ABSTRACT Artificial intelligence has moved beyond a discrete clinical tool to become an ambient condition, reshaping how clinicians process information, make decisions, and remain accountable. Medical education has largely responded with technical literacy approaches, neglecting deeper implications for adult learning and professional competence. This article argues that AI‐mediated practice destabilizes the foundational assumptions of adult learning theory across the full continuum of medical education. When cognition is distributed across human‐AI systems, observable performance can no longer reliably signal individual reasoning. Competence must therefore be reconceived around epistemic judgment: evaluating information sources, calibrating reliance on algorithmic outputs, and maintaining accountability in hybrid cognitive environments. This extends competence into ethical discernment and system stewardship. This article outlines implications for educational design, including making reasoning visible, introducing productive friction with AI, and aligning assessment with distributed cognition—ultimately preparing clinicians to practice responsibly while sustaining trust and professional judgment.
Samuel et al. (Wed,) studied this question.
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