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This paper reframes concerns about AI over-reliance in medical education not as misuse, but as a mechanistic failure to correctly classify task-appropriate AI interaction modes using the SCAN framework. By grounding this approach in cognitive science and Vygotsky's Zone of Proximal Development, it offers a testable method for preventing "mis-skilling" through real-time metacognitive evaluation rather than broad cohort-wide restrictions. The work provides educators with specific criteria to assess when AI should substitute, complement, aid, or remain non-negotiable in clinical reasoning development.
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AI as Teammate: Rethinking Task Distribution in Medical Training

arXiv3 min read

arXiv:2608.28373v1 Announce Type: cross Abstract: Integrating Artificial Intelligence (AI), particularly generative AI, into medical training has prompted concerns about learner over-reliance, misuse, and erosion of foundational clinical competencies. We propose a conceptual reframing at the decision level: the problem is not misuse but misclassification - a mechanistic failure of real-time metacognitive evaluation in selecting a subzone-inappropriate AI interaction mode. Drawing on "SCAN" (Substitute, Complement, Aid, Non-Negotiable), a human-centric decision-making framework for generative AI task allocation grounded in Vygotsky's Zone of Proximal Development and metacognition, we advance the emerging social-constructivist conversation around AI in medical education by offering a testable account of AI's role in clinical reasoning development. This framework yields testable predictions for how misclassification can be detected, mitigated, and, more importantly, prevented in the clinical learning environment. Regarding clinical reasoning development, we show how trajectories of skill acquisition (upskilling) and failure (the triad of skill failure: de-skilling, never-skilling, and mis-skilling) operate at the individual task level in ways that fixed-phase, cohort-wide treatments fail to capture. We further identify passive engagement within correctly classified AI-scaffolded tasks as a particularly insidious, detection-resistant pathway to mis-skilling - one requiring subzone re-identification from AI assistance to expert assistance, with human experts serving as epistemic auditors. The paper operationalizes SCAN for clinical curriculum design, supervision, and assessment, and opens an empirical research agenda grounded in cognitive science. This paradigm shift from misuse to misclassification is not semantic: it offers educators a clear perspective on what to look for, what to assess, and what to intervene on.

Abstract:Integrating Artificial Intelligence (AI), particularly generative AI, into medical training has prompted concerns about learner over-reliance, misuse, and erosion of foundational clinical competencies. We propose a conceptual reframing at the decision level: the problem is not misuse but misclassification - a mechanistic failure of real-time metacognitive evaluation in selecting a subzone-inappropriate AI interaction mode. Drawing on "SCAN" (Substitute, Complement, Aid, Non-Negotiable), a human-centric decision-making framework for generative AI task allocation grounded in Vygotsky's Zone of Proximal Development and metacognition, we advance the emerging social-constructivist conversation around AI in medical education by offering a testable account of AI's role in clinical reasoning development. This framework yields testable predictions for how misclassification can be detected, mitigated, and, more importantly, prevented in the clinical learning environment. Regarding clinical reasoning development, we show how trajectories of skill acquisition (upskilling) and failure (the triad of skill failure: de-skilling, never-skilling, and mis-skilling) operate at the individual task level in ways that fixed-phase, cohort-wide treatments fail to capture. We further identify passive engagement within correctly classified AI-scaffolded tasks as a particularly insidious, detection-resistant pathway to mis-skilling - one requiring subzone re-identification from AI assistance to expert assistance, with human experts serving as epistemic auditors. The paper operationalizes SCAN for clinical curriculum design, supervision, and assessment, and opens an empirical research agenda grounded in cognitive science. This paradigm shift from misuse to misclassification is not semantic: it offers educators a clear perspective on what to look for, what to assess, and what to intervene on.

Human-Computer Interaction (cs.HC); Artificial Intelligence (cs.AI)

arXiv:2608.28373 [cs.HC]

(or arXiv:2608.28373v1 [cs.HC] for this version)

https://doi.org/10.48550/arXiv.2608.28373 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 344 words

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