Enterprise AI Analysis
The mediating digital literacy and the moderating role of academic support in the relationship between artificial intelligence usage and creative thinking in nursing students
Artificial intelligence can be an important tool in developing creative thinking while supporting individualized learning and problem-solving skills in educational processes. The effect of artificial intelligence on creative thinking may differ depending on factors such as students' digital literacy level and the academic support they receive. This study investigates how artificial intelligence can encourage creative thinking in educational processes and how this process is shaped by digital literacy and academic support.
Key Quantitative Insights
Explore the core numerical findings from the research, highlighting critical AI impacts and mediation effects in nursing education.
0.70
Direct AI Impact on Creative Thinking (β)
0.422
Digital Literacy Mediation Effect (β)
0.298
Max AI-CT Effect with High Academic Support (β)
74.1%
Students Want AI in Curriculum
Deep Analysis & Enterprise Applications
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Background
In today's world, where health education is rapidly digitized, nursing students can significantly contribute to their profession by maintaining their creative thinking skills while developing their professional skills. Some studies conducted at this point also support this view [1, 2]. At this point, the effect of Artificial Intelligence (AI) can make a profound difference. However, there are uncertainties about how the increasing integration of AI into educational environments affects students' creative thinking processes. Moreover, students' digital literacy levels and the academic support they receive may shape this interaction positively or negatively. As a result, in parallel to determining the effect of AI use on creative thinking skills in nursing students, the mediating role of digital literacy in this effect and the situational mediating effect of academic support is aimed to understand the factors that strengthen or limit the creativity in the educational processes of AI technologies, to develop current pedagogical strategies in nursing education and to develop suggestions that will guide for increasing students' competencies suitable for the digital age. As a broad field of study that includes many theoretical and applied methods based on efforts to imitate and expand human intelligence, AI has become a concept frequently used in almost every aspect of life today [3]. AI applications have revolutionary effects in many sectors, such as health, transport, education, and finance. In this context, AI research aims to investigate methods and technologies that simulate, extend, and improve human intelligence [4]. In the education sector and curriculum, AI is used for student grading and evaluations, student attendance tracking, sentiment analysis, smart tutoring, class monitoring, research trends and process tracking, and suggestion systems [5]. It is stated that with the increase in digitalization in healthcare services, the use of AI in document management, telehealth, cost, and quality management will increase. Artificial intelligence-based technologies in digital healthcare services are frequently used to improve the quality of care and increase efficiency in early diagnosis, diagnosis and treatment of diseases, research and education, drug production and calculations, epidemic prediction, and radiology [6]. In nursing, the tools used in AI include data analyses, early warning systems, clinical decision-making, mobile health and sensor-based technologies, voice assistants, and robots [7]. The increasing number of new technologies available for nursing can improve the quality of care, improve working conditions, and reduce costs [8]. In this relationship, the adaptation and integration process of nurses, should be planned in the most effective and efficient way. Preparing nursing students and nurses for clinical practice in the age of AI requires a balance between training for current needs and anticipating future demands [9]. In nursing, AI should be included in pre- and postgraduate nursing education, and nurses' knowledge and skills for using AI should be developed [10]. Education about technology and its use will be the future of nursing education because nursing care provided in a highly technological working environment is the trajectory of nursing practice [9]. AI enriches the learning experience by enabling better adaptation of educational materials to learners' strengths and needs [11]. Furthermore, AI adds value to the educational process by supporting teachers and students in gaining the necessary competencies to succeed in an AI-supported learning environment while helping them develop digital literacy and computer skills [12]. With appropriate application and guidelines, AI tools can complement and enhance human interactions in nursing education, prepare students for a rapidly changing healthcare environment, and advance nursing [13]. The research was designed within the framework of self-determination theory, which provides a comprehensive framework for understanding human motivation and personality development and suggests that motivation results from the fulfillment of three basic psychological needs (autonomy, competence, relationship) [14]. It has shown that when these needs are met, individuals are more likely to experience enhanced motivation, greater well-being, and increased performance in a variety of contexts, including education, health, and sport [15, 16]. In conclusion, the relationship between AI use, digital literacy and creative thinking in nursing students is complex and multifaceted. By utilising the principles of Self-Determination Theory, academics can create an environment that fosters intrinsic motivation and enhances students' ability to effectively navigate digital tools. The mediating role of digital literacy and the moderating effect of academic support are critical components in this process. As nursing education continues to evolve in response to technological advances, prioritising these elements is believed to be essential to prepare future health professionals to succeed in an increasingly digitalised world.
