How Medical Students Use and Perceive Generative Artificial Intelligence for Learning and Assessment: A Cross-Sectional Study at a Regional Australian Medical School

Generative artificial intelligence has been rapidly adopted by university students, yet there is limited evidence describing how and why medical students use it, particularly in regional settings. This cross-sectional study examined the use of generative artificial intelligence for learning and assessment among medical students at James Cook University, a regional Australian medical school with three North Queensland campuses. All enrolled students (Years 1–6) were invited to complete a 24-item online survey; closed-ended items were analysed using frequency and bivariate analyses by year level and gender, with correction for multiple comparisons, and open-ended responses were analysed using qualitative content analysis. In total, 438 students responded. Eighty percent reported using artificial intelligence for their studies or assignments, and 95% supported its use in medical education in some capacity. The most common uses were explaining concepts (56%) and answering medical content questions (54%). Pre-clinical students reported greater study-related use, whereas clinical year students reported greater assessment-related use. Male students also reported higher levels of use, willingness to pay, and trust in AI tools. Although uptake was high, trust was moderate, and students expressed concerns about professionalism and critical thinking. Medical schools should provide explicit guidance on acceptable use, incorporate artificial intelligence literacy training and ethical use guidelines, and redesign assessment to protect the skills students perceive to be most at risk.