Between Co-Intelligence and Cognitive Offloading: Educators’ Perspectives from Dutch Academic Medical Settings on Generative AI, Critical Thinking, and Adult Professional Learning

Generative artificial intelligence (GenAI) is becoming embedded in adult professional education, yet its capacity to accelerate academic work may also remove cognitive processes that underpin professional judgement. This qualitative study explored how educators working in Dutch academic medical settings perceive GenAI’s implications for students’ critical thinking and how they believe it should be integrated into medical curricula. Seventeen educators from Dutch academic medical settings participated in semi-structured interviews. Data were analysed thematically using a mixed inductive–deductive approach informed by the Technology Acceptance Model and the Paul–Elder critical thinking framework. Three themes were identified: educational value and efficiency; threats to independent critical thinking; and conditions for responsible integration. Educators valued GenAI for personalised learning, writing support, research assistance, accessibility, simulation, and administrative efficiency. However, they associated low-friction use with cognitive offloading, weaker source appraisal, reduced information filtering, possible erosion of foundational knowledge, and difficulties verifying authentic student understanding. Participants proposed AI literacy, transparent use, institutionally governed models, comparative human–AI tasks, simulation, staged access, and AI-free oral or in-class assessment. The findings suggest that adult professional education should design GenAI as co-intelligence rather than cognitive substitution, preserving productive friction while verifying unassisted competence.