Purpose
This study artificial intelligence to determine the effect of artificial intelligence use on creative thinking skills in nursing students, the mediating role of digital literacy in this effect, and the situational mediating effect of academic support.
Method
This cross-sectional and descriptive correlational study was conducted with 426 nursing students from three universities in different regions of Turkey during the fall semester of 2024–2025. Simple random sampling method was used. Data were collected through demographic information form and four valid and reliable scales. AMOS 22, SPSS 24, and SPSS MACRO plug-ins were used to analyze the research data. Before testing the hypotheses designed in line with the research data, the validity and reliability analyses of the scales were first conducted. Confirmatory factor analyses (CFA) were performed through the AMOS 22 application for validity analysis. With these analyses, the goodness of fit values such as X2/df, RMSEA, CFI, TLI, NFI, and SRMR were determined, and CFA results were given. In addition, in order to determine that the CFA model has convergent validity (AVE and CR) and discriminant validity (MSV), Fornell and Larcker [39] and HTMT analyses were used to test the CFA model. After the validity analysis, Cronbach alpha analyses were performed using SPSS 24 software. Then, frequency analyses were used to analyze the participants' demographic information. After these stages, the variables' correlation coefficients were determined to test the hypotheses designed. In the last stage, to determine the mediating role of digital literacy and the moderating role of academic support perception, The mediating and moderating role was examined using Hayes's [17] SPSS MACRO Model 7 design.
Result
Research findings show that using artificial intelligence substantially and significantly affects Creative Thinking (β=0.70, p<0.001). Digital literacy plays mediating role in this relationship, indirectly strengthening the effect of artificial intelligence use on creative thinking (ẞ=0.422, LLCI=0.357, ULCI = 0.490). As a moderating factor of this relationship, the academic support creates a more limited effect at low levels of academic support (Effect = 0.224). At the same time, it maximizes this effect at high levels of support (Effect = 0.298). The effect of artificial intelligence use on Creative Thinking is significantly strengthened by the mediating role of digital literacy and the moderating role of academic support. These findings suggest that developing digital literacy skills and strengthening academic support mechanisms are critical to integrating artificial intelligence technologies into educational processes. The direct effect of the use of AI on Creative Thinking is positive and significant (β = 0.517, p<0.001), and the confidence intervals (LLCI = 0.357, ULCI = 0.490) support this effect. The use of AI has a significant and positive effect on digital literacy (ẞ = 0.594, p < 0.001). Digital literacy has a substantial effect on Creative Thinking (β = 0.711, p<0.001). The use of AI indirectly affects Creative Thinking through digital literacy (ẞ = 0.422). Academic support modifies the effect of AI usage on digital literacy and plays a moderating role (β=0.164, p<0.001). The indirect effect of AI usage on Creative Thinking through digital literacy was significant at low levels of academic support (Effect = 0.224), moderate levels (Effect = 0.261), and high levels (Effect = 0.298).
