研修医の約4割が診療現場で生成AIを活用 ー利用者はAIの限界や倫理的課題への理解が高く、望ましい診療行動との関連も確認ー

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2026-08-06 東京科学大学

東京科学大学、東京大学、順天堂大学などの共同研究グループは、日本全国の臨床研修医2,989人を対象に、診療現場での生成AI利用実態とAIリテラシー、診療行動との関連を調査した。その結果、臨床業務で生成AIを検索エンジンとして利用している研修医は39.4%に達した一方、鑑別診断の一次情報源として利用しているのは利用者の13.0%にとどまり、生成AIを補助的に活用する傾向が明らかになった。生成AI利用者は、AIの作話(ハルシネーション)や倫理的課題(公平性・透明性)への理解が非利用者より高く、身体診察の重視や適切な抗菌薬使用など望ましい診療行動とも関連していた。一方で、倫理的課題への理解は利用者・非利用者とも十分ではなく、公平性や透明性を意識していた回答者は約半数にとどまった。本研究は、生成AIの利用が臨床能力の低下とは関連せず、適切な活用が医学教育を支援する可能性を示す一方、AIリテラシー教育や倫理教育の充実が不可欠であることを示した。

研修医の約4割が診療現場で生成AIを活用 ー利用者はAIの限界や倫理的課題への理解が高く、望ましい診療行動との関連も確認ー
図1. 研修医の生成AI利用と感染症診療行動における関連調査結果。
全国546施設・研修医2,989人が回答(基本的臨床能力評価試験 受験者9,179人を対象、2025年1月実施)

<関連情報>

研修医における検索エンジンとしての生成型AI利用の現状:横断研究 Current Landscape of Generative AI Use as a Search Engine Among Resident Physicians: Cross-Sectional Study

Toshiki Miwa;  Koh Okamoto;  Yuji Nishizaki;  Yasuharu Tokuda
JMIR AI  Published:17.Jul.2026
DOI:https://preprints.jmir.org/preprint/89750

Abstract

Background:Acquiring generative AI (GenAI) literacy and avoiding knowledge collapse and inadequate skill development are critical for resident physicians in the GenAI era, who are highly susceptible to its influence, including those who are current nonusers.

Objective:This study examined the degree of GenAI use as a search engine in clinical practice among resident physicians and compared differences in AI literacy and bedside behaviors in the management of infectious diseases between GenAI users and nonusers.

Methods:This cross-sectional study was conducted through an original questionnaire survey administered in January 2025 to participants of the General Medicine In-Training Examination (GM-ITE), a nationwide computer-based test for postgraduate year 1 and year 2 resident physicians in Japan. The survey items covered the degree of GenAI use, GenAI literacy, and perceived bedside behaviors. In addition to the GM-ITE score, we collected data on demographics and survey responses. Statistical analysis was performed to compare attitudes toward GenAI use between GenAI users and nonusers. Additionally, the difference in their bedside behaviors in infectious disease management was assessed, adjusted for demographics, the learning environment, and GM-ITE score.

Results:Of 9179 GM-ITE examinees, 2989 (32.6%) resident physicians from 546 hospitals completed the survey. Subsequent analyses were performed in 2850 respondents who answered the question regarding GenAI use as a search engine in clinical work. A total of 1124 (39.4%) participants reported using GenAI as a search engine, while 1726 (60.6%) were nonusers. Only 13% (144/1110) of users relied on it as a primary reference for differential diagnoses. Compared with nonusers, users were more likely to understand limitations such as confabulation (817/1103, 74.1% vs 991/1696, 58.4%; P<.001) and to recognize competencies essential for future physicians in infectious disease management, including history taking and physical examination (965/1106, 87.3% vs 1296/1706, 76%; P<.001). Ethical considerations were less commonly addressed overall, with 47.3% (1311/2770) examining fairness and 49.8% (1381/2774) examining transparency. Awareness was greater among users than nonusers (615/1092, 56.3% vs 696/1678, 41.5%; P<.001 for fairness and 645/1095, 58.9% vs 736/1679, 43.8%; P<.001 for transparency). GenAI use was independently associated with perceived favorable behaviors, such as thorough examination (adjusted odds ratio [aOR] 1.42, 95% CI 1.18‐1.70) and appropriate antimicrobial use (aOR 1.57, 95% CI 1.32‐1.87).

Conclusions:Although GenAI use was not associated with self-reported behaviors indicative of knowledge collapse at this stage, GenAI literacy among resident physicians in Japan remains limited, particularly among nonusers. Given its rapid expansion, education on GenAI in clinical practice may be necessary for both users and nonusers, emphasizing critical thinking and ethical considerations, including transparency, in patient care.

医療・健康
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