How Does AI Augment Surgeon Judgment and Creative Thinking Skills?

It is clear that artificial intelligence (AI) is positioned to make significant contributions to surgical care and training. AI uses algorithms that allow computers to make predictions and solve problems by recognizing words, analyzing patterns, shapes, and colors in images, identifying patterns in data, and detecting correlations and anomalies in statistics.

Several companies are investing billions of dollars to solidify their spot in the AI market. Microsoft, Apple, Nvidia, Google (Alphabet Inc.), OpenAI, Amazon (Alexa), IBM, and xAI (Grok) are just a few of the companies that have made significant investments in this technology, as the potential financial return for these tools is tremendous.

While many AI algorithms are proprietary and private, many others are developed within the open-source community and are available for public review. Absent a change in the US Constitution, these algorithms likely will be protected for some time.

While a considerable portion of AI’s algorithmic logic remains outside public knowledge, what we do know is the fact that powerful computers in the AI realm collect data from large databases in order to formulate predictions. Unfortunately, AI output can be low quality and inaccurate due, in part, to faulty data. Garbage in, garbage out, is a common observation made by the AI community.

Several articles confirm that AI platforms are making mistakes. In a 2025 Los Angeles Times column, the author described AI-generated results that provided false precedents used by lawyers in supporting their cases. When the judges found the precedents had not been checked by the lawyers, fines and other punishments were levied. Another example of what has become known as “AI slop” occurred when a Texas professor flunked his entire class after an AI program erroneously accused all the students of plagiarism.

Conversely, AI has proven to be useful in diagnostic specialties where it can learn to recognize patterns and detect anomalies or markers by analyzing vast libraries of visual images and videos. Specialties such as radiology, pathology, and dermatology have shown that AI can review images and recognize visual factors that the physician may have missed.

With this in mind, is it possible that AI will eventually replace human physicians?

This question was recently raised with a retired IBM executive. The executive assured us that Watson, the IBM AI representative, is meant to help us do our job better. In the diagnostic specialties, this seemed to be a reasonable answer. We then asked if a computer could ever affect a surgeon’s creativity, namely the skills necessary to respond to unexpected events due to an overreliance on AI algorithms? As it so happens, she was reluctant to make predictions regarding the use of AI-driven ideation.

We entered the same query into a Google search, and this was the response:

“Concerns that AI could stifle a surgeon’s creative training by removing complex problem-solving are valid, though current research suggests a more nuanced outcome. AI is expected to serve as a supplementary tool in surgical training, automating standard tasks and providing realistic simulations, which can help accelerate skill acquisition. However, the human aspects of surgical creativity—including the ability to respond to unexpected intraoperative events and innovate new techniques—will remain critical for developing a surgeon’s full expertise.”

The potential for AI integration to diminish the knowledge, creativity, and skills of a surgeon was recently addressed by Abiodun Adegbesan, MD, MPhil, with the Department of Public Health and Primary Care at the University of Cambridge in England, and colleagues, in a letter to the editor of a medical journal, which stated, in part, “…there is a danger that surgeons may become passive operators which can potentially lead to a reduction in their surgical dexterity, clinical expertise, and overall problem-solving abilities.”

Generative AI

ChatGPT is an advanced AI language model developed by OpenAI. It is a generative pre-trained transformer that “learns” from internet data to perform tasks such as answering questions, summarizing information, and writing papers.

In a recent article by Keith S. Naunheim, MD, FACS, and Mark Ferguson, MD, FACS, four popular chatbots were tested against 21 board-certified thoracic surgeons in 10 clinical scenarios. The surgeons performed at a significantly higher level than the chatbots. In this study, the authors concluded that “[a]lthough they are becoming increasingly sophisticated, chatbots do not yet perform at the level of a practicing thoracic surgeon when faced with complex clinical scenarios.” It would be interesting to see how the chatbots perform against thoracic surgical residents who have not yet garnered the experience of the certified surgeons.

In a world that has already seen computers beat human opponents at Jeopardy (IBM’s Watson) and Grand Masters at Chess (IBM’s Deep Blue), it is somewhat surprising that several chatbots were not able to outperform the board-certified thoracic surgeons in vignettes relating to well-known clinical scenarios. It may very well be just a matter of time before the computer can surpass surgeons in making diagnoses and formulating treatment plans.

Enhancing Robotic Dexterity

At this time, robots cannot be programmed to independently perform operations as well as surgeons can due to the fact that robotic arms and graspers are limited in their physical ability. Human hands are superior to any known robot platforms, but this difference is being challenged.

