis? | 189 | 62.2 | 28 | 9.2 | 87 | 28.6”

Among nursing students (n=304), 56.2% cited lack of proper training as a reason for reduced practice of AI in Palestine.

“According to you what might be the reason for reduced practice of AI in Palestine? | Lack of proper training | Lack of proper training | Lack of proper training | Lack of proper training | 171 | 56.2”

There was no significant difference in attitudes toward AI across age groups (p = 0.144).

“Table 10 shows that there was no significant difference in attitudes across the age groups (p = 0.144).”

Of 75 classified responses about ChatGPT use in nursing practice, 7 were negative experiences.

“Negative Experiences (n = 7): A few people mentioned accuracy problems, called it”

Among nursing students (n=304), 50.7% expressed doubt that ChatGPT can improve patient outcomes.

“With respect to whether ChatGPT can improve patient outcomes, the students were divided almost evenly, with a majority (50.7%) expressing doubt.”

Among nursing students (n=304), 37.2% did feel comfortable using ChatGPT for patient care.

“Among the students, 62.8% did not feel comfortable using ChatGPT for patient care, whereas 37.2% did.”

There were no significant differences between males and females in overall AI knowledge.

“However, there were no significant differences in terms of their overall knowledge.”

Among nursing students (n=304), 16.4% had never applied AI technology in any field.

“Have you ever applied AI technology in any field? | 178 | 58.6 | 58.6 | 76 | 25.0 | 50 | 16.4”

There was no statistically significant difference in attitudes toward AI between males and females (p > 0.05).

“Table 9 shows that there was no statistically significant difference in attitudes between males and females (p > 0.05).”

Among nursing students (n=304), 58.6% had applied AI technology in any field.

“Have you ever applied AI technology in any field? | 178 | 58.6 | 58.6 | 76 | 25.0 | 50 | 16.4”

68.1% of students felt comfortable with technology.

“and 68.1% felt comfortable with technology”

There were no significant differences in AI knowledge by university attended.

“The results of an ANOVA revealed that third-year students aged 23–27 years had high levels of AI knowledge, but there were no significant differences in terms of where they attended university and lived.”

Negative experiences with ChatGPT in nursing practice included accuracy problems and wrong answers in the nursing field.

“Negative Experiences (n = 7): A few people mentioned accuracy problems, called it”

Among nursing students (n=304), 52.3% cited lack of awareness as a reason for reduced practice of AI in Palestine.

“According to you what might be the reason for reduced practice of AI in Palestine? | Lack of awareness | Lack of awareness | Lack of awareness | Lack of awareness | 159 | 52.3”

Palestinian nursing students expressed concerns about AI's impact on future job security.

“and its impact on future job security.”

Among Palestinian nursing students, there was a statistically significant difference in excited attitudes toward incorporating ChatGPT into practice by university affiliation (p=0.029), in favor of Modern University College, Al-Quds University, and Arab American University.

“The p value is 0.029, indicating a significant difference in excited attitudes toward incorporating ChatGPT into practice on the basis of university affiliation in favor of Modern University College, Al-Qud University and Arab American University.”

58.6% of Palestinian nursing students had used AI.

“In terms of practical application, 58.6% of students had used AI”

Over half of Palestinian nursing students found AI easy to apply in their academic or professional tasks.

“with over half finding it easy to apply in their academic or professional tasks.”

Among Palestinian nursing students, there was a statistically significant difference by age in believing that ChatGPT can improve patient outcomes (p=0.015), with younger participants (19-22 years) being more likely to believe this.

“The p value (0.015) was significantly different, with younger participants (19–22 years) being more likely to believe that ChatGPT can improve patient outcomes.”

There was no significant variation in AI usage across residences (p = 0.203).

“There was no significant variation in AI usage across residences (p = 0.203).”

43% of Palestinian nursing students disagree that AI could replace healthcare providers.

“while 43% disagree”

45% of Palestinian nursing students cited financial constraints as a barrier to AI integration.

“as indicated by 45% of the students citing financial constraints”

There was significant variation in ChatGPT knowledge across year levels (p = 0.000).

“The university-level p value is 0.000, indicating significant variation in ChatGPT knowledge across year levels, with fourth-year students being more familiar.”

Age significantly differed in AI practice (p = 0.000).

“Age did, however, significantly differ in AI practice (p = 0.000), with the 23–27 age group exhibiting the lowest levels of practice.”

Attitudes toward AI varied significantly across university levels (p = 0.022).

“The attitudes toward AI varied significantly across university levels (p = 0.022).”

There was no statistically significant difference in AI practices between males and females (p = 0.108).

