Nurses’ ethical leadership, artificial intelligence, and moral sensitivity activation

BackgroundWith the widespread adoption of artificial intelligence (AI) in healthcare and nursing, nurses' subjective perception of AI has become a key indicator of their professional adaptability. However, the underlying mechanisms shaping this perception remain insufficiently understood. This study adopts a dual-perspective approach, integrating organizational management and individual psychology, to investigate the synergistic role of ethical leadership and moral sensitivity in facilitating nurses' technological adaptation. The findings provide new insights into the development of a supportive and ethically grounded nursing work environment in the digital era.ObjectiveTo examine how ethical leadership influences nurses' AI perception over time and the mediating role of moral sensitivity.MethodsData were collected in three waves from 584 nurses across six tertiary hospitals in China. Cross-lagged panel modeling and structural equation modeling were used to analyze the temporal predictive pathways and mediating mechanisms among the key variables.ResultsEthical leadership measured at Time 1 (T1) significantly and positively predicted AI perception at Time 2 (T2; β = 0.25, <i>p</i> < .001) and Time 3 (T3; β = 0.26, <i>p</i> < .001) and also significantly enhanced nurses' moral sensitivity (T2: β = 0.36, <i>p</i> < .001; T3: β = 0.18, <i>p</i> < .001). Further mediation analysis revealed that moral sensitivity at T2 partially mediated the effect of ethical leadership on AI perception at T3, accounting for 18.50% of the total effect. These results highlight a synergistic mechanism between the organizational ethical climate and individual moral resources in the process of adapting to AI technologies.ConclusionsEthical leadership and moral sensitivity jointly promote nurses' understanding and acceptance of AI systems, thereby strengthening their psychological adaptability and professional integration during technological transitions. These factors serve as essential supports for fostering a healthy nursing work environment.