The mediating effect of self-efficacy on the relationship between digital literacy and artificial intelligence anxiety in nursing students

OBJECTIVE: The integration of digital technologies and artificial intelligence (AI) into healthcare has transformed nursing education, while also raising concerns about AI-related anxiety among students. This study aimed to examine the mediating role of self-efficacy in the relationship between digital literacy and AI anxiety among nursing students. METHODS: This correlational study was conducted with 319 undergraduate nursing students enrolled at two universities in Türkiye. Data were collected using the Artificial Intelligence Anxiety Scale, Digital Literacy Scale, and Student Self-Efficacy Scale. Pearson correlation analysis and regression-based mediation analysis were performed using PROCESS macro (Model 4) with 5000 bootstrap samples. RESULTS: Digital literacy was negatively associated with AI anxiety (r = - .20, p < .01) and positively associated with self-efficacy (r = .54, p < .01). Self-efficacy was also negatively related to AI anxiety (r = - .23, p < .01). Mediation analysis revealed that self-efficacy fully mediated the relationship between digital literacy and AI anxiety. While the total effect of digital literacy on AI anxiety was significant (B = - 0.40, p < .001), the direct effect became nonsignificant after controlling for self-efficacy, whereas the indirect effect through self-efficacy remained significant (B = - 0.19, 95% CI [- 0.35, - 0.05]). CONCLUSIONS: Self-efficacy plays a critical mediating role in the relationship between digital literacy and AI anxiety among nursing students. Interventions aimed at enhancing both digital literacy and self-efficacy may be effective in reducing AI-related anxiety and supporting nursing students' psychological adaptation to emerging technologies.