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  • Uncategorized

    Teaching Tomorrow’s Doctors: Why AI Belongs in the Medical Curriculum Today

    [This blog entry was created using AI tools as part of an exploratory process. The initial step involved identifying relevant articles using Open Evidence (OpenEvidence). After filtering the results, the writer selected the four most salient articles for deeper analysis. These were then input into ChatGPT with instructions to generate a 500-word blog post tailored to an audience of medical educators across disciplines. Several rounds of revisions followed, involving both AI-assisted editing and human review, including careful cross-checking of references. This process illustrates one example of how leveraging the strengths of various AI tools can enhance academic and professional communication.]

    Artificial intelligence (AI) isn’t coming to healthcare—it’s already here. From diagnostic support to personalized treatment planning, AI is reshaping how clinicians work. Yet, as the tools grow smarter, are we making sure our future doctors are ready to use them wisely?

    For many medical schools, integrating AI into the curriculum still feels like a futuristic challenge, reserved for tech-forward institutions or students with a coding background. But that mindset may be doing our learners—and their future patients—a disservice.

    As Lee et al. (2021) noted in their scoping review, most current efforts to teach AI in undergraduate medical education are fragmented and inconsistent. Students get glimpses of AI—perhaps in a radiology elective or a data science lecture—but rarely develop a foundational understanding of how it fits into clinical reasoning, ethical decision-making, or patient care.

    Fortunately, the conversation is shifting. Gordon et al. (2024), in their comprehensive BEME review, advocate for a structured, competency-based approach to AI education. Rather than teaching “about technology,” they propose helping students become critical consumers of AI—able to evaluate algorithms, question biases, and make informed clinical choices in AI-augmented environments. 

    What should this look like in practice? Çalışkan et al. (2022) provide a helpful starting point. Through a Delphi study, they identified core competencies that medical students should acquire, including data literacy, understanding the limitations of AI, and ethical awareness. These aren’t just technical skills—they’re critical thinking tools.

    This shift isn’t about turning every med student into a programmer. It’s about preparing them to ask smart questions: Can I trust this algorithm’s output? Is it transparent? Could it reinforce existing healthcare inequities?

    Engaging students in these conversations is not just possible—it’s essential. As Chen et al. (2019) emphasized, students respond well to case-based and clinical examples where AI tools are already in use. Imagine a cardiology module that includes AI-based EKG interpretation, or an ethics seminar that tackles algorithmic bias in patient triage.

    Wartman and Combs (2018) take it a step further, arguing that AI should catalyze a reimagining of medical education itself. In a world where machines can recall every clinical guideline, the value of a physician lies in synthesis, judgment, and humanity. Our curricula and means of evaluation should evolve accordingly.

    And AI isn’t just the content—it can also be the method. Tools that offer AI-powered feedback (Aquifer, 2025) or assist in curriculum mapping (Raskob et al., 2025) are already helping educators personalize learning and identify gaps.

    Medical educators don’t need to become data scientists—but we do need to lead this transformation. Let’s give our students the tools to engage with AI thoughtfully, challenge it where needed, and use it to deliver more equitable, effective care. Because the future of medicine isn’t just high-tech—it’s human-led, AI-enabled.

    What do you think?

    1. Where in your current curriculum could AI naturally be introduced or integrated?
      Think about existing modules (e.g., radiology, pathology, ethics) where AI tools are already being used in clinical practice.
    2. What competencies do you think are most important for students to develop regarding AI in medicine?
      How might you prioritize ethical reasoning, data literacy, or critical evaluation of AI tools?
    3. How prepared do you feel—individually or institutionally—to teach about AI in medical education?
      What support, training, or partnerships would help you feel more confident?
    4. How can AI be used not just as content, but as a tool for teaching and assessment in your program?
      Have you considered ways to use AI for formative feedback, curriculum mapping, or adaptive learning?
    5. What potential risks or unintended consequences should we be mindful of as we integrate AI into medical education?
      How do we ensure equity, transparency, and student-centered learning while adopting new technologies?

