When AI Becomes a Teammate: Explaining How Responsible AI Leadership Shapes Human–AI Co-Thinking and Preserves Employees’ Professional Agency in Healthcare Organizations

Abstract

Artificial intelligence (AI) is reshaping healthcare work, professional decision-making, and human–AI collaboration. However, limited research explains how leadership can support AI integration while preserving professional agency. This study developed an integrated model linking Responsible AI Leadership, Human–AI Co-Thinking, and Professional Agency. A sequential exploratory mixed-methods design was employed, combining Gioia-based qualitative analysis with partial least squares structural equation modeling. Findings showed that responsible AI leadership supports human–AI co-thinking, which in turn strengthens professional agency. Human–AI co-thinking also emerged as an important mechanism connecting responsible leadership with employees’ professional agency. The findings highlight the importance of transparent communication, human oversight, critical evaluation, contextual judgment, and professional accountability in AI-enabled healthcare work. The study contributes to organizational behavior research by positioning human–AI cothinking as a key mechanism through which responsible leadership can support professional agency.