The Ambient AI Era and Medical Student Education: Insights From Family Medicine Clerkship Directors

BACKGROUND AND OBJECTIVE: Artificial intelligence (AI) adoption in medicine is rapidly expanding, including ambient AI (AAI), which converts clinician-patient conversations into documentation. Despite growing use among practicing physicians, little is known about student access to AAI or barriers to implementation during medical student clerkships. METHODS: We surveyed 174 family medicine clerkship directors (CDs) through the Council of Academic Family Medicine Educational Research Alliance network regarding AAI availability, permissibility, and opinions on student use. We analyzed responses using descriptive statistics and Fisher's exact tests. RESULTS: Ninety-four CDs responded to AAI-related questions. Student AAI use was permitted for only 3% of core family medicine clerkships. CDs cited missing technology (38.3%) or institutional restrictions (42.5%) as barriers. Opinions on student use were divided: 42.6% opposed any use, 41.5% supported some use, and 16% were unsure. Among those who opposed use, major concerns included potential negative effects on clinical reasoning (82.5%) and communication skills (85%). Supporters of student use were significantly more likely to believe AI will improve training and become commonplace in students' careers than those who did not support student use of AAI (P<0.0001). CONCLUSIONS: Access to AAI for medical students during core family medicine clerkships is rare, and CDs expressed substantial concerns regarding its impact on clinical reasoning and communication skills. Given the expeditious integration of AI into clinical practice, medical educators must be prepared to teach with technology, proactively design curricula that assume AAI availability, and consider modalities in addition to clinical documentation to assess student clinical reasoning.