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Artículos de Revisión

Vol. 6 Núm. 13 (2026): Revista Simón Rodríguez

Inteligencia artificial y razonamiento clínico en educación médica: una revisión sistemática

Artificial intelligence and clinical reasoning in medical education: a systematic review
Publicado
2026-10-12
Contexto: La inteligencia artificial ha transformado los escenarios de aprendizaje en ciencias de la salud y ha generado un debate sobre su papel en la formación del razonamiento clínico. Objetivo: Analizar el papel de la inteligencia artificial en el desarrollo del razonamiento clínico en la educación médica. Método: Se realizó una revisión sistemática siguiendo la guía PRISMA 2020. Se seleccionaron 22 publicaciones, incluidos estudios primarios, revisiones y textos de reflexión, publicados entre 2021 y 2026. Resultados: El metaanálisis incluido de Takita et al. (2025) reportó una precisión diagnóstica global del 52.1 % en 83 estudios. En Gordon et al. (2024), el 6.8 % (13/191) de los artículos/innovaciones se centró en enseñar o evaluar razonamiento clínico. Arcos Huaman et al. (2025) reportaron un 31 % de barreras regulatorias en diagnóstico cardiovascular latinoamericano, sin evaluar su prevalencia curricular. Conclusiones: La inteligencia artificial constituye un recurso pedagógico complementario valioso, cuya integración curricular exige supervisión docente activa, marcos éticos explícitos y validación empírica continua
Context: Artificial intelligence has transformed learning environments in the health sciences and prompted debate about its role in developing clinical reasoning. Objective: To analyze the role of artificial intelligence in developing clinical reasoning in medical education. Methods: A systematic review followed PRISMA 2020 guidelines. Twenty-two publications, including primary studies, reviews, and reflective papers, published between 2021 and 2026 were selected. Results: The included meta-analysis by Takita et al. (2025) reported an overall diagnostic accuracy of 52.1% across 83 studies. In Gordon et al. (2024), 6.8% (13/191) of articles/innovations focused on teaching or assessing clinical reasoning. Arcos Huaman et al. (2025) reported 31% regulatory barriers in Latin American cardiovascular diagnosis, without assessing their curricular prevalence. Conclusions: Artificial intelligence is a valuable complementary educational resource whose curricular integration requires active faculty supervision, explicit ethical frameworks, and ongoing empirical validation.
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Artículos de Revisión

Referencias

  1. Abdalla, M., Saad, M., Abazia, D., Advani, A., Alhammad, A. M., Bernknopf, A., Bitra, V., Blommel, M., Conn, K. M., Goldwire, M. A., Gosser, R. A., Iso, T., Johnson, S. T., Kier, K. L., Kostrzewa, A., Majerczyk, D., Munir, F., Phillips, J., Segovia, M., et al. (2025). Responsible use of artificial intelligence in health care: evidence, challenges, and best practices: an opinion of the drug information practice and research network of the American college of clinical pharmacy. Journal of the American College of Clinical Pharmacy, 8(12), 1333-1361. https://doi.org/10.1002/jac5.70131
  2. Ahmed, M. I., Spooner, B., Isherwood, J., Lane, M., Orrock, E. y Dennison, A. (2023). A systematic review of the barriers to the implementation of artificial intelligence in healthcare. Cureus, 15(10), e46454. https://doi.org/10.7759/cureus.46454
  3. Ahsan, Z. (2025). Integrating artificial intelligence into medical education: a narrative systematic review of current applications, challenges, and future directions. BMC medical education, 25, 1187. https://doi.org/10.1186/s12909-025-07744-0
