THE CLASH OF AUTHORITY IN DENTAL EDUCATION: A QUALITATIVE STUDY ON HOW PESHAWAR’S DENTAL RESIDENTS BALANCE AI RECOMMENDATIONS WITH CONSULTANT EXPERTISE
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Keywords
Health Professions Education; Medical Education; Artificial Intelligence; Hidden Curriculum; Professional Identity Formation; Workplace-Based Learning
Abstract
Background: Artificial Intelligence (AI) is increasingly integrated into health professions education, particularly within workplace-based clinical training environments. While AI-supported tools promote evidence-informed decision-making, they may also challenge traditional supervisory authority. These tensions represent important but underexplored educational challenges in postgraduate dental training.
Objective: To explore how dental residents in Peshawar experience and manage conflicts between AI-generated clinical recommendations and consultant expertise, and how these encounters influence learning, professional identity formation, and the hidden curriculum.
Methods: A qualitative phenomenological study was conducted between January and June 2024. Fourteen senior dental residents were recruited using purposive maximum variation sampling from public and private dental institutions. Semi-structured interviews focused on critical learning incidents involving authority conflict. Data were analyzed using thematic analysis.
Results: Four major themes emerged: (1) clinical dissonance as a learning tension, (2) hierarchy, assessment, and silence in workplace-based learning, (3) institutional culture shaping epistemic authority, and (4) professional identity formation between obedience and evidence. Residents described emotional discomfort, fear of evaluation, and gradual shaping of professional identity through implicit institutional norms.
Conclusion: Conflicts between algorithmic recommendations and consultant authority are educational phenomena with significant implications for health professions education. Addressing epistemic authority, psychological safety, and algorithmic humility is essential for preparing reflective, evidence-informed clinicians.
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Khadija Bibi
BDS, MPH, MHPE (Scholar) Lecturer, Department of Dental Education Peshawar Dental College Peshawar,
Syed Gohar Hussain Shah
BDS, MHPE (Scholar) Lecturer, Department of Dental Education Dental Section, Abbottabad International Medical College, Abbottabad
Abdul Basit
BDS, MHPE (Scholar) Lecturer, Department of Dental Education Dental Section, Abbottabad International Medical College, Abbottabad
Wasif Ali Shah
BDS, MHPE (Scholar), Lecturer, Orthodontics, Institute of Dental Sciences Kohat, Khyber Medical University
Muhammad Abbas Khan
BDS, House officer, Sardar Begum Dental College, Peshawar
Hanzala Waqar
BDS, CHPE, MHPE (scholar), Lecturer Department of Medical Education Institute of Dental Sciences Kohat, Khyber Medical University
