The association between AI dependence, AI literacy, and critical thinking ability among nursing interns: a multicenter cross-sectional study

Aim To examine the associations between Artificial intelligence (AI) dependence and critical thinking ability among nursing interns and to explore the potential mediating role of AI literacy. Methods A convenience sampling method was used to select nursing interns recruited from multiple hospitals in Hunan, China between January and February 2026. A general information questionnaire, AI literacy scale, AI dependence scale, and critical thinking ability scale were used to conduct the online questionnaire survey. Data were analyzed using descriptive statistics, Pearson correlation analysis, and regression-based mediation analysis (PROCESS Model 4) with 5,000 bootstrap resamples. Results A total of 517 nursing interns were included in the final analysis. AI dependence was positively associated with AI literacy and critical thinking ability (all p 0.001). After adjusting for covariates, AI literacy partially mediated the relationship between AI dependence and critical thinking ability. The indirect effect was significant 95%CI (0.399, 0.610), and the model explained 52.0% of the variance in critical thinking ability. Conclusion AI dependence was positively associated with critical thinking ability among nursing interns, both directly and indirectly through AI literacy. These findings suggest that integrating AI literacy training into nursing education may help optimize the educational benefits of AI.