Insights into the relationship between anxiety and attitudes toward artificial intelligence among nursing students

Background Artificial Intelligence (AI) integration in healthcare education represents a critical technological advancement that requires careful examination of student preparedness and acceptance. In the Palestinian context, limited research exists on nursing students' psychological responses to AI implementation, despite growing global emphasis on AI competency in healthcare professions. Understanding the relationship between anxiety and attitudes toward AI is essential for developing effective educational strategies that can facilitate successful technology adoption while addressing cultural and contextual barriers specific to the Palestinian healthcare education environment. Introduction Artificial Intelligence (AI) integration in nursing education remains underexplored in the Palestinian context, where limited research addresses students' anxiety and attitudes toward AI. This study examines this relationship to fill a critical gap and inform culturally relevant strategies for AI adoption in healthcare education. Methods A cross-sectional study was conducted among 264 nursing students at Palestine Ahliya University (2024-2025). Validated scales (AI Anxiety Scale, SATAI) assessed anxiety and attitudes. We analyzed data via correlation and regression using SPSS v26. Results High AI anxiety (mean = 80.3, SD = 9.4) contrasted with positive attitudes (mean = 114.3, SD = 12.8). Regression identified attitude as the strongest predictor of anxiety (B = 5.171, p < .001), alongside younger age, female gender, and non-use of AI. Academic year and AI education showed no significant effects. Conclusion Negative attitudes and limited AI exposure drive anxiety, particularly among younger females and non-users. To mitigate this, we recommend integrating AI literacy modules into curricula, fostering hands-on AI experiences, and designing gender-sensitive training. These findings emphasize the urgency of addressing sociocultural and educational barriers to AI readiness in Palestinian nursing education. Clinical trial number Not applicable.