Abstract
AIM: To determine the relationship between nursing managers' diverse leadership styles and nurses' artificial intelligence (AI) literacy. BACKGROUND: Nurses' AI literacy serves as a core competency for optimizing clinical workflows and safeguarding patient safety. Although leadership has been recognized as a critical factor in the adoption of technology, empirical evidence linking specific leadership styles to AI literacy among nurses remains unclear. METHODS: A cross-sectional study was conducted between October and November 2025, involving 1644 nurses recruited from 15 general tertiary hospitals across Sichuan, Jilin, Tibet, Hunan, and Hubei Provinces in China. Data were collected using five standardized instruments: a demographic information form, the AI Literacy Scale, the Multifactor Leadership Questionnaire (MLQ), the Authentic Leadership Questionnaire (ALQ), and the Servant Leadership Questionnaire (SLQ). The univariate analysis, Pearson correlation analysis, and multiple linear regression analysis were employed to examine the relationships among the study variables. RESULTS: Univariate analysis revealed significant differences in nurses' AI literacy associated with work experience, received AI-related training, and prior experience in using AI (all p < 0.05). Four leadership styles (transformational, transactional, authentic, and servant leadership) were observed to be positively correlated with AI literacy (r = 0.184-0.378, p < 0.001). Multiple linear regression identified five significant predictors of AI literacy: received AI-related training (β = 0.147, p < 0.001), prior experience in using AI (β = 0.131, p < 0.001), transformational leadership (β = 0.163, p < 0.001), transactional leadership (β = 0.073, p = 0.037), and authentic leadership (β = 0.113, p = 0.015), with the model explaining 20.2% of variance. CONCLUSIONS: Our study demonstrated that transformational, transactional, and authentic leadership in nursing managers were positively associated with nurses' AI literacy, whereas servant leadership showed no significant predictive effect. These findings highlight the multidimensional nature of leadership in fostering AI literacy among nurses and inform the strategic design of targeted leadership development initiatives within healthcare organizations.