Effects of Midwifery and Nursing Students' Readiness about Medical Artificial Intelligence on Artificial Intelligence Anxiety

The Age of Artificial Intelligence (AI) is the current era, where AI technologies play an important and pervasive role in various aspects of human life, society and industry. This era refers to integrating artificial intelligence into daily life, business processes, healthcare, education, entertainment and more (OpenAI, 2023). The development of artificial intelligence benefits all aspects of life, while also bringing great economic and social development to humanity in a new era (Zhang & Lu; 2021). Recent users living, studying and working are all involved in the internet of things network. By taking advantage of smart environments in the home and city; eHealth; and smart transportation systems, there have been tremendous changes (Lu et al., 2019).

One of the areas particularly affected and used by AI is the health sector. Developments in the healthcare sector related to AI-related technologies are associated with medical information, identification, hospital emergencies, remote monitoring and home care, drug and production control, medical equipment and medical waste tracking, blood management, infection control and more (Lu et al., 2021; Miorandi et al., 2012). Medical professionals also need to understand and familiarise themselves with advances in AI technologies to provide better healthcare to larger groups of people (Amisha et al., 2019).

The earliest examples of AI in everyday life, computer programs that mimic a human expert's decision-making abilities in a particular field such as medicine or finance, were used in the 1980s and 1990s. In the 21st century, artificial intelligence has been increasingly integrated into various consumer products and services (Vodanović et al., 2023).

In the field of healthcare, different technologies are being adopted and experimented with to increase automation. Today, in the field of medicine, artificial intelligence is used to keep medical records in digital format, to examine patients using smart technologies and to guide the doctor in diagnosis, treatment and surgery (Haleem et al., 2019, Bohr and Memarzadeh, 2020). AI has also been widely applied in fields that require analysis of imaging data, particularly in radiology (Hosny et al., 2018), ultrasound (Huang & Zhang, 2018), pathology (Wong, 2018), dermatology (Estava et al., 2017) and ophthalmology (Gulshan et al., 2016, Zhou et al., 2019). Artificial intelligence systems can also increase the efficiency of nursing and management activities of hospitals (Lee & Yoon, 2021).

There is an undeniable relationship between humans, technology and the environment and these relationships need to effectively use artificial intelligence to enhance patient experiences and health outcomes. Artificial intelligence is a term that therefore needs to be further examined through the lens of nursing practice (Watson et al., 2020).

Nurses are in a key position to shape and drive the evolution of modern AI in healthcare, both as potential users of AI-based technologies and as professional education experts (McGrow, 2019). However, nurses have often been excluded from the development and design stages of AI (Zhou et al., 2021). There is a need for guidelines for clinical nurses regarding the safe adoption of innovations (Ronquillo et al., 2021). Furthermore, as nurses play a vital role in adopting new technologies in healthcare, it is clear that there is a need to understand nurses' attitudes towards using these technologies (Rababah et al., 2021).

It is generally believed that artificial intelligence tools will facilitate and improve human work and will not replace the work of doctors and other healthcare personnel (Bohr and Memarzadeh, 2020). Today, artificial intelligence offers ways to reduce healthcare costs and increase the efficiency of healthcare services (Matheny et al., 2019). AI is predicted to create potential health savings of $150 billion by 2025 (McGrow, 2019). A study conducted on 2,167 students from 10 different health professions from 18 universities across Canada reported that students had a positive view of the emerging role of artificial intelligence in their field. In the same study, although attitudes towards AI varied by discipline, students wanted basic information about AI to be included in their curriculum (Teng et al., 2022).

In the literature, studies show that nurses do not have concerns that artificial intelligence will replace health professionals in the future (Buchanan et al., 2020, Ergin et al., 2022) and think that it will reduce their workload (Ergin et al., 2022). Nurses should be supported to gain knowledge and skills related to artificial intelligence applications to follow, adapt to and lead technological developments. Education on this subject should be encouraged (Ng et al., 2022). The World Medical Association (WMA) has stated that curricula should be reviewed and educational opportunities should be evaluated for patients, health managers, health professionals and students to determine the positive and negative effects of artificial intelligence in health (WMA, 2019). In many studies on this subject, it has been emphasised that health department students should gain knowledge and skills about artificial intelligence and that artificial intelligence should be included in the education programs at universities (von Gerich et al., 2022; Jung, 2023; Irwin et al., 2023; O'Connor, 2022; O'Connor et al., 2023).

Although integrating artificial intelligence technologies into healthcare applications facilitates clinical decision-making, it can sometimes yield erroneous results. The final decision-maker in health care is therefore the health professional (Alderden and Johnny, 2023, Pailaha, 2023). Health professionals are responsible for providing safe, fair, transparent and accurate care services in line with algorithms using their clinic knowledge and skills. In this vein, it is essential for healthcare professionals to keep up with current technology and closely follow developments to improve healthcare services (Alderden & Johnny, 2023). It is of value to conduct studies on artificial intelligence for midwifery and nursing undergraduate students who will provide health care services in clinics as health professionals in the next few years. This study aims to determine the variables affecting the artificial intelligence anxiety of students studying in midwifery and nursing departments. For this purpose, artificial intelligence characteristics (AI knowledge, daily life, occupational threat, trusting AI) variables were selected and their effects on AI readiness and AI anxiety were analysed. Answers to the following research questions were sought:

Q1: What is the midwifery and nursing students' readiness level for medical artificial intelligence?

Q2: What are the artificial intelligence anxiety levels of midwifery and nursing students?

Q3: Do midwifery and nursing students' medical artificial intelligence readiness levels affect their artificial intelligence anxiety levels?

Q4: Do midwifery and nursing students' artificial intelligence characteristics (artificial intelligence knowledge, using artificial intelligence in daily life, occupational threat, artificial intelligence trust) affect their medical artificial intelligence readiness and artificial intelligence anxiety levels?

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