Mediating effects of artificial intelligence readiness and self-efficacy on innovative behavior in Chinese standardized training nurses: a structural equation model study

BMC Nursing https://doi.org/10.1186/s12912-026-04842-2 Article in Press Mediating effects of artificial intelligence readiness and self-efficacy on innovative behavior in Chinese standardized training nurses: a structural equation model study Xiting Huang, Qingxuan Niu, Zhisheng Feng, Fang Shen, Hong Yu, Xiuhong Yuan, Xiaoxue Chen & Fang Xiao Received: 25 December 2025 Accepted: 29 May 2026 Cite this article as: Huang X., Niu Q., Feng Z. et al. Mediating effects of artificial intelligence readiness and self-efficacy on innovative behavior in Chinese standardized training nurses: a structural equation model study. BMC Nurs (2026). https://doi.org/10.1186/ s12912-026-04842-2 A E R P S S We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. IN If this paper is publishing under a Transparent Peer Review model then Peer Review reports will publish with the final article. I T R E L C © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS The Front Page Title: Mediating effects of artificial intelligence readiness and self-efficacy on innovative behavior in Chinese standardized training nurses: a structural equation model study Authors: Xiting Huang1¶, Qingxuan Niu1¶, Zhisheng Feng1¶, Fang Shen1, Hong Yu1, Xiuhong Yuan1,*, Xiaoxue Chen1,*, Fang Xiao1,* Affiliations: 1Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China. Corresponding authors: S S E R P *Xiuhong Yuan, Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun IN Yat-sen University Cancer Center, Guangzhou 510060, P. R. China. No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangdong, China E L C I T R A Email: *Xiaoxue Chen, Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China. No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangdong, China Email: *Fang Xiao, Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yatsen University Cancer Center, Guangzhou 510060, P. R. China. No. 651, Road Dongfengdong, Yuexiu District, Guangzhou, Guangdong, China Email: Other author footnotes: ¶ Xiting Huang, Qingxuan Niu, and Zhisheng Feng made equal contributions to this manuscript. Abstract ACCEPTED ARTICLEMANUSCRIPT IN PRESS Background: Innovative behavior is crucial for enhancing clinical efficiency, promoting patient recovery, and advancing the nursing discipline. As an emerging group within the nursing workforce, standardized training nurses represent a key cohort for fostering innovation. Nevertheless, the psychological mechanisms underlying their innovative behavior remain insufficiently explored. In particular, the chain mediating roles of AI readiness and self-efficacy in the relationship between self-directed learning, perceived organizational support, and innovative behavior have yet to be systematically examined. This study aims to address this research gap by investigating the mediating effect of AI readiness and self-efficacy between self-directed learning ability, perceived organizational support and innovative behavior among standardized training nurses. Methods: A cross-sectional survey was conducted between January and July 2025 using convenience sampling. Participants were recruited from two tertiary hospitals S S E R P in Guangdong Province and one tertiary hospital in Gansu Province. Data were collected using the following instruments: the General Information Questionnaire, Innovative Behavior Inventory, Medical AI Readiness Scale for Medical Students, IN General Self-Efficacy Scale, Self-Directed Learning Ability Instrument, and Perceived Organizational Support Scale. Structural equation modeling was E L C I T R A performed using AMOS software for analyze the data. Results: The structural equation model exhibited a good fit. Path analysis showed that both self-directed learning and perceived organizational support were directly associated with the innovative behavior. For the self-directed learning pathway, only the sequential indirect effect through AI readiness and self-efficacy was statistically significant (small indirect effect, β=0.018, 95%CI: 0.004, 0.048); For the perceived organizational support pathway, both the indirect effect through the sequential indirect effect through AI readiness and self-efficacy was statistically significant (small indirect effect, β=0.014, 95%CI: 0.004, 0.045). Conclusions: The relationships between self-directed learning, perceived organizational support, and innovative behavior are mediated by AI readiness and self-efficacy. These findings highlight that fostering AI readiness and self-efficacy could be of practical significance in improving innovative behavior of standardized training nurses. Keywords ： Standardized Training Nurses, Innovative behavior, Artificial Intelligence Readiness, self-efficacy, Perceived Organizational Support, Self- ACCEPTED ARTICLEMANUSCRIPT IN PRESS directed Learning. 1. Background The International Council of Nurses (ICN) 2025 Congress, held in Helsinki, adopted the theme “Nursing Power to Change the World” [1]. Innovative behavior among nurses is of great significance for enhancing work efficiency, accelerating patient recovery, and advancing the nursing discipline [2]. At the congress, the ICN Student Assembly highlighted the vital role of early-career nurses in co-creating the fu (...truncated)