From Consumer to Creator: Positioning Towards Generative Artificial Intelligence in Medical Education
Keywords:
artificial intelligence; education, medical; generative artificial intelligence; learning; students, medicalAbstract
Introduction: The integration of generative artificial intelligence into medical education has become a daily practice among Cuban and Latin American medical sciences students, as documented by recent studies. The problem does not lie in the tool itself, but rather in the position that the student adopts towards it.
Objective: To substantiate the need for medical students to transition from a consumer-oriented use of generative artificial intelligence to a creator-oriented one, with special attention to the context of Cuban medical education.
Methods: A narrative argumentative review of sources indexed in PubMed/MEDLINE, Scopus, SciELO, and recognized preprint repositories, in Spanish and English, mostly published between 2022 and 2026, supplemented by regulatory documents from international organizations.
Development: Evidence is contrasted between cognitive offloading and gains in critical thinking under guided use; the pedagogical rationale for the Socratic tutor model versus the oracle model is established, supported by cognitive load theory and self-regulated learning. The editorial requirement for source verification is examined as a formative exercise, along with the specificity of the Cuban context of limited connectivity.
Conclusions: Generative artificial intelligence does not by itself determine the student's cognitive destiny; this depends on the pedagogical and institutional design that regulates its use. The integration of critical AI literacy as an explicit curricular competency from the first year of the medical program is advocated.
Downloads
References
1. Boris Miclin CD, Estrada Rodríguez Y, Leyva Argibay SR. Uso de ChatGPT por estudiantes de medicina en su proceso de enseñanza-aprendizaje. UNIMED [Internet]. 2024 [citado 20/08/2026];6(3):[aprox. 16 p.]. Disponible en: https://revunimed.sld.cu/index.php/revestud/article/view/398/pdf
2. Vega Jiménez J, Borja Gómez EE, Ramírez Álvarez PJ. ChatGPT e inteligencia artificial artificial: ¿obstáculo o ventaja para la educación médica superior? Educ Méd Super [Internet]. 2023 [citado 20/08/2026];37(2):[aprox. 5 p.]. Disponible en: https://ems.sld.cu/index.php/ems/article/view/3851/1503
3. Izquierdo Condoy JS, Arias Intriago M, Nati Castillo HA, Gollini Mihalopoulos R, Cardozo Espínola CD, Loaiza Guevara V, et al. Exploring smartphone use and its applicability in academic training of medical students in Latin America: a multicenter cross-sectional study. BMC Med Educ [Internet]. 2024 [citado 20/08/2026];24(1):[aprox. 18 p.]. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC11607876/
4. Mayta Tovalino F, Espinoza Carhuancho F, Alvitez Temoche D, Mauricio Vilchez C, Munive Degregori A, Barja Ore J. Scientometric analysis on the use of ChatGPT, artificial intelligence, or intelligent conversational agent in the role of medical training. Educ Méd [Internet]. 2024 [citado 20/08/2026];25(2):[aprox. 7 p.]. Disponible en: https://www.elsevier.es/es-revista-educacion-medica-71-articulo-scientometric-analysis-on-use-chatgpt-S1575181323000839
5. Gerlich M. AI tools in society: impacts on cognitive offloading and the future of critical thinking. Societies [Internet]. 2025 [citado 20/08/2026];15(1):[aprox. 28 p.]. Disponible en: https://www.mdpi.com/2075-4698/15/1/6
6. Zhai Ch, Wibowo S, Li LD. The effects of over-reliance on AI dialogue systems on students’ cognitive abilities: a systematic review. Smart Learn Environ [Internet]. 2024 [citado 20/08/2026];11(28):[aprox. 37 p.]. Disponible en: https://link.springer.com/article/10.1186/s40561-024-00316-7
7. Kosmyna N, Hauptmann E, Yuan YT, Situ J, Liao XH, Beresnitzky AV, et al. Your brain on ChatGPT: accumulation of cognitive debt when using an AI assistant for essay writing task [Internet]. arXiv [Preprint]. 2025 [consultado el 20 de agosto de 2026]:216 p. Disponible en: https://arxiv.org/pdf/2506.08872
8. Stankovic M, Hirche E, Kollatzsch S, Doetsch JN. Comment on: your brain on ChatGPT: accumulation of cognitive debt when using an AI assistant for essay writing tasks [Internet]. arXiv [Preprint]. 2025 [consultado el 20 de agosto de 2026]:7 p. Disponible en: https://arxiv.org/pdf/2601.00856
9. Abdelwanis M, Alarafati HK, Tammam MMS, Simsekler MCE. Exploring the risks of automation bias in healthcare artificial intelligence applications: a Bowtie analysis. J Saf Sci Resil [Internet]. 2024 [citado 20/08/2026];5:[aprox. 10 p.]. Disponible en: https://khazna.ku.ac.ae/en/publications/exploring-the-risks-of-automation-bias-in-healthcare-artificial-i/
10. Aljamaan F, Temsah MH, Altamimi I, Al-Eyadhy A, Jamal A, Alhasan K, et al. Reference hallucination score for medical artificial intelligence chatbots: development and usability study. JMIR Med Inform [Internet]. 2024 [citado 20/08/2026];12:[aprox. 11 p.]. Disponible en: https://medinform.jmir.org/2024/1/e54345/PDF