    References

    Aquifer (2025). AI-Powered Feedback: Enhancing Clinical Reasoning in Medical Education. Available at https://aquifer.org/blog/ai-powered-feedback-enhancing-clinical-reasoning-in-medical-education/. Accessed June 17, 2025.

    Çalışkan, S. A., Demir, K., & Karaca, O. (2022). Artificial intelligence in medical education curriculum: An e-Delphi study for competencies. PLOS ONE, 17(7), e0271872. https://doi.org/10.1371/journal.pone.0271872

    Chen, J. H., Asch, S. M., & Wren, S. M. (2019). Artificial intelligence in medical education: A review. JMIR Medical Education, 5(1), e13930. https://doi.org/10.2196/13930

    Gordon, M., Daniel, M., Ajiboye, A., Atkinson, H., Downer, J., & Parise, A. (2024). A scoping review of artificial intelligence in medical education: BEME Guide No. 84. Medical Teacher, 46(4), 446–470. https://doi.org/10.1080/0142159X.2024.2314198

    Lee, J., Wu, A. S., Li, D., & Kulasegaram, K. M. (2021). Artificial intelligence in undergraduate medical education: A scoping review. Academic Medicine, 96(11S), S62–S70. https://doi.org/10.1097/ACM.0000000000004291

    Raskob, K., Duman, H., Kinder, J., Lee, J., Wilson, J., & Segerson, K. (2025). Twelve tips to harness the power of AI for curriculum mapping. Medical Teacher, 1–10. https://doi.org/10.1080/0142159X.2025.2513427

    Wartman, S. A., & Combs, C. D. (2018). Reimagining medical education in the age of AI. Academic Medicine, 93(8), 1107–1109. https://doi.org/10.1097/ACM.0000000000002111

    Author: Silka Patel, M.D., MPH; Association of Professors of Gynecology and Obstetrics

  • Grading

    Clinical Competency Committees in Undergraduate Medicine

    How do you fairly assess a medical student with discrepant clinical evaluations? Or a medical student with professionalism concerns despite successfully completing all academic and clinical requirements? These are some of the challenges faced by Clerkship Directors when grading students.

    Clinical competency committees (CCC) provide a methodical approach to assessing a medical student’s progress and readiness for the next stage of training. Unlike traditional grading policies that might promote a student who meets minimum criteria within a defined block of time, clinical competency committees evaluate a learner’s mastery of expected milestones (1).

    CCCs have consistently been used in graduate medical education to communicate expectations, standardize evaluation of trainees, identify trainees who are not on a satisfactory trajectory, and develop individualized growth plans (1). Additionally, the CCC encourages a resident to assess their current ability in various competencies, reflect on any gaps, and take accountability for future growth (1). CCCs are a requirement for accreditation of residency and fellowship programs, and the Accreditation Council for Graduate Medical Education (ACGME), has published a comprehensive guidebook for programs to use (2).

    Similar models have been used in undergraduate education (3-5). A national survey administered to internal medicine clerkship directors and conducted by the Alliance of Academic Internal Medicine revealed that 42% of respondents had some form of a grading committee. The grading committees varied considerably in content and purpose; however, they were primarily used to determine the final grade of students at risk for failing, have differing clinical evaluations, and have professionalism issues (6).

    The AAMC Core Entrustable Professional Activities (EPAs) provides a standardized framework to evaluate a medical student’s readiness to enter residency, regardless of specialty. The authors define an “entrusted learner” as one who demonstrates proficiency across 13 defined behaviors without any direct supervision. Although there are similarities, the authors distinguish EPAs from competencies in that EPAs are intended to mirror real-life situations encountered by a physician during their daily workflow. Various competencies and associated milestones are integrated into each activity (7).

