Teaching Doctors in Training to Reason With Artificial Intelligence (TEACH-AI)

September 6, 2026 updated by: Jacob Koshy, Beth Israel Deaconess Medical Center

Teaching Internal Medicine and Family Medicine Residents to Reason With Generative AI: A Multi-Site Randomized Controlled Trial (TEACH-AI)

The purpose of the TEACH-AI study is to assess whether a brief, structured workshop on artificial intelligence can improve the performance of medicine doctors in training (i.e. residents) in their diagnostic and management reasoning.

In this multi-site randomized controlled trial, internal medicine and family medicine residents are assigned either to receive an in-person workshop on safe, effective LLM use before a standardized AI-assisted assessment, or to complete the same assessment before receiving the workshop. Residents will review clinical cases that are fully synthetic, no protected health information is used, using a password protected LLM interface.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Large language models (LLMs) have rapidly entered routine use in medical education and clinical practice. Prior randomized trials have shown that, although LLMs can outperform individual clinicians on some reasoning benchmarks, providing physicians with access to an LLM does not necessarily improve their diagnostic or management performance, and LLMs alone may perform better than physician-plus-LLM teams. These findings suggest that human-AI collaboration is fraught, non-trivial and may require explicit training.

TEACH-AI is a pragmatic, multi-site, two-arm randomized controlled trial embedded within protected residency didactic time. The primary objective is to determine whether a single in-person workshop on the basics of LLMs and best practices of prompting/verification strategies improves residents' performance on an AI-assisted assessment, compared with residents who complete the simulation before receiving the workshop. All participants will ultimately receive the same workshop and the same assessment (either workshop-first vs assessment-first).

The simulation consists of multiple fully synthetic vignettes delivered via a password protected LLM interface. Residents interact freely with the LLM using natural-language prompts and then submit structured final responses regarding aspects such as leading diagnosis, differential, management plan, and/or justification. The platform will record prompts, model outputs, final answers, and timing. Vignette scoring combines correctness of the final diagnosis or management plan. Scoring is conducted by blinded faculty using standardized rubrics and then any discrepancies will be resolved through multiple rounds of discussions.

The trial will enroll up to 200 residents across four ACGME-accredited programs (internal medicine at Beth Israel Deaconess Medical Center, Stanford University, and Cambridge Health Alliance; family medicine at AdventHealth Orlando).

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • California
      • Palo Alto, California, United States, 94305
        • Stanford University
        • Contact:
        • Principal Investigator:
          • Kevin R Keet, MD
    • Florida
      • Orlando, Florida, United States, 32804
    • Massachusetts
      • Boston, Massachusetts, United States, 02215
        • Beth Israel Deaconess Medical Center
        • Contact:
        • Principal Investigator:
          • Jacob M Koshy, MD, MPH
      • Cambridge, Massachusetts, United States, 02139
        • Cambridge Health Alliance
        • Contact:
          • Priyank Jain, MD
          • Phone Number: 617-665-1000
        • Principal Investigator:
          • Priyank Jain, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Participants must be licensed physicians and have started at least post-graduate year 1 (PGY1) of medical training.
  • Training in Internal medicine or family medicine or emergency medicine.
  • Able to provide informed consent and complete assessments in English.

Exclusion Criteria:

  • Not currently practicing clinically.
  • Resident directly involved in the design of the study, development of the workshop, or creation/piloting of the assessment vignettes.
  • Resident who declines or withdraws consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Assessment-First
Participants assigned to this group will be tasked with completing the assessment using a password protected LLM interface first in advance of the workshop. The workshop will be delivered during a scheduled mandatory didactic time slot.
Experimental: Workshop-first
Participants assigned to this group will be tasked with completing the assessment using a password protected LLM interface after they participate in a scheduled mandatory didactic time slot.
Other: Workshop-First
Participants will attend a workshop during their didactic time that will review various aspects of large language models including fundamentals and best practices of interacting and interpreting their outputs.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Score on Expert-Development Rubrics
Time Frame: Within 24 hours of assessment completion.
The primary outcome will be the number of correct responses for all cases using select questions from expert-developed scoring rubrics. The rubrics were developed using a Delphi consensus process by expert physicians as established by Goh et al (Nature Medicine, 2025; DOI: 10.1038/s41591-024-03456-y). The primary outcome will be analyzed at the case level, comparing performance between the randomized study groups, with a higher number of correct responses indicating a better outcome.
Within 24 hours of assessment completion.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time Spent on Management
Time Frame: Within 24 hours of assessment completion.
Comparison of time spent per case between the two study groups.
Within 24 hours of assessment completion.
Prompt Count
Time Frame: Within 24 hours of assessment completion.
Comparison of the number of resident-initiated prompts to the LLM per case between the two study groups.
Within 24 hours of assessment completion.
Management Reasoning Using Expert-Derived Rubrics
Time Frame: Within 24 hours of assessment completion.
Comparison of management reasoning accuracy based on the number of correct responses per case between the two groups on expert-developed scoring rubrics. The rubrics were developed using a Delphi consensus process by expert physicians as established by Goh et al (Nature Medicine, 2025; DOI: 10.1038/s41591-024-03456-y). The primary outcome will be analyzed at the case level, comparing performance between the randomized study groups with more correct responses indicating a better outcome.
Within 24 hours of assessment completion.
Diagnostic Reasoning
Time Frame: Within 24 hours of assessment completion.
Comparison of diagnostic reasoning accuracy based on the number of correct responses per case between the two groups.
Within 24 hours of assessment completion.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Beth Israel Deaconess Medical Center

Collaborators

Stanford University
AdventHealth
Cambridge Health Alliance

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

August 10, 2026

First Submitted That Met QC Criteria

September 6, 2026

First Posted (Actual)

September 10, 2026

Study Record Updates

Last Update Posted (Actual)

September 10, 2026

Last Update Submitted That Met QC Criteria

September 6, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2026P000369
  • 63901784-350738 (Other Grant/Funding Number: Macy Foundation)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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