Toward an AI-integrated nursing curriculum: A Kano model analysis of generative AI competency needs

BACKGROUND: Generative artificial intelligence (GenAI) is increasingly influencing nursing practice and education, yet a gap remains between technological advances and clinical nurses' competencies. Research from nurses' perspectives that systematically differentiates and prioritizes GenAI learning needs remains limited. OBJECTIVE: To investigate clinical nurses' current use of GenAI and their learning attitudes, and to categorize and prioritize their learning needs using the Kano model. METHODS: A cross-sectional survey was conducted among 1219 clinical nurses in a tertiary hospital in China. Eighteen GenAI-related learning needs were classified using the Kano model. Better-Worse coefficients were calculated and visualized in a quadrant plot. The Average Satisfaction Coefficient (ASC) was further used to rank attributes within each quadrant. RESULTS: Most participants reported prior use of GenAI (87.69%) and positive attitudes (97.10%), while only 7.39% had received formal training. Six learning needs were identified as one-dimensional attributes, primarily related to practical applications such as teaching material development and patient education. One attribute (personalized nursing education) was classified as attractive. Eleven items, including foundational knowledge, ethics, and advanced clinical applications, were classified as indifferent. Within this category, usage standards, nursing rounds, and multidisciplinary case discussions showed relatively higher ASC values. CONCLUSION: Nurses' GenAI learning needs are currently oriented toward practical, application-focused skills. Curriculum development may benefit from a phased approach that prioritizes high-impact practical skills while progressively incorporating foundational, ethical, and advanced competencies. Ethics should be included as a core component. Educator preparedness and pedagogical leadership are important for effective integration of GenAI into nursing education.