    Although CCCs have the advantage of offering a standardized and transparent evaluation process based on expected competencies, there may be several barriers to successful implementation. Clerkships must determine the optimal number of committee members, types of committee members, and frequency of meetings. In addition, committee members must agree on the role of the CCC in determining grades and promoting student self-reflection and growth. Members must develop a shared mental model regarding the impact of variable grading styles used by evaluators when completing clinical evaluations, methods to address discordant data, and strategies to minimize bias (7). Despite these challenges, CCCs offer a promising method for ensuring medical students are on a successful trajectory for advancing to the next level.

    What do you think?

    • Are CCCs the optimal way to evaluate students? What are some of the limitations of this strategy?
    • Does your UME program use a CCC? If so, what were some unexpected hurdles to overcome? Can you recommend some keys to success?
    • Can you think of any examples where a CCC may have provided a different outcome in a student’s evaluation?

    References

    1. Goldhamer MEJ, et al. Reimagining the Clinical Competency Committee to Enhance Education and Prepare for Competency – Based Time-Variable Advancement. J Gen Intern Med 2022; 37 (9):2280-90.
    2. Andolsek K, et al. Accreditation Council for Graduate Medical Education Clinical Competency Committees: A Guidebook for Programs (3rd ed). https://www.acgme.org/globalassets/acgmeclinicalcompetencycommitteeguidebook.pdf
    3. Monrad SU, et al. Competency Committees in Undergraduate Medical Education: Approaching Tensions Using a Polarity Management Framework. Acad Med 2019;94(12:1865-72. doi:10.1097/ACM.0000000000002816
    4. Murray KE, et al. Crossing the Gap: Using Competency-Based Assessment to Determine Whether Learns are Ready for the Undergraduate – to – Graduate Transition. Acad Med: 2019; 94(3): 338-45 doi:10.1097/ACM.0000000000002535.
    5. Mejicano GC, et al. Describing the Journey and Lessons Learned Implementing a Competency-Based, Time-Variable Undergraduate Medical Education Curriculum. Acad Med 2018;93:S42-S48 doi:10.1097/ACM.0000000000002068.
    6. Alexandraki I, et al. Structures and Processes of Grading Committees in Internal Medicine Clerkships: Results of a National Survey. Acad Med 2025;100 (1), 78-85.
    7.  AAMC Core Entrustable Professional Activities for Entering Residency: Curriculum Developers’ Guide 2014. https://store.aamc.org/downloadable/download/sample/sample_id/63/%20

    Author: Catherine Derber, M.D.; Eastern Virginia Medical School. Organization: Clerkship Directors in Internal Medicine

  • Communication,

    Fragile Snowflakes or Feedback-Starved Learners? Finding the Middle Ground in Medical Education

    Faculty today often feel like they’re walking a tightrope when it comes to giving feedback to medical students. On one hand, students consistently express a desire for more feedback. On the other, their responses (especially to constructive or feedback they deem to be more a criticism) can leave educators feeling demoralized, cautious, or even labeled as “toxic.” This tension often drives educators into what Kim Scott calls “Ruinous Empathy”, where feedback is diluted with niceties, lacking the clarity necessary for growth (1,2). 

    Giving meaningful feedback is an emotional labor. It demands vulnerability, courage, and a strong sense of responsibility. Faculty don’t want to be the villain in a student’s narrative, especially in an era where student well-being is prioritized—rightly so—but sometimes conflated with emotional protection from professional critique, and where “negative” feedback, if it finds itself into the student’s narrative record, can reduce opportunities to match for a residency. Yet Scott reminds us that honest feedback doesn’t have to be cruel. In fact, the hallmark of “Radical Candor” is the ability to “…challenge directly while caring personally” (1).

    Consider the now-famous anecdote of Sheryl Sandberg giving feedback to Scott after a successful presentation. After offering praise, Sandberg added, “But you said *um* a lot… it makes you sound stupid.” It was blunt—but it came from a place of trust and investment in Scott’s growth (2,3). The lesson is that radical candor is not about brutal honesty. It’s about building relationships where truth and compassion coexist.

