What are the knowledge, use, and perceived benefits and limitations of artificial intelligence chatbots among Italian nursing students? A cross-sectional multicentre study

Abstract

Exploring students’ knowledge, use, and perceptions of Artificial Intelligence (AI) chatbots may inform strategies in the educational context. However, limited evidence is available on Italian nursing students, leaving this field largely unexplored. A cross-sectional online survey was conducted, following the Checklist for Reporting Results of Internet E-Surveys, the Strengthening the Reporting of Observational Studies in Epidemiology, and the Consensus-Based Checklist for Reporting of Survey Studies. Eligible participants were students enrolled in the nursing program at three universities. The questionnaire was developed by a panel of experts based on the available literature and pilot-tested. Descriptive (e.g., interquartile range) and inferential statistics (e.g., odds ratio, OR) were used. A total of 812 nursing students participated (response rate 58.4%). Most participants were aware of AI chatbots ( n = 700; 86.2%), which were generally perceived as “Somewhat useful” (median 2 out of 4; IQR 2–3). With respect to the introduction of AI chatbots in education, more than half of the students reported that it is too early to have a clear opinion ( n = 445; 54.8%). Increasing age was associated with lower odds of having heard of AI chatbots (OR = 0.96; 95% CI 0.93–0.99; p = 0.021) and of having used them for academic purposes (OR = 0.97; 95% CI 0.94–0.99; p = 0.046). Male students had higher odds of being aware of AI chatbots than female students (OR = 2.06; 95% CI 1.19–3.55; p = 0.009) and, among those with previous academic use, higher odds of reporting more frequent use (OR = 2.15; 95% CI 1.28–3.63; p = 0.004). Students with regular academic progression had lower odds of previous academic use than those experiencing difficulties in academic progression (OR = 0.71; 95% CI 0.51–0.99; p = 0.044). Positive self-perceived digital competence was associated with higher odds of reporting a greater likelihood of future AI chatbot use (OR = 1.97; 95% CI 1.08–3.59; p = 0.026). These findings support the inclusion of digital literacy education and ethical guidance in nursing programmes to promote informed and responsible use of AI chatbots. Further research is needed to evaluate their implications for nursing education and to identify appropriate strategies for their integration into the curriculum.