Conclusion
This cohort study found that learning bimanual surgical skills in simulation with metric-specific instructions on AI-selected competencies was associated with unintended changes in other competency domains. These extrinsic outcomes had both positive and negative associations with learners’ expertise level compared with the skilled consultant’s benchmarks. Considering these unintended changes, assessment of AI-enhanced curricula requires a cost-benefit evaluation by subject matter experts to determine their acceptance in formal training. Finally, this AI-enhanced curriculum may benefit from contextual and timely feedback either from a live instructor or a real-time performance assessment system.