The efficiency gains are clear. The training implications are more complex.
Evidence for Benefit
More patient interaction time — studies report 20-25% increases in direct patient engagement when scribes handle documentation. Reduced burnout from administrative burden. Structured note quality — AI-generated SOAP notes are often more consistently structured than handwritten notes under time pressure.
Concern for Training
Documentation is a learned clinical skill. Writing a consultation note forces you to structure your clinical thinking — organising your assessment, articulating your reasoning, selecting appropriate codes. If AI does this from day one, when does the trainee develop the skill?
Clinical coding is a competency. SNOMED coding requires understanding which codes are clinically and contractually appropriate. AI-generated codes need human validation — but trainees may not develop the knowledge to validate effectively if they never learn to code independently.
The Cognitive Processing Argument
Writing notes after a consultation is not just administrative — it is a cognitive processing step. Structuring your thoughts into a note reveals gaps in your reasoning ("I haven't documented what I'll do if the symptoms worsen" becomes "I haven't thought about what I'll do if symptoms worsen"). Dictation into a scribe may reduce this processing.
The Parallel
Calculators did not replace mathematics education — students still learn to calculate by hand before using tools. Scribes should not replace documentation education. The skill is foundational even if the tool eventually handles the task.
Practical Recommendation
Use scribes for efficiency — the time recovery is genuine and valuable. Manually write notes for 2-3 consultations per week — deliberate practice maintaining the skill. Compare AI notes to your own — the differences are learning moments. Discuss documentation competence with your ES — ensure assessed consultations include your own notes.
Where iatroX Fits
The same principle applies to clinical knowledge: AI can answer questions for you, but learning comes from generating your own answers first. iatroX's adaptive quiz tests your knowledge, not AI's — deliberate practice for clinical reasoning alongside AI efficiency tools.