At Northwestern University’s Center for Robotics and Biosystems in Evanston, Illinois, researchers are working on improving tactile sensing and flexibility of robotic hands. Kevin Lynch, professor of mechanical engineering and director of the center, has shared, “The team has set a 10-year goal to achieve dexterity sufficient for basic humanlike tasks.”

Engineers at Tesla also are working to improve their humanoid robot, Optimus, so that it will be capable of “performing the small, precise motions that define most skilled labor.” As Elon Musk told The Wall Street Journal, “In order to have a useful generalized robot, you do need an incredible hand.”

But what about the creative skills that are essential for any surgeon facing a rapidly changing and challenging environment in the OR? Can these spontaneous, problem-solving skills be programmed into the AI platform?

Creative problem-solving also is paramount for job performance in other fields. In a military context, for example, war gaming is essential in training intelligence professionals. A quote from President Dwight Eisenhower is particularly relevant in this context: “Plans are worthless, but planning is everything.”

A recent article developed by the Combating Terrorism (CT) Center at the US Military Academy West Point in New York, suggested that AI may result in overreliance on this technology by special operators who need to be creative and quickly responsive to sudden changes on the battlefield.

“While generative AI may assist in automating routine tasks, it lacks the capacity for nuanced judgment, uncertainty quantification, and dynamic responsiveness critical to effective CT work. The use of generative AI for operational planning may, in fact, make our planners worse by removing the real benefits of the planning process and limit the CT forces’ ability to respond dynamically to branches and sequels,” the article stated.

But what about doing operations without human control? Could the surgical robots with AI platforms be programmed to do operations by themselves? Robotic operations are being done by humans around the world daily. The operations are being done with surgeons at a console, controlling the robot arms. So far, the critical difference is that the surgeon controls the robot arms and has hands, which the robot does not. If things go bad, the surgeon can abort the robotic procedure, open the patient, and complete the operation in the conventional way.

Can the computer be programmed to learn when it is over its head and abandon the robotic procedure? If faced with circumstances that are not answerable with the database provided (i.e., aberrant anatomy, arterial bleeding, hollow viscus injury), could the computer be creative and provide a solution? How can creativity be programmed? This is a difficult question because we do not know how to define “creativity,” and we do not understand the process of being creative in the first place.

When circumstances in the operating room change, the surgeon generally has the knowledge, education, experience, and skills to adjust appropriately. They may need to call in a colleague, which is part of being a professional. Could AI act professionally and be creative if the circumstance calls for it? At our present state of knowledge, if creativity is required, it is unlikely that a computer can replace a human surgeon. However, as AI platforms continue to improve, they may enhance simulation exercises, but this should be extrapolated to live surgery with caution. As the retired IBM executive stated, “AI computers are meant to help us, not replace us.”

Medical education and surgery are growing at a rapid pace. Being creative and using judgment to adapt to rapidly changing circumstances are often the difference between life and death. AI should only be used when its strengths outweigh its weaknesses. We must continue to train our surgeons to be creative and resourceful to better help our profession grow and keep us at least one step ahead of AI and robots.

The sole AI-generated portion of this article is the response provided to the Google search query.

Disclaimer

The thoughts and opinions expressed in this column are solely those of the authors and do not necessarily reflect those of the ACS.

Dr. Darryl Weiman is the associate program director for the General Surgery Residency Program at Baptist Health Sciences University in Memphis, TN.

Dr. Stephen Behrman is a professor of clinical surgery and surgical oncology, and chair of surgery at Baptist Health Sciences University in Memphis, TN.

Bibliography

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Bryan DS, Platz JJ, Naunheim KS, Ferguson MK; Research in Artificial Intelligence Development for Surgery (RAIDS) Working Group. How soon will surgeons become mere technicians? Chatbot performance in managing clinical scenarios. J Thorac Cardiovasc Surg. 2025;170(4):1179-1184.

Clark N. Commentary: The Dangers of Overreliance on Generative AI in the CT Fight. CTC Sentinel. August 2025.

Eisenhower, D. Remarks at the National Defense Executive Reserve Conference, November 14, 1957.

Jacobs S. Engineering the perfect robotic hand could unlock a $5 trillion humanoid market. Wall Street Journal. October 26, 2025.

Kosmyna N. Your brain on Chat GPT: Accumulation of cognitive debt when using an AI assistant for essay writing task. Cornell University. June 10, 2025. Available at: https://arxiv.org/abs/2506.08872. Accessed January 9, 2026.

Runco MA. AI can only produce artificial creativity. Journal of Creativity. December 2023. Available at: https://www.sciencedirect.com/science/article/pii/S2713374523000225. Accessed January 9, 2026.

United States Constitution, Article I, Section 8, Clause 8. The Congress shall have Power…To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries.