Clinician and simulated patient perspectives on ambient AI scribes in psychiatric consultations: a qualitative study

Documentation burden contributes significantly to psychiatric clinician burnout, with psychiatrists spending an average of three hours per workday on administrative tasks rather than direct patient care. While quantitative studies demonstrate that ambient artificial intelligence (AI) scribes reduce workload and improve documentation quality, the experiential perspectives of clinicians and standardized patients (SPs) remain unexplored, particularly in psychiatry where the therapeutic relationship is central to practice. Our aims were to explore clinician and standardized simulated patient perspectives on ambient AI scribes in psychiatric consultations, examining experiences, concerns, and conditions for successful implementation.

This study was part of a cross-sectional quantitative simulation study, where qualitative part was planned a-priori. We conducted focus groups with psychiatrists and SPs following a simulation-based crossover study comparing traditional versus AI-assisted documentation. Data were analyzed using Braun and Clarke's reflexive thematic analysis framework.

In this focus group session with eight psychiatrists and four SPs, total six themes were identified: (1) Clinical Presence, whereby reduced documentation barriers were perceived to allow more authentic human connection; (2) Liberation from documentation burden, with clinicians describing cognitive and emotional relief beneficial for their mental health; (3) Clinical Competence Amplified, in which clinicians perceived the AI scribe as enhancing practice through intelligent translation to psychiatric terminology and prompting for missed assessments; (4) Calibrating Trust, where participants navigated initial uncertainty while recognizing the importance of human oversight; (5) Privacy, stigma, and psychiatric exceptionalism, highlighting unique consent and confidentiality considerations for psychiatric populations; and (6) Perceptions of an enhanced standard of care, with both groups expressing strong preference for AI-assisted consultations with conditions for adoption.

In this exploratory simulation-based qualitative study, AI scribes were perceived as having potential to support more present, patient-centered psychiatric consultations by reducing documentation burden. Implementation should be cautious and requires transparent consent processes, clinician training in behavioral adaptations, robust human oversight, specialty-specific templates, and real-world evaluation with patients receiving psychiatric care.