“There was no statistically significant difference (p > 0.05) in the difference in AI practices between males and females, as indicated by a p value of 0.108.”

69% of Palestinian nursing students reported no formal education on ChatGPT use.

“Similarly, knowledge of ChatGPT followed the same pattern, with 69% of students reporting no formal education on its use.”

33.9% of Palestinian nursing students had used ChatGPT in their nursing practice.

“Despite this engagement with AI, only 33.9% of students had used ChatGPT in their nursing practice.”

Fourth-year students exhibited the least amount of AI practice (M = 4.25).

“There was a significant difference between university levels (p = 0.000), with fourth-year students exhibiting the least amount of practice (M = 4.25).”

Among Palestinian nursing students, there were statistically significant differences by university affiliation in optimism about patient receptivity to interacting with ChatGPT (p=0.018), in favor of Modern University College, Al-Quds University, and Arab American University.

“and university affiliation (p = 0. 018) in favor of Modern University College, Al-Quds University and Arab American University, respectively”

There was a significant difference in AI practice between university levels (p = 0.000).

“There was a significant difference between university levels (p = 0.000), with fourth-year students exhibiting the least amount of practice (M = 4.25).”

There was no significant difference in AI practices with respect to university (p = 0.694).

“With respect to university, there was no significant difference in AI practices (p = 0.694).”

There was no significant variation in ChatGPT knowledge based on living place (p = 0.056).

“There was no significant variation in ChatGPT knowledge based on living place, as indicated by the p value of 0.056 for living place.”

Fourth-year students were more familiar with ChatGPT.

“The university-level p value is 0.000, indicating significant variation in ChatGPT knowledge across year levels, with fourth-year students being more familiar.”

46.7% of Palestinian nursing students are unfamiliar with AI's applications in the medical field.

“The study identified a significant knowledge gap, with 46.7% of respondents unfamiliar with AI’s applications in the medical field.”

The institutions with highest ChatGPT knowledge were Al Quds University, Modern University College, and Arab American University, in that order.

“In support of Al Quds University, Modern University College, and Arab American University, in that order.”

There was no significant difference in familiarity with ChatGPT between males and females (p = 0.882).

“There was no significant difference in the level of familiarity with ChatGPT between males and females, as indicated by the gender p value of 0.882.”

Structured AI education remains scarce among Palestinian nursing students, with 69.9% reporting no formal exposure to AI training.

“However, structured AI education remains scarce, with 69.9% of students reporting no formal exposure to AI training.”

79% of Palestinian nursing students support the inclusion of AI in nursing curricula.

“and 79% supporting its inclusion in nursing curricula.”

Fourth-year students scored the highest (M = 29.99) in attitudes toward AI.

“First-year students scored the lowest (M = 27.25), and fourth-year students scored the highest (M = 29.99) in terms of attitudes.”

37.2% of Palestinian nursing students felt comfortable utilizing ChatGPT in practice.

“While 37.2% felt comfortable utilizing ChatGPT in practice”

Among Palestinian nursing students, there were no statistically significant differences in optimism about patient receptivity to interacting with ChatGPT by gender, age, or living place.

“but not in terms of gender, age, or living place.”

Among Palestinian nursing students, there was a statistically significant difference by living place in believing that ChatGPT can improve patient outcomes (p=0.022), with those from villages being more likely to believe this.

“The p value (0.022) indicates a significant difference in living place, with those from villages being more likely to believe that ChatGPT can improve patient outcomes.”

There was no significant difference in ChatGPT knowledge according to age (p = 0.066).

“The age-related p value was 0.066, indicating that there was no significant difference in ChatGPT knowledge according to age.”

82.9% of Palestinian nursing students consider AI crucial for the medical field.

“Overall, students held positive attitudes toward AI, with 82.9% considering it crucial for the medical field”

62.8% of Palestinian nursing students expressed concerns about accuracy and trust regarding ChatGPT.

“a majority (62.8%) expressed concerns about accuracy and trust.”

Among Palestinian nursing students, there was a statistically significant difference by university affiliation in believing that ChatGPT can improve patient outcomes (p=0.010), in favor of Modern University College, Al-Quds University, and Arab American University.

“The p value (0.010) indicates a significant difference in responses based on university affiliation in favor of Modern University College, Al-Quds University and Arab American University.”

Palestinian nursing students demonstrate a high level of AI awareness (84.5%).

“This study reveals that Palestinian nursing students demonstrate a high level of AI awareness (84.5%) and acknowledge its significance in medical education.”

51.7% of Palestinian nursing students believe AI could replace healthcare providers.

“Findings indicate that 51.7% of students believe AI could replace healthcare providers”

First-year students scored the lowest (M = 27.25) in attitudes toward AI.

