Adopting GenAI-Assisted Writing Feedback in L2 Learning: A UTAUT Study of Medical Students
Keywords:
English Writing Feedback; Generative Artificial Intelligence (GenAI); Medical Students; Technology Acceptance; UTAUTAbstract
The use of generative artificial intelligence (GenAI) in English as a Foreign Language (EFL) writing instruction has created new opportunities to support students’ English language writing. Yet little is known about the factors that influence medical students’ acceptance of GenAI-assisted writing feedback. This study modified the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine the determinants of medical students’ adoption of GenAI-assisted English language writing feedback. A cross-sectional survey was conducted among 357 medical students at a Chinese medical university. The data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). The proposed model showed satisfactory explanatory power (R² = 0.475 for use behaviour) and predictive relevance (Q² > 0.41). All hypothesised relationships were significant. Social influence was the strongest predictor of use behaviour (? = 0.274, p < .001), followed by performance expectancy. Intention to use significantly mediated the relationships between the antecedent variables and use behaviour, indicating partial mediation. Social influence and performance expectancy also had stronger total effects than effort expectancy and facilitating conditions. The findings extend the application of the UTAUT model to medical students’ English language education. They suggest that successful implementation of GenAI-assisted writing feedback depends on both clear educational value and strong support from teachers and peers. These factors may encourage continued student use of the technology.
https://doi.org/10.26803/ijlter.25.8.10
References
Abbad, M. M. M. (2021). Using the UTAUT model to understand students’ usage of e-learning systems in developing countries. Education and Information Technologies, 26(6), 7205–7224. https://doi.org/10.1007/s10639-021-10573-5
Abduljawad, S. A. (2024). Investigating the impact of ChatGPT as an AI tool on ESL writing: Prospects and challenges in Saudi Arabian higher education. International Journal of Computer-Assisted Language Learning and Teaching, 14(1). https://doi.org/10.4018/IJCALLT.367276
Acosta-Enriquez, B. G., Arbulu Ballesteros, M., Vilcapoma Pérez, C. R., Huamaní Jordan, O., Martin Vergara, J. A., Martel Acosta, R., Arbulu Perez Vargas, C. G., & Arbulú Castillo, J. C. (2025). AI in academia: How do social influence, self-efficacy, and integrity influence researchers’ use of AI models? Social Sciences & Humanities Open, 11, 101274. https://doi.org/10.1016/j.ssaho.2025.101274
Adabor, E. S., Addy, E., Assyne, N., & Antwi-Boasiako, E. (2025). Enhancing sustainable academic course delivery using AI in technical universities: An empirical analysis using adaptive learning theory. Sustainable Futures, 10, 100828. https://doi.org/10.1016/j.sftr.2025.100828
Adiyono, A., Jasiah, J., Ritonga, M., & Al-Matari, A. S. (2024). ChatGPT and active learning. In M. Lahby (Ed.), Empowering Digital Education with ChatGPT (1st ed., pp. 189–209). Chapman & Hall/CRC. https://doi.org/10.1201/9781032716350-13
Ahmed, W. M., Azhari, A. A., Alfaraj, A., Alhamadani, A., Zhang, M., & Lu, C.-T. (2024). The quality of AI-generated dental caries multiple choice questions: A comparative analysis of ChatGPT and Google Bard language models. Heliyon, 10(7), e28198. https://doi.org/10.1016/j.heliyon.2024.e28198
Aladini, A., Ismail, S. M., Ahmad Saleem Khasawneh, M., & Shakibaei, G. (2025). Self-directed writing development across computer/AI-based tasks: Unraveling the traces on L2 writing outcomes, growth mindfulness, and grammatical knowledge. Computers in Human Behavior Reports, 17, 100566. https://doi.org/10.1016/j.chbr.2024.100566