    In medical education, we often talk a lot about the importance of feedback. But what’s missing is what has been referred to as feedback literacy, for faculty AND for learners. Students must be taught how to interpret, process, and apply feedback without collapsing into shame or defensiveness, and to expect it as a significant component towards their professional growth. As Indiana Lee (4) argues, empathy in the workplace isn’t about avoiding discomfort—it’s about engaging with it productively. Emotional responses like frustration and hurt are human. But if students are conditioned to view all constructive feedback as a threat, they will lose invaluable opportunities for learning and increased self-awareness.

    Faculty, too, need support in learning how to navigate these moments. Avoiding critical conversations under the guise of being “nice” is not kindness (1,5). Ruinous Empathy not only undermines student development but ultimately erodes trust. As one study cited by Scott noted, mentors and advisors who challenged their mentees while showing care built stronger, more effective relationships, whether in finance, teaching, or leadership (5,6).

    Psychological safety must be the foundation of educational environments (7). That means faculty must both validate student emotions and hold up a mirror to them. Feedback, as Scott reminds us, is simply information. It’s what we do with it that counts (1). By modeling care and candor ourselves, we can foster a culture where feedback is welcomed as a gift rather than feared as judgment. On the student side, the school must establish and foster the perception of psychological safety by the students and create the environment in which the student learn to expect frank feedback and are given tools to accept it as it is offered. 

    Are students ready to receive honest feedback? Not always. But can they learn to be? Absolutely! The school needs to own preparation of the student to receive and synthesize feedback. Individual faculty need to prepare the student for how they communicate feedback.

    And are we, as educators, ready to stop using ruinous empathy as a shield? Because while it may feel like kindness in the moment, avoiding honest feedback ultimately does more harm than good. 

    Let’s stop confusing kindness with comfort. Real kindness is helping someone grow—even when it’s uncomfortable in the moment. In fact, there’s good evidence that discomfort is a path to growth (8).

    • What do you readers think?  How can we address the following questions?
      How might you create a no-nonsense zone in your teaching or clinical environment—where truth is welcomed and compassion is assumed?
    • When was the last time you withheld feedback out of fear? What might have changed if you had used Radical Candor instead?
    • What would it look like to teach students explicitly how to receive feedback as a professional skill?

    References

    1. Scott K. Video Tip: What is Radical Candor? Learn the Basic Principles In 6 Minutes. Available at https://www.radicalcandor.com/blog/what-is-radical-candor/. Accessed on April 18, 2025.
    2. Steiner W. Radical Candor: The Importance of Guidance vs Feedback. 2017. Available at https://executivecoachingconcepts.com/radical-candor/. Accessed on April 18, 2025.
    3. Raso R. Using Radical Candor. Nursing Mgmt 2018; 49(12):5.
    4. Lee I. What Is Empathy In the Workplace? (Not to Be Confused with Ruinous Empathy). 2023. Available at https://www.radicalcandor.com/blog/empathy-in-the-workplace/. Accessed April 18, 2025.
    5. Scott K. Ruinous Empathy Can Wreck Client Relationships. 2021. Available at https://www.radicalcandor.com/blog/ruinous-empathy-client-relationships/. Accessed on April 18, 2025.
    6. Scott K. What is Ruinous Empathy? Available at https://www.radicalcandor.com/faq/what-is-ruinous-empathy/. Accessed on April 18, 2025.
    7. Johnson CE, Keating JL, Molloy EK. Psychological safety in feedback: What does it look like and how can educators work with learners to foster it? Med Educ. 2020 Jun;54(6):559-570.
    8. Wilson B. Discomfort: A Pathway to Growth. 2023. Available at https://www.psychologytoday.com/us/blog/explorations-in-positive-psychology/202307/discomfort-a-pathway-to-growth. Accessed on April 18, 2025.