Conclusion
The effect of artificial intelligence use on Creative Thinking is significantly strengthened by the mediating role of digital literacy and the moderating role of academic support. These findings suggest that developing digital literacy skills and strengthening academic support mechanisms are critical to integrating artificial intelligence technologies into educational processes. The research findings reveal that AI significantly supports creative thinking through digital literacy. While AI increases individuals' creative thinking skills, digital literacy is a key mediating variable in this effect. The finding of a robust positive relationship between digital literacy and Creative Thinking clearly shows the importance of digital competencies in creative processes. Moreover, as a moderating factor, the academic support significantly strengthens the relationship between the use of AI and digital literacy. While this effect is limited when the level of academic support is low, this effect is maximized as the level of support increases. These findings suggest that the potential of AI technologies to support creative thinking skills can be revealed more effectively with digital literacy and academic support mechanisms. The effective integration of AI technologies in educational environments provides an opportunity to improve students' digital skills and increase their creative thinking capacities. However, academic support can further strengthen the positive effects of using AI by increasing students' motivation. This suggests that integrating academic support mechanisms into digital transformation processes in education programs is strategically important.
Discussion
In this study, it was determined that AI significantly supports creative thinking through digital literacy. While the use of AI increased nurse students' creative thinking skills, digital literacy was found to be an important mediating factor in this effect. In addition, academic support as a moderating factor was found to significantly strengthen the relationship between AI use and digital literacy. In this context, if we make an evaluation in parallel with the research hypotheses, firstly, according to the H₁ hypothesis, it was determined that the AI usage by nurse students significantly and positively affects their creative thinking. When the literature is evaluated; The study of Fang et al. [52] emphasizes the positive effects of AI -supported tools on generating ideas and improving creative fluency in creative processes. The research showed that AI technologies encourage creative thinking by increasing individuals' ability to develop ideas. However, it was noted that these tools could sometimes provide decon-textualized suggestions, which suggests the need for further technology optimization. Similarly, Solihat et al. [53] examined the impact of AI -based learning tools on creative thinking. They showed that these tools optimize creative problem-solving processes by providing personalized, interactive, and adaptive learning environments. The study emphasizes that AI supports individuals in producing innovative solutions without being limited only by existing knowledge and can be considered an active partner in educational processes. Finally, Liu et al. [54] examined the potential of ChatGPT, an AI -based language model, to support creative thinking processes. The study found that the personalized and interactive learning environments offered by ChatGPT provide positive effects on creative problem-solving and innovative idea generation. However, the importance of being aware of the limitations of information accuracy and supporting the technology with traditional methods was emphasized. According to the H2 hypothesis accepted within the scope of the findings, it was determined that digital literacy has a mediating role in the relationship between nurse students' AI usage and their creative thinking. In this context, when the literature was examined, it was observed that there is literature in parallel with our research results. These studies reveal the significant and positive effect of AI on the development of individuals' creative thinking capacities and also show that these technologies play a role as both a tool and an active partner in innovation processes. The impact of AI technologies on digital literacy has been studied in different fields in recent years. For example, Kazanidis and Pellas [55] emphasize that AI tools improve digital literacy skills, especially their benefits in pedagogical content production. The research revealed that AI can potentially enhance learning performance and user experience. Similarly, Bender [56] stated that generative AI tools such as ChatGPT can improve aesthetic engagement and critical thinking skills by supporting digital literacy skills. Studies in the health sector also point to a similar effect. Božić and Poola [57] showed that AI is an important tool in developing digital skills, significantly increasing the digital literacy of healthcare workers through clinical decision support systems and electronic health records. According to the other accepted hypotheses H3 and H4 of the study, it was determined that nurse students' perceptions of academic support have a regulatory role in the relationship between the use of artificial intelligence and digital literacy and also have a situational mediation role in this complex relationship. In this context, when the literature was examined, it was also seen that there is literature compatible with our research results. The effect of digital literacy on creative thinking has been directly addressed in the literature, and