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Mixed-methods study on GenAI Usage, dependence behaviors, and standardized application paths among Chinese medical
Liujie Fu1, Ruifeng Li1, Wuxiang Shi2
1School of Management, Beijing University of Chinese Medicine, Beijing, China.
NPJ Digital Medicine
|June 2, 2026
Summary
Generative artificial intelligence (GenAI) is widely used by medical students, but reliance is high. Critical thinking is negatively correlated with GenAI dependence, highlighting a need for balanced integration in medical education.
Area of Science:
- Medical Education
- Artificial Intelligence in Healthcare
- Educational Technology
Background:
- Generative artificial intelligence (GenAI) is increasingly integrated into medical education.
- This integration raises concerns about technological dependence among students.
- Understanding student usage patterns and factors influencing dependence is crucial.
Purpose of the Study:
- To investigate the extent of GenAI integration in Chinese medical students' learning routines.
- To identify factors correlating with GenAI dependency among these students.
- To explore medical educators' perspectives on GenAI in medical training.
Main Methods:
- An explanatory sequential mixed-methods design was utilized.
- Quantitative phase: Survey data from 1295 Chinese medical students.
- Qualitative phase: Thematic analysis of interviews with 16 medical educators.
Main Results:
- GenAI is deeply integrated into daily learning, with a preference for general-purpose tools over specialized medical ones.
- Over 60% of students reported GenAI dependence (score 21.91±6.75), with low clinical application (under 20%).
- Performance expectancy, academic pressure, and social influence positively correlated with dependence, while critical thinking showed a negative correlation.
Conclusions:
- Medical students exhibit significant dependence on GenAI, with limited use in clinical contexts.
- Critical thinking skills appear inversely related to GenAI dependency.
- Future medical education should position GenAI as a cognitive scaffold, emphasizing critical thinking and standardized usage guidelines for responsible development.