Artificial intelligence readiness in healthcare and health professions education in conflict-affected Syria: an online cross-sectional study

Abstract Artificial intelligence (AI) is increasingly relevant to healthcare delivery, clinical training, and health professions education. Evidence from conflict-affected settings remains limited, despite workforce shortages, disrupted training pathways, and constrained digital infrastructure. This study assessed AI knowledge, trust, willingness, and digital capability among Syrian adults and healthcare respondents (students and qualified professionals), with emphasis on implications for AI literacy and professional education. We conducted a cross-sectional online survey of Syrian adults from March 4th to May 31st 2026, using a 35-item questionnaire distributed via social media through convenience sampling. The survey assessed AI awareness, trust, willingness, perceived risks and benefits, barriers to healthcare and digital health use, and Digital Literacy. Healthcare respondents (students and qualified professionals) completed additional items on clinical AI use and exposure to unsafe AI recommendations. Composite scores were calculated for AI Trust (3–15), AI Willingness (4–20), and Digital Literacy (2–10). Internal consistency was acceptable to excellent across scales (Cronbach’s alpha = 0.787–0.856). Among 829 participants, 353 (42.6%) were healthcare respondents (119 students and 234 qualified professionals). Mean AI Willingness, AI Trust, and Digital Literacy scores were 14.5 (SD 3.25), 11.0 (SD 2.34), and 6.67 (SD 1.80), respectively. In multivariable linear regression, AI Trust (β = 0.483) and Digital Literacy (β = 0.305) were the strongest predictors, followed by General AI Knowledge (β = 0.165). In sensitivity models excluding the Willingness item that loaded on Trust, Trust (β = 0.44 and 0.38) and Digital Literacy (β = 0.31 and 0.33) remained the strongest correlates. Educational use was the most accepted AI application (65.5%) and educational support was the leading perceived benefit (64.2%). Medical errors were the most frequently perceived risk (76.6%), while cost, unreliable internet access, and lack of Arabic-language content were major implementation barriers. In this online convenience sample, Trust and Digital Literacy were the strongest independent correlates of Willingness to use AI, followed by AI knowledge. The high acceptance of educational AI suggests a practical entry point for conflict-affected health systems. AI literacy should be integrated into undergraduate, postgraduate, and continuing health professions education, with explicit training on critical appraisal, safe use, bias, privacy, local validation, and clinician oversight.