Knowledge, attitudes, and use of artificial intelligence by medical students: a mixed-method study (Preprint)

BACKGROUND Artificial intelligence (AI) is transforming medicine by enhancing care and reducing administrative tasks, and facilitating research. AI also raises many concerns, including a lack of clinical context awareness, data dependence, and the absence of ethical judgment. As future practitioners, medical students must be prepared for these changes. Most studies assessing students' attitudes and knowledge were conducted before artificial intelligence became accessible and tailored to the needs of the population. Therefore, how medical students actually use AI remains largely unexplored. OBJECTIVE This study explores French medical students' knowledge and attitudes toward AI. METHODS A mixed-methods study was conducted in 2025 among French medical students in their 4th to 6th year of school, corresponding to the clerkship year. An online survey adapted from Ten et al. 2025 included open-ended questions about AI definition and feelings toward AI, a Likert scale item to assess specific attitudes, and multiple-choice questions about the characteristics of the student. Quantitative analysis was performed using non-parametric tests (Kruskal-Wallis) to compare attitudes by AI knowledge level, academic years, career aspirations, and ranking within the class. Qualitative analysis was performed inductively. RESULTS Of 1,377 responses received, 1,342 were included. Students had a mean age of 23.1 years and were predominantly in their 5th year. Only 6% provided a correct definition of AI, while 51% gave incorrect responses. Attitudes toward AI were generally positive, with a mean score of 6.85, with significant differences by correct response to the definition (p