11. Bhattacharyya M, Miller VM, Bhattacharyya D, Miller LE. High rates of fabricated and inaccurate references in ChatGPT-generated medical content. Cureus [Internet]. 2023 [citado 20/08/2026];15(5):[aprox. 7 p.]. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10277170/
12. Almazrou S, Alanezi F, Almutairi SA, AboAlsamh HM, Alsedrah IT, Arif WM, et al. Enhancing medical students critical thinking skills through ChatGPT: an empirical study with medical students. Nutr Health [Internet]. 2025 [citado 20/08/2026];31(3):[aprox. 11 p.]. Disponible en: https://journals.sagepub.com/doi/10.1177/02601060241273627
13. Sauder M, Tritsch T, Rajput V, Schwartz G, Shoja MM. Exploring generative artificial intelligence-assisted medical education: assessing case-based learning for medical students. Cureus [Internet]. 2024 [citado 20/08/2026];16(1):[aprox. 23 p.]. Disponible en: https://www.cureus.com/articles/215237-exploring-generative-artificial-intelligence-assisted-medical-education-assessing-case-based-learning-for-medical-students#!/
14. Izquierdo Condoy JS, Arias Intriago M, Montero Corrales L, Ortiz Prado E. Artificial intelligence in medical education: transformative potential, current applications, and future implications. JMIR Med Educ [Internet]. 2026 [citado 20/08/2026];12:[aprox. 15 p.]. Disponible en: https://mededu.jmir.org/2026/1/e77127/PDF
15. Izquierdo Condoy JS, Arias-Intriago M, Tello De la Torre A, Busch F, Ortiz Prado E. Generative artificial intelligence in medical education: enhancing critical thinking or undermining cognitive autonomy? J Med Internet Res [Internet]. 2025 [citado 20/08/2026];27:[aprox. 9 p.]. Disponible en: https://www.jmir.org/2025/1/e76340/PDF
16. Sweller J. Cognitive load theory, learning difficulty, and instructional design. Learn Instr [Internet]. 1994 [citado 20/08/2026];4(4):[aprox. 18 p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/0959475294900035
17. Zimmerman BJ. Self-regulated learning and academic achievement: an overview. Educ Psychol [Internet]. 1990 [citado 20/08/2026];25(1):[aprox. 15 p.]. Disponible en: https://www.researchgate.net/publication/243775466_Self-Regulated_Learning_and_Academic_Achievement_An_Overview
18. Kestin G, Miller K, Klales A, Milbourne T, Ponti G. AI tutoring outperforms in-class active learning: an RCT introducing a novel research-based design in an authentic educational setting. Sci Rep [Internet]. 2025 [citado 24/08/2026];15(1):[aprox. 10 p.]. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12179260/
19. Golchini N, Passalacqua E, Vaughn L, Abdulnour REE, Zack T, Finlayson S. Socratic AI: an adaptive tutor for clinical case-based learning [Internet]. medRxiv [Preprint]. 2025 [consultado el 20 de agosto de 2026]:14 p. Disponible en: https://www.researchgate.net/publication/392945629_Socratic_AI_An_Adaptive_Tutor_for_Clinical_Case_Based_Learning
20. Favero L, Pérez Ortiz JA, Käser T, Oliver N. Enhancing critical thinking in education by means of a Socratic chatbot [Internet]. arXiv [Preprint]. 2024 [consultado el 20 de agosto de 2026]:12 p. Disponible en: https://www.researchgate.net/publication/383911327_Enhancing_Critical_Thinking_in_Education_by_means_of_a_Socratic_Chatbot
21. Zielinski C, Winker MA, Aggarwal R, Ferris LE, Heinemann M, Lapeña JF, et al. Chatbots, generative AI, and scholarly manuscripts: WAME recommendations on chatbots and generative artificial intelligence in relation to scholarly publications. Colomb Méd [Internet]. 2023 [citado 20/08/2026];54(3):[aprox. 5 p.]. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10712422/
22. Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura. Guía para el uso de la IA generativa en educación e investigación [Internet]. París: UNESCO; 2024 [citado 20/08/2026]. Disponible en: https://unesdoc.unesco.org/ark:/48223/pf0000389227
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Brian Zequeira García
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Los autores que publican en esta revista están de acuerdo con los siguientes términos:- Los autores/as conservarán sus derechos de autor y ceden a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a una Licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0) que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores pueden establecer por separado acuerdos adicionales para la distribución no exclusiva de la versión de la obra publicada en la revista (por ejemplo, situarlo en un repositorio institucional o publicarlo en un libro), con un reconocimiento de su publicación inicial en esta revista.
- Se permite y se anima a los autores a difundir sus trabajos electrónicamente (por ejemplo, en repositorios institucionales o en su propio sitio web) antes y durante el proceso de envío, ya que puede dar lugar a intercambios productivos, así como a una citación más temprana y mayor de los trabajos publicados (Véase The Effect of Open Access) (en inglés).