    Author: Gary L. Beck Dallaghan, Ph.D.; Alliance for Clinical Education

  • Diversity

    Hear Me Out! Inclusion also Includes Deaf and Hard-of-Hearing Medical Students

    Sticking with the theme of our previous MedEdChat blog last month, diversity in the health care workforce in general and undergraduate medical education needs constant attention. Although this is a topic that has been well-researched, one crucial aspect of diversity often remains under-addressed: the inclusion of individuals with disabilities. This blog post explores in general terms why actively training individuals with disabilities is important and specifically focuses on deaf and hard-of-hearing individuals in medicine. 

    In 2018, Meeks and colleagues (1) reported that nearly 20 percent of the US population has a disability. Many of these individuals face healthcare disparities due to a lack of understanding of their challenges by their providers. One example noted that many primary care settings lack appropriate exam tables, weight scales, and restrooms for patients with disabilities (2). Although studies have identified the benefits of a workforce that embraces diverse healthcare providers, relatively few individuals with disabilities work in medicine. Moreso, only 2.7% of medical students disclose disabilities, 10% of which have apparent disabilities and 90% do not (2). 

    To be totally transparent about why this blog focuses on deaf and hard-of-hearing (DHoH) individuals entering medicine, I was a sign language interpreter for nearly 25 years and also have a prominent hearing loss. The most obvious benefit for more DHoH providers in medicine is the ability to communicate directly with patients. As McKee and colleagues (3) also point out, DHoH physicians enrich the medical education experience by fostering greater disability awareness among their peers and faculty. Increased awareness translates to a better understanding of how to interact with and care for DHoH patients and their families, ultimately improving patient care and outcomes (1). Furthermore, DHoH professionals offer unique perspectives and lived experiences that can lead to innovative approaches in UME, patient care and healthcare delivery (3). They can also serve as role models and advocates for their community, fostering greater trust and engagement between healthcare providers and DHoH patients (4).

    Despite the clear benefits, DHoH individuals remain underrepresented in medical schools and the physician workforce (4). This underrepresentation is often attributed to systemic barriers, including biases in application processes, a lack of inclusive educational opportunities, and insufficient accessibility support (5,6). As Meeks et al. (5) note, disability is often an “unexamined diversity,” with many institutions lacking comprehensive policies and practices to support students with disabilities. Although universities provide central disability resources, the unique demands of medical education programs challenge these offices (6).

    Additionally, the Liaison Committee on Medical Education standards stipulate every school has technical standards (7). Even in light of the Americans with Disabilities Act, the Standards are often written in ways that do not take into consideration individuals with disabilities. If a school expects that all students, for example, can use a stethoscope and appreciate rales and murmurs, what accommodations are made for someone with profound hearing loss? If the school expects all students to perform “inspection” as part executing a physical exam, how can one accommodate a blind person?

    The inclusion of DHoH individuals in medicine has far-reaching benefits. It not only improves healthcare access and quality for the DHoH community but also strengthens the medical field as a whole. A diverse physician workforce brings unique perspectives, problem-solving skills, and lived experiences that enhance medical training and research (8). By embracing diversity, the medical field can better reflect the communities it serves and provide more equitable and effective care for all.

    What do readers think? How can we address the following questions?

    1. How does inclusion of DHoH individuals in medical education programs challenge admission and accreditation standards for medical schools? Specifically, are technical standards essential for the practice of medicine truly essential? Can they be modified?
    2. How can medical educators and advisors become better equipped to support students with disabilities in rigorous and fast-paced programs?
    3. What are the potential long-term benefits of having more DHoH doctors in the healthcare workforce for both the medical community and patients?

    Give us your thoughts!