  4. Arcos Huaman, J. D., Andia Ascama, C. A. y Cabrera Garcia, C. A. (2025). Systematic Review of Obstacles to the Implementation of Artificial Intelligence in the Diagnosis of Cardiovascular Diseases in Latin America. Actas de la 23.ª Conferencia Internacional LACCEI. https://doi.org/10.18687/LACCEI2025.1.1.773
  5. Baumgärtner, K., Byczkowski, M., Schmid, T., Muschko, M., Woessner, P., Gerlach, A., Bonekamp, D., Schlemmer, H.-P., Hohenfellner, M. y Görtz, M. (2024). Effectiveness of the medical chatbot PROSCA to inform patients about prostate cancer: results of a randomized controlled trial. European urology open science, 69, 80-88. https://doi.org/10.1016/j.euros.2024.08.022
  6. Bin Abdulrahman, K. A. y Hefny, M. A. (2026). Theoretical evolution of AI in medical education: models, frameworks, and future directions. Frontiers in Education, 11, 1796632. https://doi.org/10.3389/feduc.2026.1796632
  7. Borg, A., Georg, C., Jobs, B., Huss, V., Waldenlind, K., Ruiz, M., Edelbring, S., Skantze, G. y Parodis, I. (2025). Virtual patient simulations using social robotics combined with large language models for clinical reasoning training in medical education: mixed methods study. Journal of Medical Internet Research, 27, e63312. https://doi.org/10.2196/63312
  8. Chávez-Martínez, O. y Ragacini, L. A. (2025). Educación médica e inteligencia artificial: perspectivas y desafíos éticos. Revista Médica del Instituto Mexicano del Seguro Social, 63(5), e6736. https://doi.org/10.5281/zenodo.16748310
  9. Cheng, F., Yang, C. y Deng, R. (2026). The Evolution of Visualization Technologies in Healthcare: A Bibliometric Analysis of Studies Published from 1994 to 2025. Information, 17(3), 281. https://doi.org/10.3390/info17030281
  10. Çiçek, F. E., Ülker, M., Özer, M. y Kıyak, Y. S. (2025). ChatGPT versus expert feedback on clinical reasoning questions and their effect on learning: a randomized controlled trial. Postgraduate Medical Journal, 101(1195), 458-463. https://doi.org/10.1093/postmj/qgae170
  11. Corrao, S. y Argano, C. (2022). Rethinking clinical decision-making to improve clinical reasoning. Frontiers in medicine, 9, 900543. https://doi.org/10.3389/fmed.2022.900543
  12. Cuestas, E. (2023). El razonamiento clínico y la inteligencia artificial. Revista de la Facultad de Ciencias Médicas de Córdoba, 80(4), 306–310. https://doi.org/10.31053/1853.0605.v80.n4.42544
  13. Da Silva, M. (2023). Explainability, Public Reason, and Medical Artificial Intelligence. Ethical Theory and Moral Practice, 26(5), 743-762. https://doi.org/10.1007/s10677-023-10390-4
  14. Fehr, J., Jaramillo-Gutierrez, G., Oala, L., Gröschel, M. I., Bierwirth, M., Balachandran, P., Werneck-Leite, A. y Lippert, C. (2022). Piloting a survey-based assessment of transparency and trustworthiness with three medical AI tools. Healthcare, 10(10), 1923. https://doi.org/10.3390/healthcare10101923
  15. Gaebe, K. y van der Woerd, B. (2025). Evaluation of large language models as a diagnostic tool for medical learners and clinicians using advanced prompting techniques. PLoS One, 20(8), e0325803. https://doi.org/10.1371/journal.pone.0325803
  16. García-Torres, D., Fernández, C., Mira, J. J., Morales, A. y Vicente, M. A. (2025). Using AI-based virtual simulated patients for training in psychopathological interviewing: Cross-sectional observational study. JMIR Medical Education, 11, e78857. https://doi.org/10.2196/78857
  17. Gaur, A., Kirani Tan, J., Sridhar Rao, M., Fuad, M., Bhatti, T., Rishab Bharadwaj, H. y Mohamed Ahmed, K. A. H. (2026). AI in UK Medical Education: A Framework for Curriculum Reform. JMIR Medical Education, 12, e81953. https://doi.org/10.2196/81953
