Abstract
BACKGROUND: Artificial intelligence is increasingly integrated into nursing education, making AI literacy a key competency for students. Academic resilience is also essential for coping with learning challenges. However, the mechanisms linking AI literacy to academic resilience remain unclear, particularly the roles of self-efficacy and AI anxiety. This study examines these associations and tests the mediating effects of self-efficacy and AI anxiety. METHODS: A cross-sectional study was conducted among 415 undergraduate nursing students from a university in northern China. AI literacy, academic resilience, self-efficacy and AI anxiety were assessed using validated scales. Statistical analyses included descriptive analysis, Pearson correlation and serial mediation testing using the PROCESS macro in SPSS with bootstrap sampling. RESULTS: (1) Academic resilience was significantly and positively correlated with AI literacy (r = 0.229, p < 0.01) and self-efficacy (r = 0.340, p < 0.01), and negatively correlated with AI anxiety (r = -0.426, p < 0.01). AI literacy was positively correlated with self-efficacy (r = 0.118, p < 0.05) and negatively correlated with AI anxiety (r = -0.143, p < 0.01). (2) AI literacy was positively associated with self-efficacy (β = 0.118, p = 0.017) and was negatively associated with AI anxiety (β = -0.143, p = 0.006). Self-efficacy positively was positively associated with academic resilience (β = 0.340, p < 0.001), while AI anxiety was negatively associated with academic resilience (β = -0.426, p < 0.001). (3) In the model of AI literacy → self-efficacy → AI anxiety → academic resilience, the total indirect effect was 0.055. The mediating effect of self-efficacy accounted for 36.4% of the total indirect effect (0.020), while AI anxiety accounted for 58.2% (0.032). The serial mediation effect of self-efficacy and AI anxiety contributed 5.4% (0.003) to the total indirect effect, which was statistically significant but small in magnitude. Overall, the mediation pattern supported partial (rather than full) mediation. CONCLUSION: AI literacy is is an important correlate of nursing students’ academic resilience. Strengthening AI literacy, improving self-efficacy and reducing AI anxiety may be linked to better adaptation to AI-supported learning environments. CLINICAL TRIAL NUMBER: Not applicable.