Abstract
Background and Objectives: With the increasing application of artificial intelligence (AI) in healthcare (such as image analysis and robotic surgery), the World Medical Association (WMA) emphasizes the need to integrate AI education into medical curricula. This study aims to assess the awareness, perceptions, and attitudes of medical undergraduates at Umm Al-Qura University in Makkah, Saudi Arabia, regarding AI and its applications in healthcare, providing a basis for integrating AI courses into medical education.
Materials and Methods: A cross-sectional study was conducted in March 2025, using stratified random sampling to select 170 undergraduate medical students from Umm Al-Qura University, ensuring representative samples across all academic years. A self-administered online questionnaire, designed based on previously validated tools, was used to collect data on demographic information, AI knowledge, usage, and attitudes. Statistical analysis was performed using SPSS 20.0, including chi-square tests, independent samples t-tests, and one-way analysis of variance (ANOVA), with a significance level of p<0.05.
Results: Among the 170 students, 70.0% were female, and 91.8% were Saudi nationals. A total of 95.9% were aware of AI, and 97.1% knew about ChatGPT, with 94.1% having used ChatGPT. Additionally, 61.2% considered AI an auxiliary tool for medical professionals rather than a substitute. Positive attitudes toward AI were associated with higher academic years (p=0.006) and greater AI awareness (p=0.008), but not with gender, age, or nationality. Although students recognized the value of AI in diagnosis and decision-making, they expressed concerns about potential ethical issues such as dehumanization, occupational replacement risks, privacy, and information accuracy. Notably, 55.3% of students had not received formal AI education, highlighting the need for integrating structured courses.
Conclusion: Medical undergraduates in Saudi Arabia have a high level of awareness of AI, generally recognizing its value but maintaining a cautious attitude. Incorporating formal AI training into undergraduate medical education is crucial to helping students adapt to future AI-enhanced clinical environments.
Introducción
Artificial intelligence (AI) is reshaping global healthcare systems irreversibly—from automated detection of diabetic retinopathy and precise operations of surgical robots to real-time analysis by clinical decision support systems. AI has moved from laboratories to core clinical practice scenarios. The World Medical Association (WMA) clearly states that medical education must keep pace with this transformation, integrating AI knowledge and application capabilities into core training objectives to ensure that future healthcare practitioners can effectively harness technology while balancing efficiency and humanistic care.
However, significant differences exist in medical students’ awareness and acceptance of AI across regions and cultural backgrounds. In Middle Eastern and Arab countries, although the application of medical AI is accelerating (e.g., the layout of digital healthcare in Saudi Arabia’s “Vision 2030”), research on medical students’ perceptions, attitudes, and educational needs regarding AI remains scarce. Existing international studies show that medical students’ views on AI often fall into a “hope-fear” contradiction: they expect AI to alleviate clinical burdens and improve diagnostic accuracy, yet worry that it may weaken clinical judgment, pose risks of occupational replacement, and even exacerbate inequalities in healthcare resource allocation.
As an important medical education institution in Saudi Arabia, Umm Al-Qura University is committed to training talents adapted to future healthcare needs. How aware are its students of AI? Do they recognize AI’s role in healthcare? Does the current medical curriculum meet the needs of cultivating AI-related capabilities? Answering these questions can not only provide a basis for medical education reform in Saudi Arabia but also offer references for the localized advancement of medical AI in the Middle East. Based on this, this study aims to systematically assess the awareness, perceptions, and opinions of medical undergraduates at Umm Al-Qura University regarding AI through a cross-sectional survey, laying the foundation for constructing an appropriate AI education system.
Materials and Methods
Study Design and Participants
This was a descriptive cross-sectional study conducted at Umm Al-Qura University in Makkah, Saudi Arabia, from January 1 to April 26, 2025. The participants were undergraduate medical students at the university (excluding medical specialists and non-medical majors). The sample size was estimated using Raosoft software, with a final sample size of 170 determined within a 95% confidence interval and 5% margin of error. Stratified random sampling was used to ensure adequate representation of students across all academic years (from basic medical studies to clinical internship stages).
- Data Collection Tool
An adjusted self-administered online questionnaire was used, designed based on previously validated studies and reviewed by preventive medicine experts to ensure cultural adaptability and content validity. The questionnaire included four parts:
1. Demographic information (gender, age, nationality, academic year, etc.);
2. AI knowledge (awareness of AI definitions and medical application scenarios);
3. AI usage (whether tools such as ChatGPT have been used, frequency, and purposes);
4. Attitudes and opinions toward AI (an 18-item Likert scale to assess recognition of AI-assisted healthcare and concerns).
A pre-survey (n=17) showed good internal consistency of the questionnaire (Cronbach’s α=0.840), and pre-survey participants were included in the final analysis. Questionnaire links (via the SurveyMonkey platform) were distributed through WhatsApp and email, with class teachers assisting to ensure coverage. Participants were required to sign an informed consent form.
