Health Care Professionals' Concerns About Medical AI and Psychological Barriers and Strategies for Successful Implementation: Scoping Review

Abstract

Background: The rapid progress in the development of artificial intelligence (AI) is having a substantial impact on health care (HC) delivery and the physician-patient interaction.

Objective: This scoping review aims to offer a thorough analysis of the current status of integrating AI into medical practice as well as the apprehensions expressed by HC professionals (HCPs) over its application.

Methods: This scoping review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to examine articles that investigated the apprehensions of HCPs about medical AI. Following the application of inclusion and exclusion criteria, 32 of an initial 217 studies (14.7%) were selected for the final analysis. We aimed to develop an attitude range that accurately captured the unfavorable emotions of HCPs toward medical AI. We achieved this by selecting attitudes and ranking them on a scale that represented the degree of aversion, ranging from mild skepticism to intense fear. The ultimate depiction of the scale was as follows: skepticism, reluctance, anxiety, resistance, and fear.

Results: In total, 3 themes were identified through the process of thematic analysis. National surveys performed among HCPs aimed to comprehensively analyze their current emotions, worries, and attitudes regarding the integration of AI in the medical industry. Research on technostress primarily focused on the psychological dimensions of adopting AI, examining the emotional reactions, fears, and difficulties experienced by HCPs when they encountered AI-powered technology. The high-level perspective category included studies that took a broad and comprehensive approach to evaluating overarching themes, trends, and implications related to the integration of AI technology in HC. We discovered 15 sources of attitudes, which we classified into 2 distinct groups: intrinsic and extrinsic. The intrinsic group focused on HCPs' inherent professional identity, encompassing their tasks and capacities. Conversely, the extrinsic group pertained to their patients and the influence of AI on patient care. Next, we examined the shared themes and made suggestions to potentially tackle the problems discovered. Ultimately, we analyzed the results in relation to the attitude scale, assessing the degree to which each attitude was portrayed.

Conclusions: The solution to addressing resistance toward medical AI appears to be centered on comprehensive education, the implementation of suitable legislation, and the delineation of roles. Addressing these issues may foster acceptance and optimize AI integration, enhancing HC delivery while maintaining ethical standards. Due to the current prominence and extensive research on regulation, we suggest that further research could be dedicated to education.

Keywords: anxiety; artificial intelligence; attitudes; digital health; fear; health care professionals; reluctance; resistance; skepticism.

Figure 1

The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) flow diagram illustrating the study selection process. The PRISMA-ScR flow diagram provides a visual summary of the study selection process. It details the number of studies identified (N=217), screened, assessed for eligibility, and included (n=32) in this scoping review. The diagram highlights the systematic approach to selecting relevant studies, ensuring transparency in the review methodology. AI: artificial intelligence. *Identified from PubMed.

Figure 2

Classification of sources of attitudes among health care professionals (HCPs) as identified in the review. This figure categorizes the 15 identified sources of attitudes of HCPs related to the use of medical artificial intelligence (AI). The sources of attitudes are divided into 2 main categories: extrinsic (external factors such as organizational policies, ethical issues, patient connections, and technological limitations) and intrinsic (internal factors such as personal beliefs, skills, personal identity, and expert status). Two sources, uncertainty about the future and responsibility, are shown to overlap, affecting both HCPs and their patients. The classification aids in understanding the multifaceted nature of these concerns.