Artificial Intelligence in Healthcare: Exploring Knowledge, Attitudes, and PracticesAmong Healthcare Workers in a Tertiary Care Hospital in Mardan, Pakistan — Insightsfrom a Low- and Middle-Income Country

Abstract

Artificial Intelligence (AI) is revolutionizing healthcare worldwide by improving diagnostics,
treatment planning, and patient management. However, its effective integration into healthcare
systems in low- and middle-income countries (LMICs) like Pakistan remains limited. Successful
implementation largely depends on the knowledge, attitudes, and practices of healthcare
professionals. This study aims to assess these factors among healthcare workers at a tertiary care
hospital in Mardan, Pakistan, offering valuable insights from an LMIC context. To evaluate the
knowledge, attitudes, and practices of healthcare professionals regarding the use of Artificial
Intelligence (AI) in healthcare settings. A cross-sectional study was conducted from July to
December 2024. Healthcare workers were consecutively surveyed using a validated KAP
questionnaire with strong reliability (Cronbach’s alpha: 0.89 for KAP, 0.79 for
awareness/behavior). Scores ranged from 0–12 for knowledge, 0–18 for attitude, and 0–16 for
practice. Data were analyzed using descriptive statistics and group comparisons (t-tests, Chisquare,
Mann–Whitney U) based on age, gender, occupation, and qualification; significance was
set at p < 0.05. Among 250 participants (mean age 32.1 ± 6.1 years; 67% male), 58.3% were
doctors, 30.9% paramedics, and 10.9% nurses. Mean scores were: knowledge 9.2 ± 2.9, attitude
12.8 ± 3.6, and practice 11.7 ± 3.6. Good knowledge, positive attitudes, and adequate practice were
observed in 60%, 54.8%, and 64.8% of participants, respectively. Female participants and
paramedics had comparatively higher KAP scores than their counterparts. Attitude differed
significantly by occupation and education (p=0.01), while practice varied among diploma holders
and paramedics. Healthcare professionals in this LMIC setting demonstrate moderate knowledge,
positive attitudes, and fair practices towards AI. Targeted education and policy initiatives are
essential to improve AI readiness and integration in healthcare systems like Mardan.