Dai Qianqian, Li Ming, Yang Maoshu, Shi Shiwu, Wang Zhaoyu, Liao Jiaojiao, Li Zhaoji, E Weinan, Tao Liyuan, Tang Yi-Da
Center for Data Science in Clinical Medicine, Peking University Third Hospital, Beijing, China.
Institute of Social Science Survey, Peking University, Beijing, China.
J Med Internet Res. 2025 Aug 8;27:e75343. doi: 10.2196/75343.
BACKGROUND: Artificial intelligence (AI) has demonstrated transformative potential in the health care field; yet, its clinical adoption faces challenges such as inaccuracy, bias, and data privacy concerns. As the primary operators of AI systems, physicians and nurses play a pivotal role in integrating AI into clinical workflows. Their acceptance and use of AI are essential for bridging the gap between technological innovation and practical implementation. Exploring Chinese medical staff's attitudes and identifying key factors influencing AI adoption are fundamental to developing targeted strategies to facilitate the effective application of AI in clinical settings. OBJECTIVE: This study aims to investigate attitudes and perceptions regarding medical AI among physicians and nurses in China and identify the factors influencing its adoption. METHODS: A nationwide cross-sectional survey was conducted online from December 12 to 26, 2024. Participants were recruited from the Chinese Medical Association and the Chinese Nursing Association. The structured questionnaire assessed demographic characteristics, knowledge and attitudes toward medical AI, experiences and insights regarding using medical AI, and perceptions and factors influencing the adoption of AI based on the unified theory of acceptance and use of technology (UTAUT) model. Multiple linear regression and Karlson-Holm-Breen mediation analysis were used to identify influencing factors. Sample weighting by regional distribution was applied for sensitivity analysis. RESULTS: The survey included 991 physicians and 1714 nurses. Among the respondents, 92.4% (916/991) of the physicians and 84.19% (1443/1714) of the nurses reported awareness of medical AI applications, 22.8% (226/991) of the physicians and 17% (291/1714) of the nurses had used AI, and 82.6% (819/991) of the physicians and 80.22% (1375/1714) of the nurses held optimistic views about AI's prospects. After adjusting for covariates, performance expectancy (physicians: B=0.144, 95% CI 0.092-0.197; nurses: B=0.292, 95% CI 0.245-0.338), effort expectancy (physicians: B=0.681, 95% CI 0.562-0.800; nurses: B=0.440, 95% CI 0.342-0.538), social influence (physicians: B=0.264, 95% CI 0.187-0.341; nurses: B=0.098, 95% CI 0.045-0.152), and facilitating conditions (physicians: B=0.098, 95% CI 0.030-0.165; nurses: B=0.158, 95% CI 0.105-0.212) had significant positive impacts on willingness to use AI. Perceived risk showed no significant effect on physicians' intention to use AI (B=0.012, 95% CI -0.022 to 0.045) but negatively impacted nurses' intention to use AI (B=-0.041, 95% CI -0.066 to -0.015). Performance expectancy and effort expectancy partially mediated the relationship between facilitating conditions and intention to use. Age, educational level, hospital level, work experience, and personal views also significantly influenced willingness. Weighted and unweighted analyses yielded consistent results, confirming the robustness of the findings. CONCLUSIONS: Substantial disparities exist between high willingness to adopt medical AI and its low actual use among Chinese medical staff. System optimization focusing on utility enhancement, workflow integration, and risk mitigation for medical staff, along with support for infrastructure and training, could accelerate AI adoption in clinical practice.
背景:人工智能(AI)在医疗保健领域已展现出变革潜力;然而,其在临床应用上面临着诸如不准确、偏差以及数据隐私等问题的挑战。作为人工智能系统的主要操作者,医生和护士在将人工智能融入临床工作流程中起着关键作用。他们对人工智能的接受和使用对于弥合技术创新与实际应用之间的差距至关重要。探索中国医务人员对人工智能的态度并确定影响人工智能采用的关键因素,对于制定有针对性的策略以促进人工智能在临床环境中的有效应用至关重要。 目的:本研究旨在调查中国医生和护士对医疗人工智能的态度和看法,并确定影响其采用的因素。 方法:于2024年12月12日至26日进行了一项全国性的在线横断面调查。参与者从中华医学会和中华护理学会招募。结构化问卷评估了人口统计学特征、对医疗人工智能的知识和态度、使用医疗人工智能的经验和见解,以及基于技术接受与使用统一理论(UTAUT)模型的对人工智能采用的看法和影响因素。采用多元线性回归和卡尔森 - 霍尔姆 - 布林中介分析来确定影响因素。通过区域分布进行样本加权以进行敏感性分析。 结果:该调查包括991名医生和1714名护士。在受访者中,92.4%(916/991)的医生和84.19%(1443/1714)的护士报告了解医疗人工智能应用,22.8%(226/991)的医生和17%(291/1714)的护士使用过人工智能,82.6%(819/991)的医生和80.22%(1375/1714)的护士对人工智能的前景持乐观态度。在调整协变量后,绩效期望(医生:B = 0.144,95%置信区间0.092 - 0.197;护士:B = 0.292,95%置信区间0.245 - 0.338)、努力期望(医生:B = 0.681,95%置信区间0.562 - 0.800;护士:B = 0.440,95%置信区间0.342 - 0.538)、社会影响(医生:B = 0.264,95%置信区间0.187 - 0.341;护士:B = 0.098,95%置信区间0.045 - 0.152)和便利条件(医生:B = 0.098,95%置信区间0.030 - 0.165;护士:B = 0.158,95%置信区间0.105 - 0.212)对使用人工智能的意愿有显著的正向影响。感知风险对医生使用人工智能的意图没有显著影响(B = 0.012,95%置信区间 - 0.022至0.045),但对护士使用人工智能的意图有负面影响(B = - 0.041,95%置信区间 - 0.066至 - 0.015)。绩效期望和努力期望部分中介了便利条件与使用意图之间的关系。年龄、教育水平、医院级别、工作经验和个人观点也显著影响意愿。加权和未加权分析得出一致结果,证实了研究结果的稳健性。 结论:中国医务人员对采用医疗人工智能的高意愿与其低实际使用率之间存在显著差异。以提高实用性、整合工作流程以及减轻医务人员风险为重点的系统优化,以及对基础设施和培训的支持,可以加速人工智能在临床实践中的采用。
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