Ethics and Statistical Analysis
This study was approved by the Biomedical Research Ethics Committee of Umm Al-Qura University (approval number: HAPO-02-K-012-2024-12-2417). Strict adherence to privacy protection principles was followed, and data were anonymized. SPSS 20.0 software was used for analysis: descriptive statistics (mean, percentage, standard deviation) summarized basic information; Pearson’s chi-square test analyzed the association between demographic factors and AI awareness; independent samples t-tests and one-way ANOVA compared attitude scores among different groups; the Kolmogorov-Smirnov test verified data normality. A p-value <0.05 was considered statistically significant.
Results
Basic Demographic Characteristics
Among the 170 participants, 119 (70.0%) were female and 51 (30.0%) were male; the median age was 21 years (range: 18-25 years); 156 (91.8%) were Saudi nationals, and 14 (8.2%) were non-Saudi nationals; they covered 1st to 5th-year undergraduate medical students, accounting for 20.0%, 22.3%, 19.4%, 18.8%, and 19.5% respectively.
- AI Awareness and Usage
Awareness: 95.9% (163 participants) reported being aware of AI, 97.1% (165 participants) knew about ChatGPT, and only 2.9% (5 participants) were unaware of both.
Usage behavior: 94.1% (160 participants) had used ChatGPT, mainly for literature retrieval (68.2%), organizing study materials (57.5%), and simulated case analysis (31.3%); only 5.9% (10 participants) had not used any AI tools.
- Attitudes and Opinions Toward AI
Role positioning: 61.2% (104 participants) believed AI “should serve as an auxiliary tool for medical personnel,” 28.8% (49 participants) thought “its application scenarios need to be cautiously restricted,” and only 10.0% (17 participants) worried that it “may replace medical personnel.”
Influencing factors: One-way ANOVA showed that senior students had significantly higher positive attitude scores toward AI than junior students (p=0.006); those with higher AI awareness (able to accurately describe 3 or more medical applications) had significantly higher positive attitude scores than those with lower awareness (p=0.008); gender, age, and nationality had no significant impact on attitude scores (p>0.05).
Main concerns: The top three concerns were “weakening humanistic communication between doctors and patients” (67.6%), “risk of privacy data leakage” (62.3%), and “responsibility definition for AI decision-making errors” (58.8%).
Educational status: 55.3% (94 participants) reported “no formal AI education,” only 12.9% (22 participants) had taken courses containing AI content; 89.4% (152 participants) supported “incorporating AI into compulsory medical courses.”
Discussion
This study is the first to systematically reveal the awareness and attitudes of medical undergraduates at Umm Al-Qura University, Saudi Arabia, toward AI. The results show that medical students at the university have a high level of awareness and usage of AI (95.9% aware of AI, 94.1% having used ChatGPT), consistent with the global trend of high acceptance of emerging technologies among medical students. Notably, 61.2% of students positioned AI as an “auxiliary tool” rather than a substitute, which aligns with the international consensus that “AI acts as an ‘enhancer’ rather than a ‘replacer'” and reflects students’ rational expectation for balancing technology and humanism.
The study found that students in higher academic years and with higher AI awareness held more positive attitudes toward AI, possibly because senior students have been exposed to clinical practice and can better appreciate the potential value of AI in improving efficiency (such as image analysis and medical record sorting); while junior students’ concerns may stem from their unfamiliarity with clinical work. Additionally, over half of the students had not received formal AI education, yet 89.4% supported incorporating AI into compulsory courses. This contradiction highlights the disconnect between medical education and student needs—the current curriculum has not kept up with the development of AI in healthcare, which may make future practitioners unable to adapt to AI-enhanced clinical environments.
Compared with studies in Europe and America, Saudi students in this study showed more prominent concerns about “dehumanization” (67.6%), which may be related to the emphasis on the humanistic nature of doctor-patient relationships in Middle Eastern culture. This suggests that AI education should strengthen the concept of “technology serving humanism” to avoid instrumental rationality dominating medical practice. Meanwhile, concerns about privacy and responsibility definition (58.8%-62.3%) reflect students’ attention to ethical norms of medical AI, requiring supplementary content in courses (such as data security regulations and legal boundaries of AI decision-making).
Conclusion
Medical undergraduates at Umm Al-Qura University have a high level of awareness of AI, generally recognizing its auxiliary value in healthcare but maintaining a cautious attitude, with concerns about its ethical risks and dehumanizing effects. The lack of AI-related training in current medical education contrasts sharply with students’ strong needs, indicating the urgent need to incorporate structured AI courses into undergraduate education. The content should cover technical principles, clinical applications, ethical norms, and humanistic balance to cultivate future healthcare talents capable of skillfully utilizing AI.
The limitations of this study include the sample being from a single institution, so the results may not fully represent the national situation in Saudi Arabia; the cross-sectional design makes it difficult to reflect the dynamic changes in attitudes. Future studies can conduct multi-center, longitudinal research and combine qualitative interviews to explore the impact of cultural factors on students’ attitudes toward AI, providing more detailed basis for localized education of medical AI.
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