SynthesisBMC medical education2026
Artificial intelligence augmented tutoring vs expert instruction on learning simulated general surgical skills: a systematic review and meta-analysis.
Synthesis in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical training suffers from a global deficit; 5 billion people lack access to safe surgery, with an estimated 143 million additional procedures needed annually. Traditional surgical education, constrained by the apprenticeship model, faces critical limitations in standardization and scalability, particularly in low- and middle-income countries where expert mentors are scarce. AI-augmented tutoring systems represent a potentially transformative solution. This systematic review and meta-analysis were conducted to address that evidence gap.
methodsFollowing PRISMA 2020 guidelines, we systematically searched major databases for trials comparing AI tutoring with expert instruction. Primary outcomes were performance (Intelligent Continuous Expertise Monitoring System [ICEMS] score) and skill acquisition (Objective Structured Assessment of Technical Skills [OSATS] score). Cognitive load was a secondary outcome, measured using the Mental Effort Scale (MES) and Cognitive Load Index (CLI).
resultsOur search yielded 40 studies for narrative synthesis. Four studies (3 RCTs and 1 pilot prospective study), encompassing a total of 268 participants, were included in the meta-analysis. AI tutoring showed a small, statistically significant improvement in expert-rated OSATS scores (MD 0.20; 95% CI, 0.01 to 0.39) with no heterogeneity (I2 = 0%) but with low certainty. The AI group reported a significantly higher extraneous cognitive load (MD 0.23; p = 0.01). No significant difference was found in ICEMS scores.
conclusionAI tutoring systems demonstrated comparable effectiveness to expert instructors in simulated surgical skill acquisition. The small OSATS advantage (0.20 points) is of uncertain clinical significance, falling below commonly published competency cut-points for meaningful change on global rating scales, and is based on low-certainty evidence driven by a single high-risk-of-bias study. AI tutoring imposed a higher extraneous cognitive load. These findings do not support replacing human instructors with AI. Instead, the evidence supports a hybrid model, though this itself requires rigorous empirical validation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.