Attitudes towards artificial intelligence and their association with innovative behaviour among diploma nursing students in selected state nursing training schools in Sri Lanka: a cross-sectional study

Abstract Background Artificial intelligence (AI) is increasingly embedded in healthcare and education. Nursing students will enter AI-enabled clinical environments, yet evidence from Sri Lanka on their attitudes towards AI and how these relate to innovative behaviour is limited. This study assessed AI attitudes and innovative behaviour and examined their association among diploma nursing students in selected state nursing training schools in Sri Lanka. Methods A descriptive cross-sectional study was conducted among 282 diploma nursing students from Kalutara and Galle Nursing Training Schools using systematic random sampling. Data were collected using an expert-reviewed and pretested self-administered questionnaire comprising sociodemographic items, the 13-item Artificial Intelligence Attitude Scale, and the 10-item Innovative Work Behaviour Scale. Descriptive statistics and tests of normality were performed in IBM SPSS Statistics version 27. Because the total scores were not normally distributed, Spearman's rank-order correlation was used to examine the association between AI attitudes and innovative behaviour. Statistical significance was set at p < 0.05. Results Among 282 participants, 228 (80.9%) were female and 260 (92.2%) were third-year students. The mean AI attitude score was 44.32 (SD 4.65), and the mean innovative behaviour score was 35.73 (SD 4.79). AI attitude scores showed a weak but statistically significant positive correlation with innovative behaviour scores (Spearman's rho = 0.203, p < 0.001). Conclusions More favourable AI attitudes were associated with slightly higher innovative behaviour among diploma nursing students, although the association was weak and does not establish causality. The findings support consideration of structured, responsible AI literacy and innovation-focused learning activities in nursing education. Larger multi-site and longitudinal studies are needed to identify additional factors that shape innovative behaviour.