Ali, O., Murray, P. A., Momin, M., Dwivedi, Y. K., & Malik, T. (2024). The effects of artificial intelligence applications in educational settings: Challenges and strategies. Technological Forecasting and Social Change, 199, 123076. https://doi.org/10.1016/j.techfore.2023.123076
Alkhaaldi, S. M. I., Kassab, C. H., Dimassi, Z., Oyoun Alsoud, L., Al Fahim, M., Al Hageh, C., & Ibrahim, H. (2023). Medical student experiences and perceptions of ChatGPT and artificial intelligence: Cross-sectional study. JMIR Medical Education, 9, e51302. https://doi.org/10.2196/51302
Alsofyani, A. H., & Barzanji, A. M. (2025). The effects of ChatGPT-generated feedback on Saudi EFL learners’ writing skills and perception at the tertiary level: A mixed-methods study. Journal of Educational Computing Research, 63(2), 431–463. https://doi.org/10.1177/07356331241307297
Annamalai, N., Bervell, B., Mireku, D. O., & Andoh, R. P. K. (2025). Artificial intelligence in higher education: Modelling students’ motivation for continuous use of ChatGPT based on a modified self-determination theory. Computers and Education: Artificial Intelligence, 8, 100346. https://doi.org/10.1016/j.caeai.2024.100346
Baffour, P., Saxberg, T., & Crossley, S. (2023). Analyzing bias in large language model solutions for assisted writing feedback tools: Lessons from the Feedback Prize competition series. In E. Kochmar, J. Burstein, A. Horbach, R. Laarmann-Quante, N. Madnani, A. Tack, V. Yaneva, Z. Yuan, & T. Zesch (Eds.), Proceedings of the 18th Workshop on Innovative Use of NLP for Building Educational Applications (BEA 2023) (pp. 242–246). Association for Computational Linguistics. https://doi.org/10.18653/v1/2023.bea-1.21
Bannister, P., Alcalde Peñalver, E., & Santamaría Urbieta, A. (2024). Transnational higher education cultures and generative AI: A nominal group study for policy development in English medium instruction. Journal for Multicultural Education, 18(12), 173–191. https://doi.org/10.1108/JME-10-2023-0102
Barrot, J. S. (2023). Using ChatGPT for second language writing: Pitfalls and potentials. Assessing Writing, 57, 100745. https://doi.org/10.1016/j.asw.2023.100745
Butler, Y. G., & Jiang, S. (2025). How do pre-service language teachers perceive generative AIs’ affordance?:A case of ChatGPT. System, 129, 103606. https://doi.org/10.1016/j.system.2025.103606
Cai, Q. (2025). Factors influencing engagement in EFL learning of higher education learners in blended learning environments. International Journal of Educational Research, 131, 102587. https://doi.org/10.1016/j.ijer.2025.102587
Cammarano, A., Varriale, V., Michelino, F., & Caputo, M. (2024). Discovering technological opportunities of cutting-edge technologies: A methodology based on literature analysis and artificial neural network. Technological Forecasting and Social Change, 209, 123811. https://doi.org/10.1016/j.techfore.2024.123811
Chadli, E. M., Bellet, M., & Belfakir, L. (2024). Predicting EFL university students' acceptance of mobile-assisted language learning through the UTAUT2 model. Journal of Computer Science and Technology Studies, 6(5), 29–37. https://doi.org/10.32996/jcsts.2024.6.5.3
Cheng, Y., Fan, Y., Li, X., Chen, G., Gaševi?, D., & Swiecki, Z. (2025). Asking generative artificial intelligence the right questions improves writing performance. Computers and Education: Artificial Intelligence, 8, 100374. https://doi.org/10.1016/j.caeai.2025.100374
Chu, P. Q., Chowdhury, R., & Le, T. T. T. (2025). Using the UTAUT2 model to determine the factors affecting students’ acceptance of blended learning for English writing. Computer-Assisted Language Learning Electronic Journal, 26(3), 24–42. https://doi.org/10.54855/callej.252632
Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd ed.). Sage Publications.
