Summary: NEJM 2023 08 03, AI in Med Education, Cooper, Rodman

 By Cooper & Rodman, NEJM 389:385-7.

https://www.nejm.org/doi/full/10.1056/NEJMp2304993

See just-prior "AI in Medicine" at NEJM by McKinsey authors.  Here.

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The article titled "AI and Medical Education — A 21st-Century Pandora’s Box," written by Avraham Cooper, M.D., and Adam Rodman, M.D., M.P.H., discusses the potential impact of generative artificial intelligence (AI) on medical education and clinical practice. The authors highlight that AI, particularly large language models like ChatGPT, has the ability to produce human-like text and mimic human thought, making it a disruptive force in medical training and practice.

The authors argue that throughout history, technological advancements have reshaped the way physicians think and practice medicine. For instance, the invention of the stethoscope led to the development of the physical exam and shaped physicians' self-conception as diagnostic detectives. Similarly, modern information technology, like electronic health records, has influenced clinical reasoning and record-keeping practices.

ChatGPT, since its release in 2022, has shown potential to be as disruptive as other historical medical advancements. It has already passed licensing and clinical reasoning exams, approximating the diagnostic thought patterns of physicians. Major healthcare companies are partnering with technology firms to deploy AI widely in the U.S. healthcare system, and chatbots intended to replace physicians are imminent.

The authors emphasize that medical educators face a critical choice: actively integrate AI into physician training, ensuring the safe and appropriate use of the technology, or allow external forces to dictate its integration. They advocate for curriculum designers, program leaders, and accreditation bodies to account for AI in medical education.

Medical schools must teach students how to use AI in practice and adapt to the academic use of AI by students and faculty. To prepare students for the future clinical landscape, medical schools need to incorporate AI didactics into clinical skills courses, diagnostic reasoning lessons, and systems-based practice training. This process has already started with identifying thought leaders and content experts to adapt curricula.

Graduate medical education must also prepare residents and fellows for a future where AI tools are integral to their practice. Trainees should become comfortable working with AI and understand its capabilities and limitations, considering that patients are already using it. Physicians already in practice must also develop familiarity with AI, and professional societies can lead in preparing members for new health care realities.

The article raises important concerns about AI's role in medical practice, including the impact on cognitive apprenticeship, learning theories, ethical decision-making, and the professional identity of physicians. The authors argue that medical education should take the lead in integrating AI into clinical practice to shape the future of health care rather than allowing technology companies to dictate the course.

### SUMMARIZE EVERYTHING writes...

Medical education is facing significant disruption with the integration of AI, particularly large language models like ChatGPT, which could impact the thought structures and practice patterns of medical trainees and physicians. The article emphasizes the need for medical educators to take an activist approach to prepare the physician workforce for the safe and appropriate use of AI in healthcare.

Facts

• 🤖 Generative AI, including large language models like GPT, is rapidly transforming medical education and practice.
• 🧠 Throughout history, technological advancements have shaped the way physicians think and practice medicine.
• 📚 Medical schools need to teach students how to use AI in practice and adapt to its academic use by students and faculty.
• 👩‍⚕️ Residents and fellows need to be trained to work effectively with AI as integral components of their practice.
• ❓ Questions arise about the impact of AI on medical education, such as its effect on lifelong learning and ethical decision-making.
• 🔮 Medical education must take a proactive role in integrating AI to shape the future of healthcare or risk being shaped by external forces.