An interesting short article in today's Lancet. Citation, extract and comment from me below.
CITATION: Perspectives - Digital medicine, The Lancet, Volume 406, Issue 10513 p1719 October 18, 2025
Preserving clinical skills in the age of AI assistance
Tyler M Berzina tberzin@bidmc.harvard.edu
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02075-6/fulltext?dgcid=raven_jbs_etoc_email
EXTRACTS
How are clinicians to preserve core clinical skills in an era of algorithmic assistance? As artificial intelligence (AI) assumes a growing role in clinical practice, concern is mounting that off-loading clinical tasks and reasoning will lead to loss of skills (deskilling), adopting errors or bias from AI (mis-skilling), or failure to achieve competence (never-skilling; figure). Evidence for such skill attrition has been seen with automated interpretation of electrocardiograms or radiological images. An observational study published earlier this year, however, sharpens this concern, suggesting that experienced colonoscopists lost some proficiency in colon polyp detection when routine AI support was switched off... The choices we make now about how we design, integrate, and train around AI will determine whether these systems elevate our profession or quietly erode the skills that define it.
COMMENT (NPW): The skill (knowledge) to detect a colon polyp is built over many years. It is 'hardwired' into the brains and synapses of 'experienced colonoscopists'. One would expect such skill to be relatively resilient as compared with, say, memory of factual knowledge about colon cancer. If AI erodes the ability to detect a polyp, we can expect it to have even more impact on retention of factual knowledge and, perhaps, clinical reasoning.
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org