Fränken, J., Gandhi, K., Gerstenberg, T., & Goodman, N. D. (2023). Understanding social reasoning in language models with language models. OSF Preprints. https://doi.org/10.17605/OSF.IO/ZXW6M
Fu, M., & Li, S. (2022). THE EFFECTS OF IMMEDIATE AND DELAYED CORRECTIVE FEEDBACK ON L2 DEVELOPMENT. Studies in Second Language Acquisition, 44(1), 2–34. https://doi.org/10.1017/S0272263120000388
Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R: A Workbook. Springer International Publishing. https://doi.org/10.1007/978-3-030-80519-7
Jembu, J. P., & Balang, R. V. (2025). Artificial intelligence adoption in nursing students’ academic writing: A qualitative study. Teaching and Learning in Nursing. https://doi.org/10.1016/j.teln.2025.04.015
Khojasteh, L., Shokrpour, N., & Moslehi, S. (2025). Decision-making in decoding AI-generated content: Emotional dynamics and pedagogical strategies in English for specific purposes education. Teaching and Teacher Education, 157, 104952. https://doi.org/10.1016/j.tate.2025.104952
Korchak, A., Al Murshidi, G., Getman, A., Raouf, N., Arshe, M., Al Meheiri, N., Shulgina, G., & Costley, J. (2025). The role of social influence in generative artificial intelligence ChatGPT adoption intentions among undergraduate and graduate students. Innovations in Education and Teaching International, 62(5), 1559–1573. https://doi.org/10.1080/14703297.2025.2496942
Lewis, S., Bhyat, F., Casmod, Y., Gani, A., Gumede, L., Hajat, A., Hazell, L., Kammies, C., Mahlaola, T. B., Mokoena, L., & Vermeulen, L. (2024). Medical imaging and radiation science students’ use of artificial intelligence for learning and assessment. Current Issues in Radiography Education, 30, 60–66. https://doi.org/10.1016/j.radi.2024.10.006
Lin, P., Cai, Y., He, S., Li, X., Liang, Y., Huang, T., Li, J., Lin, B., Xin, G., & Lin, H. (2025). Enhancing medical English proficiency: The current status and development potential of peer-assisted learning in medical education. BMC Medical Education, 25(1), 79. https://doi.org/10.1186/s12909-024-06492-x
Lucas, H. C., Upperman, J. S., & Robinson, J. R. (2024). A systematic review of large language models and their implications in medical education. Medical Education, 58(11), 1276–1285. https://doi.org/10.1111/medu.15402
Luo, Y., & Day, M. J. (2026). Determinants of lecturer readiness to adopt generative AI in higher education: Survey evidence from UTAUT and self-determination theory. Education and Information Technologies, 31(10), 3399–3430. https://doi.org/10.1007/s10639-026-13931-3
Pan, L., & Chen, Q. (2026). Exploring EFL learners’ behavioral intention toward AI-based conversational tools through the lens of UTAUT and Self-Determination Theory. BMC Psychology. https://doi.org/10.1186/s40359-026-05059-3
Rodway, P., & Schepman, A. (2023). The impact of adopting AI educational technologies on projected course satisfaction in university students. Computers and Education: Artificial Intelligence, 5, 100150. https://doi.org/10.1016/j.caeai.2023.100150
Rong, M., & Yao, Y. (2026). From assistance to advancement: A systematic review of how GenAI supports L2 writing learning from the lens of activity theory. ECNU Review of Education, 9(2), 20965311261437802. https://doi.org/10.1177/20965311261437802
Rumangkit, S., Surjandy, & Billman, A. (2023). The effect of performance expectancy, facilitating condition, effort expectancy, and perceived easy to use on intention to using media support learning based on the Unified Theory of Acceptance and Use of Technology (UTAUT). E3S Web of Conferences, 426, 02004. https://doi.org/10.1051/e3sconf/202342602004
Venkatesh, V. (2022). Adoption and use of AI tools: A research agenda grounded in UTAUT. Annals of Operations Research, 308(1–2), 641–652. https://doi.org/10.1007/s10479-020-03918-9
Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425–478. https://doi.org/10.2307/30036540
Wang, Q. (2025). EFL learners’ motivation and acceptance of using large language models in English academic writing: An extension of the UTAUT model. Frontiers in Psychology, 15, 1514545. https://doi.org/10.3389/fpsyg.2024.1514545
Wu, C., Zhang, Y.-W., & Li, A. W. (2023). Peer feedback and Chinese medical students’ English academic writing development: A longitudinal intervention study. BMC Medical Education, 23(1), 578. https://doi.org/10.1186/s12909-023-04574-w
Xing, P., Sun, Q., Yang, Z., Yu, H., Zhang, W., & Kalam, O. (2025). Exploring factors influencing AI adoption in L2 English academic writing: A latent profile analysis based on UTAUT and ecological theory. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.5295744
Yang, Y. (2025). Exploring factors influencing L2 learners’ use of GAI-assisted writing technology: Based on the UTAUT model. Asia Pacific Journal of Education, 1–20. https://doi.org/10.1080/02188791.2025.2505664
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ziyao Ji, Naginder Kaur, Hongmei Cui

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
All articles published by IJLTER are licensed under a Creative Commons Attribution Non-Commercial No-Derivatives 4.0 International License (CCBY-NC-ND4.0).