Personality, usage, and perceptions of AI in medical education: evidence from senior pre-clinical students in China

Background As artificial intelligence (AI) tools rapidly permeate medical education, understanding individual differences in their adoption becomes increasingly important. Personality traits, particularly those defined by the Five-Factor Model, may influence how students engage with AI for learning and how they perceive its value. Objective This study aimed to examine the associations between personality traits and both AI tool use behaviors and attitudes among fourth-year clinical medical students in China. Methods A cross-sectional survey was conducted among 661 fourth-year clinical students at a medical university in Anhui Province. Personality traits were assessed using the Ten-Item Personality Inventory (TIPI). AI use frequency, specific AI-assisted learning behaviors, and attitudes toward AI in medical education were measured via structured questionnaires. Ordinal and binary logistic regressions were used to analyze behavioral outcomes, while multiple linear regression examined attitudinal associations. Results Neuroticism was negatively associated with overall AI use frequency (OR = 0.90, 95% CI: 0.83–0.98). Openness was positively linked to using AI for literature translation (OR = 1.14, 95% CI: 1.04–1.245), and conscientiousness predicted use for Auxiliary examination learning (OR = 1.15, 95% CI: 1.045–1.26). Conscientiousness, agreeableness, and openness were significantly associated with more positive attitudes toward AI's educational and clinical utility. Neuroticism was associated with greater concern over data privacy. Conclusions Personality traits meaningfully shape how students interact with AI tools and perceive their role in medical training. Tailored AI literacy programs and supportive learning environments may improve equitable adoption and optimize educational outcomes.