  18. Goh, E., Gallo, R., Hom, J., Strong, E., Weng, Y., Kerman, H., Cool, J. A., Kanjee, Z., Parsons, A. S., Ahuja, N., Horvitz, E., Yang, D., Milstein, A., Olson, A. P. J., Rodman, A. y Chen, J. H. (2024). Large language model influence on diagnostic reasoning: A randomized clinical trial. JAMA Network Open, 7(10), e2440969. https://doi.org/10.1001/jamanetworkopen.2024.40969
  19. Gonzales Aste, M. (2025). Inteligencia artificial en neumología ¿aliada clínica o desafío ético en el Perú? Respirar, 17(4), 511-526. https://doi.org/10.55720/respirar.17.4.12
  20. Gordon, M., Daniel, M., Ajiboye, A., Uraiby, H., Xu, N. Y., Bartlett, R., Hanson, J., Haas, M., Spadafore, M., Grafton-Clarke, C., Gasiea, R. Y., Michie, C., Corral, J., Kwan, B., Dolmans, D. y Thammasitboon, S. (2024). A scoping review of artificial intelligence in medical education: BEME Guide No. 84. Medical teacher, 46(4), 446-470. https://doi.org/10.1080/0142159X.2024.2314198
  21. Hager, P., Jungmann, F., Holland, R., Bhagat, K., Hubrecht, I., Knauer, M., Vielhauer, J., Makowski, M., Braren, R., Kaissis, G. y Rueckert, D. (2024). Evaluation and mitigation of the limitations of large language models in clinical decision-making. Nature medicine, 30(9), 2613-2622. https://doi.org/10.1038/s41591-024-03097-1
  22. Han, E. R., Yeo, S., Kim, M. J., Lee, Y. H., Park, K. H. y Roh, H. (2019). Medical education trends for future physicians in the era of advanced technology and artificial intelligence: an integrative review. BMC medical education, 19, 460. https://doi.org/10.1186/s12909-019-1891-5
  23. Hernández Rincón, E. H., Jimenez, D., Chavarro Aguilar, L. A., Pérez Flórez, J. M., Romero Tapia, Á. E. y Jaimes Peñuela, C. L. (2025). Mapping the use of artificial intelligence in medical education: a scoping review. BMC medical education, 25, 526. https://doi.org/10.1186/s12909-025-07089-8
  24. Joseph, G., Bhatti, N., Mittal, R. y Bhatti, A. (2025). Current application and future prospects of artificial intelligence in healthcare and medical education: a review of literature. Cureus, 17(1), e77313. https://doi.org/10.7759/cureus.77313
  25. Kang, J. y Ahn, J. (2025). Technologies, opportunities, challenges, and future directions for integrating generative artificial intelligence into medical education: a narrative review. Ewha medical journal, 48(4), e53. https://doi.org/10.12771/emj.2025.00787
  26. Kanjee, Z., Crowe, B. y Rodman, A. (2023). Accuracy of a generative artificial intelligence model in a complex diagnostic challenge. JAMA, 330(1), 78-80. https://doi.org/10.1001/jama.2023.8288
  27. Kim, D. H., Kang, Y. J. y Lee, Y. M. (2025). Twelve tips for developing and implementing AI curriculum for undergraduate medical education. Medical education online, 30(1), 2585637. https://doi.org/10.1080/10872981.2025.2585637
  28. Kıyak, Y. S., Emekli, E., İş Kara, T., Coşkun, Ö. y Budakoğlu, I. İ. (2025). AI teaches surgical diagnostic reasoning to medical students: evidence from an experiment using a fully automated, low-cost feedback system. Journal of surgical education, 82(10), 103639. https://doi.org/10.1016/j.jsurg.2025.103639
  29. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
  30. Pelaccia, T., Tardif, J., Triby, E. y Charlin, B. (2011). An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory. Medical education online, 16(1), 5890. https://doi.org/10.3402/meo.v16i0.5890
