Understanding Trust as a Mediating Mechanism in AI-Based Medical Tools and Clinical Decision Processes

Authors

• Shanthi Isparan, Teh Hong Piow Faculty of Business and Finance, Universiti Tunku Abdul Rahman, Perak, Malaysia
• Seow Ai Na, Teh Hong Piow Faculty of Business and Finance, Universiti Tunku Abdul Rahman, Perak, Malaysia
• Chang Jing Jing, Faculty of Information and Communication Technology, Universiti Tunku Abdul Rahman, Perak, Malaysia
• Hew Jun Jie, UCSI Graduate Business School, UCSI University, Kuala Lumpur, Malaysia

Corresponding Author ORCID Identifer

Seow Ai Na https://orcid.org/0000-0001-7693-9100

Document Type

Research

Abstract

The growing integration of artificial intelligence (AI) in healthcare has transformed clinical decision-making. Nevertheless, doctors’ engagement with AI-based tools remains hindered, particularly due to trust-related concerns. The purpose of this study is to examine the factors influencing doctors’ engagement with AI-based medical tools, with a focus on the mediating role of trust within the Unified Theory of Acceptance and Use of Technology (UTAUT). Data were collected from 197 doctors in Selangor and Kuala Lumpur through a structured survey and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) with SmartPLS 4 software. The findings reveal that performance expectancy, effort expectancy, social influence, and facilitating conditions significantly influence trust in AI tools, which in turn strongly predict AI-based clinical decision-making. Mediation analysis confirms that trust fully mediates the relationships between UTAUT constructs and AI engagement. Hence, trust is a critical mechanism linking user perceptions to behavioural outcomes in clinical contexts. The findings implied the need for transparent AI systems, targeted training and institutional support. Healthcare institutions should focus on clear governance to strengthen trust and facilitate effective human-AI integration.

Keywords

Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, UTAUT, Trust In AI, AI-Based Clinical Decision Making

Cite This Article

Shanthi, I., Seow, A. N., Chang, J. J., & Hew, J. J. (2026). Understanding trust as a mediating mechanism in AI-based medical tools and clinical decision processes. International Journal of Management, Finance and Accounting, 7(2), 319–354. https://doi.org/10.33093/ijomfa.2026.7.2.11

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This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.