the links between these two skills have been emphasized in various studies. Rizal et al. [58] stated that digital literacy supports creative thinking and that these two skills complement educational processes. Sangra Dempo et al. [59] showed that digital literacy positively affects creative thinking by strengthening teaching processes. Syefrinando et al. [60] found that digital literacy in the context of online education contributes to success in learning processes by increasing students' creative skills. Although the effect of AI usage on digital literacy and the contribution of digital literacy to creative thinking have been addressed separately in the literature, it is not yet clear whether there is a mediating role between these two relationships. Our hypothesis suggests in a theoretical framework that digital literacy may play a mediating role in the effect of the use of AI on creative thinking. In this context, it is thought that digital literacy should be considered a potential mediating variable since it improves individuals' ability to use technological tools effectively and contributes to creative processes. Academic support is a critical factor that increases students' motivation in their educational processes and facilitates their learning activities. The literature has widely discussed that academic support is effective in increasing students' satisfaction and motivation in their educational processes [61]. Especially in the context of online learning, teachers' support has a strong link between students' satisfaction and motivation levels. This finding suggests that academic support can help individuals overcome the difficulties they face in their learning process. Zhao et al. [62] also emphasize the impact of school support mechanisms on technology adaptation and academic engagement. In particular, it was stated that the academic support can increase students' ability to develop digital skills and integrate them into educational processes. In this context, academic support can play a regulatory role in developing students' digital literacy skills. Although there is no direct evidence that academic support moderates the relationship between AI usage and digital literacy, existing studies indirectly support this hypothesis.
Implications for Nursing Students
The integration of AI technologies into educational processes offers significant opportunities to support the development of creative thinking skills in nursing students. In this regard, the development of digital literacy should be prioritized in educational programs. In addition, structurally strengthening academic support mechanisms that increase students' motivation is a critical step in maximizing the impact of AI and digital skills on creative thinking. In particular, including AI applications in the nursing curriculum can be used as a tool to improve students' problem-solving and creative thinking capacities. In this context, including awareness training and practical studies on digital health technologies and AI in the curriculum will improve students' academic and clinical skills. Previous studies reveal that digital literacy is critical for health professionals to adapt to future technological requirements [63-65]. The findings of this study point to the need to increase the technological competencies of nursing students and emphasize the importance of pedagogical approaches to the use of artificial intelligence. Effective implementation of academic support systems will create a learning environment that encourages creative thinking skills while facilitating students' adaptation to technology. These results suggest that nursing education programs should be restructured to adapt to technology-supported learning processes, and both instructors and students should take active roles in this process.
Limitations
This research has some limitations. Firstly, adopting a cross-sectional design limits the identification of causal relationships; therefore, the findings are based only on the relationships between variables. The study was conducted with a limited sample of nursing students from three universities in Turkey, and the generalisability of the findings to student groups in other countries or different fields is limited. Furthermore, only specific scales were used in the study, and different dimensions of AI usage, subcomponents of digital literacy, and long-term effects of academic support were excluded. It is recommended that future studies address these limitations using longitudinal designs and larger samples.
Mediated Moderation Model
AI Usage (Independent Variable)
→
Digital Literacy (Mediating Variable)
→
Creative Thinking (Dependent Variable)
Academic Support moderates the link between AI Usage and Digital Literacy, strengthening the overall mediation effect.
| Relationship | Correlation (r) | Significance |
|---|---|---|
| AI Usage - Academic Support | 0.42 | p<0.01 |
| AI Usage - Digital Literacy | 0.64 | p<0.01 |
| AI Usage - Creative Thinking | 0.70 | p<0.01 |
| Digital Literacy - Creative Thinking | 0.88 | p<0.01 |
| Academic Support - Digital Literacy | 0.79 | p<0.01 |
Strategic Integration for Future Nurses
The study emphasizes that integrating AI technologies into nursing education provides a critical opportunity to enhance students' digital skills and foster creative thinking. Strong academic support mechanisms are essential to maximize these benefits, preparing future healthcare professionals for an increasingly digitalized environment. This requires curriculum adjustments and active roles for both instructors and students.
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