Metacognitive ability as a mediator between learning environment and artificial intelligence literacy among Chinese nursing students: A cross-sectional study

Abstract Background The integration of artificial intelligence (AI) into nursing education in the digital era underscores the growing need to enhance AI literacy among nursing students. However, limited research has systematically examined the factors that influence AI literacy among undergraduate nursing students. Objective This study aims to assess the current level of AI literacy among undergraduate nursing students in China and to investigate whether metacognitive ability mediates the relationship between the learning environment and AI literacy. Methods A convenience sample of 439 undergraduate nursing students was recruited from four universities in Anhui Province, China, between January and November 2024. The participants completed self-administered questionnaires designed to assess their demographic characteristics, learning environment, metacognitive abilities, and AI literacy. Results The learning environment exhibited a significant direct effect on AI literacy (β = 0.233, 95% CI: 0.142–0.326). Furthermore, metacognitive ability partially mediated the association between the learning environment and AI literacy (β = 0.417, 95% CI: 0.337–0.503). Conclusion These findings indicate that optimizing the learning environment and promoting metacognitive abilities among nursing students are essential for improving AI literacy.