  31. Peralta Ramírez, A. A., Trujillo López, S., Navarro Armendariz, G. A., De la Torre Othón, S. A., Sierra Cervantes, M. R. y Medina Aguirre, J. A. (2025). Clinical simulation with ChatGPT: a revolution in medical education? Journal of CME, 14(1), 2525615. https://doi.org/10.1080/28338073.2025.2525615
  32. Preiksaitis, C. y Rose, C. (2023). Opportunities, challenges, and future directions of generative artificial intelligence in medical education: scoping review. JMIR Medical Education, 9, e48785. https://doi.org/10.2196/48785
  33. Ruiz Orizaga, G., Romero Pérez, D. Y., Romero Pérez, F. D., González Ibarra, E. A. y Durán Bautista, M. (2024). Inteligencia artificial en la educación médica: Tendencias y desafíos. Ciencia y Reflexión, 3(2), 594-605. https://doi.org/10.70747/cr.v3i2.55
  34. Savage, T., Nayak, A., Gallo, R., Rangan, E. y Chen, J. H. (2024). Diagnostic reasoning prompts reveal the potential for large language model interpretability in medicine. NPJ Digital Medicine, 7, 20. https://doi.org/10.1038/s41746-024-01010-1
  35. Shan, G., Chen, X., Wang, C., Liu, L., Gu, Y., Jiang, H. y Shi, T. (2025). Comparing diagnostic accuracy of clinical professionals and large language models: systematic review and meta-analysis. JMIR medical informatics, 13, e64963. https://doi.org/10.2196/64963
  36. Siam, K., Varela, A., Faruk, M. J. H., Cheng, J. Q., Gu, H., Al Maruf, A. y Aung, Z. (2026). Benchmarking large language models on the United States medical licensing examination for clinical reasoning and medical licensing scenarios. Scientific Reports, 16, 1387. https://doi.org/10.1038/s41598-025-31010-4
  37. Sindhvananda, K., Ruengwattanachot, K., Leksuwankun, S., Pongpitakmetha, T., Hiransuthikul, A., Surawattanawong, T., Anukoolwittaya, P. y Panjasriprakarn, P. (2026). AI-powered simulated patients with automated feedback for enhancing headache history-taking skills: a convergent mixed-methods study. BMC Medical Education, 26, 1151. https://doi.org/10.1186/s12909-026-09511-1
  38. Strong, E., DiGiammarino, A., Weng, Y., Kumar, A., Hosamani, P., Hom, J. y Chen, J. H. (2023). Chatbot vs medical student performance on free-response clinical reasoning examinations. JAMA internal medicine, 183(9), 1028-1030. https://doi.org/10.1001/jamainternmed.2023.2909
  39. Tajima, H., Kasai, H., Shikino, K., Shimizu, I. y Ito, S. (2025). Perceptions and intentions to use generative AI among first-year medical students in Japan: cross-sectional survey study. JMIR Medical Education, 11, e77552. https://doi.org/10.2196/77552
  40. Takita, H., Kabata, D., Walston, S. L., Tatekawa, H., Saito, K., Tsujimoto, Y., Miki, Y. y Ueda, D. (2025). A systematic review and meta-analysis of diagnostic performance comparison between generative AI and physicians. NPJ Digital Medicine, 8, 175. https://doi.org/10.1038/s41746-025-01543-z
  41. Turney, J., Young, T. M., Chauhan, D. R., Beeharry, R. y Mahmud, M. (2026). AI use for medical students: Impact on clinical skill acquisition and retention. A systematic review. Advances in Medical Education and Practice, 17, 1–13. https://doi.org/10.2147/AMEP.S583763
  42. Wei, H., Dai, Y., Yuan, K., Li, K. Y., Hung, K. F., Hu, E. M., Lee, A. H. C., Chang, J. W. W., Zhang, C. y Li, X. (2025). AI-powered problem-and case-based learning in medical and dental education: a systematic review and meta-analysis. International Dental Journal, 75(4), 100858. https://doi.org/10.1016/j.identj.2025.100858
  43. Zhong, W., Liu, Y., Liu, Y., Yang, K., Gao, H., Yan, H., Hao, W., Yan, Y. y Yin, C. (2025). Performance of ChatGPT-4o and four open-source large language models in generating diagnoses based on China’s rare disease catalog: comparative study. Journal of Medical Internet Research, 27, e69929. https://doi.org/10.2196/69929