Artificial intelligence (AI), including large language models (LLMs), is becoming a daily companion in medicine — from documentation to diagnostic reasoning. Used thoughtfully, AI can enhance learning and efficiency. Used uncritically, it risks deskilling, never-skilling, and mis-skilling.
| Opportunity | Risk |
|---|---|
| Off-loads routine cognitive work | Overreliance → weaker independent reasoning |
| Enables simulation and feedback | Unverified outputs → biased or unsafe care |
| Expands access to medical knowledge | “Black box” reasoning → misplaced trust |
A structured approach to think critically during AI interactions.
| Step | Purpose | Sample Question |
|---|---|---|
| Diagnosis/Discussion | Clarify reasoning and AI use | “What did you ask the AI, and why?” |
| Evidence | Probe reasoning, verification | “What supports or contradicts this answer?” |
| Feedback | Reflect on performance | “What could you do differently next time?” |
| Teaching | Identify key learning | “What principle or rule emerged?” |
| AI Recommendation | Guide next safe step | “When is it appropriate to use this tool again?” |
Adaptive patterns of human–AI collaboration.
| Mode | Description | Best Use |
|---|---|---|
| Cyborg | Human and AI co-create iteratively | Routine or low-risk tasks (notes, drafts) |
| Centaur | Human leads, delegates tasks to AI, verifies results | High-risk, diagnostic, or uncertain tasks |
→ Skilled clinicians shift flexibly between these modes depending on risk and task complexity.
A quick checklist for responsible AI engagement.
S – Specify the task clearly.
A – Ask for reasoning (“Explain step by step”).
F – Find supporting evidence.
E – Evaluate output critically.
A – Apply clinical judgment.
I – Integrate reflectively—what did you learn?
- Treat AI output like a preliminary report — confirm before acting.
- Cross-check against guidelines, literature, and senior input.
- Verification protects your patients and your reasoning skills.
Think of one clinical or learning task you currently use AI for.
- Which DEFT–AI step could improve your approach?
- Is it better handled in centaur or cyborg mode?
- How will you verify before trusting next time?
Remember:
AI doesn’t replace your reasoning — it reveals it.
Use it to reflect, refine, and strengthen your clinical judgment.
See https://www.nejm.org/doi/10.1056/NEJMra2503232 for more....