“First-year students scored the lowest (M = 27.25), and fourth-year students scored the highest (M = 29.99) in terms of attitudes.”

The 23-27 age group exhibited the lowest levels of AI practice.

“Age did, however, significantly differ in AI practice (p = 0.000), with the 23–27 age group exhibiting the lowest levels of practice.”

Only 41.8% of Palestinian nursing students had received any formal AI instruction.

“Moreover, only 41.8% of students had received any formal AI instruction”

There was a statistically significant variation in level of acquaintance with ChatGPT among institutions (p = 0.005).

“A statistically significant variation in the level of acquaintance with ChatGPT among institutions is indicated by the p value of 0.005 for university affiliation.”

There was no significant difference in attitudes toward AI according to university (p = 0.178).

“There was no significant difference in attitudes according to university (p = 0.178).”

Palestinian nursing students expressed concerns about AI's potential for diagnostic errors (62.2%).

“However, Palestinian students expressed concerns about AI's potential for diagnostic errors (62.2%) and its impact on future job security.”

A sample of 367 participants was determined to be needed based on 5% margin of error, 95% confidence level, and 50% response distribution.

“After Raosoft was used to determine the appropriate sample size, the researchers reported that a sample of 367 participants would be needed on the basis of a 5% margin of error, 95% confidence level, and 50% response distribution.”

A total of 304 individuals responded to the survey.

“A total of 304 individuals, including nursing students from various universities in Palestine, responded to the survey.”

Cronbach's alpha for the attitudes section was 0.81.

“Attitudes Section: α = 0.81.”

Disparities in proficiency and access remain key barriers to effective AI integration.

“disparities in proficiency and access remain key barriers to effective AI integration.”

Cronbach's alpha for the practice section was 0.76.

“Practice Section: α = 0.76.”

In Palestine, there is a notable gap in the literature regarding the knowledge of health profession students toward AI.

“In Palestine, there is a notable gap in the literature regarding the knowledge of health profession students toward AI [11, 12].”

• cites [11] Barghot M, Abusakran MN, Hamad MH, Sourani AIEL. The Role of Scientific Research in Developing Educational Policies for Higher Education Institutions. An-Najah Univ J Res - B (Humanities). 2024;38(6):1259–88. sourceNot checked yet

  Not checked in the free run.

• cites [12] Khlouf M. Impact of employing artificial intelligence on media institutions in Palestine from the viewpoint of those in charge of communication. An-Najah Univ J Res - B (Humanities). 2024;38(6):1093–120. sourceNot checked yet

  Not checked in the free run.

Cronbach's alpha for the knowledge section was 0.78.

“Knowledge Section: α = 0.78.”

Students in AI-integrated healthcare systems, such as those in the United States and Germany, benefit from structured exposure to AI tools, including ChatGPT-based simulations and clinical decision-support systems, which fosters greater confidence in AI applications.

“In contrast, students in AI-integrated healthcare systems, such as those in the United States and Germany, benefit from structured exposure to AI tools, including ChatGPT-based simulations and clinical decision-support systems, which fosters greater confidence in AI applications [10].”

• cites [10] Khumrin P, Ryan A, Judd T, Verspoor K. Diagnostic Machine Learning Models for Acute Abdominal Pain: Towards an e-Learning Tool for Medical Students. Stud Health Technol Inform. 2017;245:447–51. sourceNot checked yet

  Not checked in the free run.

The study's cross-sectional design captures data at a single point in time, which limits the ability to establish causal relationships between AI awareness, attitudes, and actual usage trends.

“The study employed a cross-sectional design, which captures data at a single point in time. While this approach effectively provides a snapshot of students’ perceptions and experiences, it limits the ability to establish causal relationships between AI awareness, attitudes, and actual usage trends.”

AI adoption in medical education remains a challenge in the Middle East, including Palestine.

“Despite this global progress, AI adoption in medical education remains a challenge in the Middle East, including Palestine.”

• cites [7] Doumat G, Daher D, Ghanem N-N, Khater B. Knowledge and attitudes of medical students in Lebanon toward artificial intelligence: a national survey study. Front Artif Intell. 2022;5:1015418. sourceNot checked yet

  Not checked in the free run.

The study's reliance on self-reported data collected through an online questionnaire is prone to social desirability bias and recall bias.

“While self-reporting is an efficient means of gathering large-scale data, it is prone to social desirability bias, where participants may overestimate their AI knowledge or engagement due to perceived expectations.”

• Also stated in: § Limitation of the study · hedged

  “Additionally, recall bias may affect responses, particularly regarding past AI training or experiences.”