    References

    1. Meeks LM, Herzer K, Jain NR. Removing Barriers and Facilitating Access: Increasing the Number of Physicians With Disabilities. Acad Med. 2018 Apr;93(4):540-543. doi: 10.1097/ACM.0000000000002112.
    2. Mudrick NR, Breslin ML, Liang M, Yee S. Physical accessibility in primary health care settings: results from California on-site reviews. Disabil Health J. 2012 Jul;5(3):159-67. doi: 10.1016/j.dhjo.2012.02.002.
    3. McKee MM, Smith S, Barnett S, Pearson TA. Commentary: What are the benefits of training deaf and hard-of-hearing doctors? Acad Med. 2013 Feb;88(2):158-61. doi: 10.1097/ACM.0b013e31827c0aef.
    4. Moreland CJ, Latimore D, Sen A, Arato N, Zazove P. Deafness among physicians and trainees: a national survey. Acad Med. 2013 Feb;88(2):224-32. doi: 10.1097/ACM.0b013e31827c0d60.
    5. Meeks LM, Case B, Stergiopoulos E, Evans BK, Petersen KH. Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools. J Med Educ Curric Dev. 2021 May 26;8:23821205211018696. doi: 10.1177/23821205211018696.
    6. Meeks LM, Case B, Herzer K, Plegue M, Swenor BK. Change in Prevalence of Disabilities and Accommodation Practices Among US Medical Schools, 2016 vs 2019. JAMA. 2019 Nov 26;322(20):2022-2024. doi: 10.1001/jama.2019.15372.
    7. Liaison Committee on Medical Education. Functions and Structure of a Medical School, 2025-26. Available at https://lcme.org/publications/. Accessed February 19, 2025.
    8. Meeks LM, Plegue M, Swenor BK, Moreland CJ, Jain S, Grabowski CJ, Westervelt M, Case B, Eidtson WH, Patwari R, Angoff NR, LeConche J, Temple BM, Poullos P, Sanchez-Guzman M, Coates C, Low C, Henderson MC, Purkiss J, Kim MH. The Performance and Trajectory of Medical Students With Disabilities: Results From a Multisite, Multicohort Study. Acad Med. 2022 Mar 1;97(3):389-397. doi: 10.1097/ACM.0000000000004510.

    Blog Author: Gary L. Beck Dallaghan, Ph.D.; Administrative Director, Alliance for Clinical Education. 

     

    Blog Response – February 19, 2025:

    1. How does inclusion of DHoH individuals in medical education programs challenge admission and accreditation standards for medical schools? Specifically, are technical standards essential for the practice of medicine truly essential? Can they be modified?

    Yes, technical standards are essential and important; however, they must be written so they are not exclusionary.  For example, instead of using the sensory words like “hear” and “see” the tech standards should say “communicate” or “observe”; in other words, the TS should say what needs to be accomplished without stating how the task should be accomplished.  Also include that TS can be accomplished with accommodations when the accommodations do not equal a fundamental alteration. 

    1. How can medical educators and advisors become better equipped to support students with disabilities in rigorous and fast-paced programs?

    Partner with your disability services office; attend disability related professional development sessions/workshops; invite experts (including disabled students) to speak to faculty and staff.  Invite in doctors with disabilities to speak about strategies that were important for them to progress through med ed. 

    1. What are the potential long-term benefits of having more DHoH doctors in the healthcare workforce for both the medical community and patients?

    Understanding a person’s lived experiences is important to provide the best possible care.  Having lived those or similar experiences gives a doctor an advantage in treating patients by allowing a level of knowledge others without such experiences may not have.  As human beings live longer, the population of those with hearing loss will continue to grow.  The long term positive impact of D/d/HH doctors is essential to address the needs of these individuals. 

    Note:  “D” is for those who  consider deafness their culture and don’t consider themselves disabled.  “d” is those who are deaf, but don’t consider deafness their culture.  HH is hard of hearing.  Important terminology to include when speaking about these populations.

    Cindy Poore-Pariseau, Ph.D.; Director, Office of Disability Services, Rutgers Health