Actionable companion · Instructional improvement

From evidence to district action: Generative artificial intelligence acceptance, anxiety, and behavioral intention in the middle east: a TAM-based structural equation modelling approach

AI-assisted editorial implementation guide. The district actions are proposed applications, not findings or recommendations attributed to the original authors. No additional peer review is asserted.

Evidence and context

Health-professions education context: test transfer to K–12 rather than assuming it.

Original authors’ abstract, reproduced under the linked source license:

Abstract Background Adopting generative artificial intelligence (GenAI) in education rapidly transforms learning environments, yet nursing students’ acceptance and anxiety toward these technologies remain underexplored in Middle Eastern contexts. This study extends the Technology Acceptance Model (TAM) by incorporating constructs such as Facilitating Conditions (FC) and Social Influence (SI). It investigates the moderating role of Anxiety on Behavioral Intention to Use (BIU) generative AI tools. Methods A cross-sectional study was conducted among 1,055 undergraduate nursing students across four Middle Eastern countries, including Egypt, Jordan, Saudi Arabia, and Yemen. Data were collected using a structured questionnaire comprising the Generative Artificial Intelligence Acceptance Scale and the Artificial Intelligence Anxiety Scale. Structural equation modeling was employed to evaluate relationships among Performance Expectancy (PE), Effort Expectancy (EE), FC, SI, and BIU, with Anxiety as a moderator. Descriptive statistics, confirmatory factor analysis, and path analysis were performed using SPSS and Python’s semopy library. Results The model demonstrated strong explanatory power, with 75.09% of the variance in BIU explained by the TAM constructs and Anxiety. Path coefficients revealed significant positive relationships between PE (β = 0.477, p < 0.001), EE (β = 0.293, p < 0.001), FC (β = 0.189, p < 0.001), and SI (β = 0.308, p < 0.001) and BIU. Anxiety had the strongest moderating effect (β = 0.552, p < 0.001), indicating its critical role in shaping behavioral intentions. Gender, year of study, and access to technology emerged as significant demographic variables influencing acceptance and anxiety levels. Conclusions This study emphasizes the importance of reducing anxiety and enhancing support systems to foster GenAI acceptance among nursing students. The findings provide actionable insights for designing culturally tailored educational interventions to promote the effective integration of AI in nursing education. Clinical trial number Not applicable. Keywords: Artificial intelligence, Technology acceptance model, Nurse, Nursing education, Anxiety, Behavioral intention, Structural equation modeling

A 90-day district pilot

1. Days 1–15 · Appraise. Have the curriculum lead and a teacher read the methods and limitations. Record the study design, sample, comparator, outcomes and evidence gaps. Define a local question that the study can help inform.
2. Days 16–30 · Design. Choose one instructional unit and a specific teacher-supervised AI use. Compare it with the existing approach using a common learning objective, equivalent tasks and a shared rubric. Name an accountable owner and set the baseline, success threshold and budget before implementation.
3. Days 31–60 · Test. Start with a small voluntary cohort, preserve an accessible non-AI route and require teacher review. Use synthetic or de-identified examples; approve data handling and tool terms through district processes.
4. Days 61–90 · Decide. Measure unaided learning on a new task, factual errors, student workload and teacher review time. Disaggregate results where group sizes permit responsible interpretation. Compare with baseline, document uncertainty and stop or revise if learning worsens, access is unequal or critical errors persist.

The board decision brief

Report the learning problem, evidence quality, participating population, total cost including review time, measured benefit, errors, access differences and remaining uncertainties. Make a dated recommendation to stop, revise or expand. A positive perception survey alone does not establish learning improvement.

Attribution and reuse

Mona Gamal Mohamed; Polat Goktas; Shimaa Abdelrahim Khalaf; Aycan Kucukkaya; Ibrahim Al-Faouri; Ebtisam Abd Elazeem Saber Seleem; Awatef Ibraheem; Aya M Abdelhafez; Saleh O Abdullah; Hanan Nasef Zaki; Abdulqadir J Nashwan. Generative artificial intelligence acceptance, anxiety, and behavioral intention in the middle east: a TAM-based structural equation modelling approach. BMC Nursing (2025-07-01). https://doi.org/10.1186/s12912-025-03436-8

Companion prepared 2026-10-30. Original authorship and DOI are preserved. The abstract is an attributed source extract; the implementation plan is new AI-assisted editorial material, offered under the same CC BY 4.0 license. This guide has not undergone independent peer review.