Assessment the Effects of Using Artificial Intelligence (AI) Assisted Tools on Critical Thinking Skills in Undergraduates Nursing Students in Khyber Pakhtunkhwa Pakistan

Abstract

Background: Artificial intelligence (AI)-assisted tools are increasingly used in nursing education, but concerns remain regarding excessive reliance on AI and its relationship with independent critical-thinking behaviors. Objective: To assess AI-assisted tool use and examine its relationship with self-reported critical-thinking behaviors among undergraduate nursing students. Methods: A quantitative descriptive cross-sectional study included 435 undergraduate BSN students in Khyber Pakhtunkhwa, Pakistan. Data were collected using a structured questionnaire assessing demographics, six critical-thinking items, four AI use/engagement items, and five perceived AI-related effect items. Data were analyzed using IBM SPSS Statistics version 26.0 with frequencies, percentages, means, standard deviations, and independent-samples t-tests. Results: Participants had a mean age of 20.87 ± 1.68 years, and 81.1% were male. High AI use/engagement was reported by 49.0% of participants, while 40.2% had moderate and 10.8% low use. The mean AI-use score was 10.3 ± 3.0. Critical-thinking scores were moderate in 66.0%, low in 21.4%, and high in 12.6%, with a mean score of 12.6 ± 4.0. Overall, 56.3% reported often or always relying on AI for problems requiring critical thinking. Critical-thinking scores did not differ significantly between males and females (12.5 ± 4.0 vs 12.9 ± 3.7; p=0.409). Conclusion: AI-assisted tool use was common among undergraduate nursing students, while most reported moderate critical-thinking behaviors. The findings highlight the importance of integrating AI into nursing education in ways that preserve independent evaluation and reflective reasoning.