Generative AI and knowledge management in health education: a cross-sectional study of students’ digital literacy and attitudes from a developing-country context

Background Generative artificial intelligence (AI) is rapidly transforming higher education and digital learning. However, a scarcity of information remains regarding the students’ perspectives on AI’s role in education. We investigated AI-related knowledge, use, and attitudes among entry-level healthcare students in Kosovo. Methods Cross-sectional online survey (June–August 2025) of entry-level students from two institutions (≈ 700 invited; N = 302; response 43.1%). Analyses used χ² with Cramér’s V, and Kruskal–Wallis with ε²; α = 0.05. Results ChatGPT was reported as the primary AI instrument (84.2%). 74.8% of participants perceived AI integration positively, 77.2% supported curricular integration, and its ability to facilitate access to information was 91.4%. Interest in AI training was as high as 71.2%, whereas major concerns included error risks (29.5%) and reduced creativity (29.0%). Program differences were observed for faculty use of AI-assisted materials ( p = 0.006; Cramér’s V = 0.20), AI-training opportunities ( p = 0.037; V = 0.17), and institutional AI-tool provision ( p = 0.032; V = 0.151); self-rated AI knowledge did not differ ( p = 0.274; ε²=0.003). Conclusions Findings indicate general positivity towards AI, alongside concerns regarding unequal access and limited formal training. These findings underscore the importance of integrating generative AI within e-learning strategies, strengthening students’ digital literacy, and ensuring institutional support in developing country settings.