The integration of AI tools, such as OpenEvidence, into healthcare is raising concerns about the development of clinical skills among medical trainees. OpenEvidence, an AI chatbot for clinicians, is used by approximately two-thirds of US doctors for diagnosing symptoms, checking drug interactions, and consulting clinical guidelines. Medical students, residents, and fellows are also adopting these tools early in their training.
A key concern is that trainees might not develop their own clinical judgment, a phenomenon termed "never-skilling." Traditionally, medical training involves struggling with incomplete information and learning from mistakes. AI tools provide nearly perfect answers instantly, potentially allowing trainees to bypass this crucial learning process and appear competent without internalizing the reasoning.
Medical training is an apprenticeship where clinical reasoning is built through years of repetition, failure, and supervision. While technology has always influenced medical education, AI differs by inserting itself directly into the cognitive processes that training aims to build. This could prevent trainees from developing the inner architecture of clinical reasoning that comes from independent thought and problem-solving.
Experienced clinicians, with established intuition and judgment, may be better equipped to critically evaluate AI-generated answers. However, for trainees whose understanding of medicine is still forming, relying on AI from the outset creates a more problematic dynamic. Their foundational knowledge and decision-making processes are being shaped alongside these tools, potentially hindering the development of independent critical thinking.
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There is a growing concern that medical trainees using AI tools like OpenEvidence may not develop essential clinical judgment, leading to a "never-skilling" problem rather than deskilling. While experienced clinicians might critically evaluate AI outputs, trainees forming their understanding of medicine alongside AI face a more complex relationship that could hinder their learning process.