From Passive Tools to Autonomous Educators: The Transformative Role of Agentic Artificial Intelligence in Competency-Based Healthcare Education — A Review

Authors

Abstract

The growth of intelligent systems in healthcare has increased the demand for future-ready clinical competencies in medical graduates. Current AI applications in medical education—rule-based intelligent tutoring systems, fixed e-learning platforms, and passive decision-support systems—lack the ability to provide personalized, adaptive learning in line with competency-based medical education (CBME). A substantive paradigm shift is agentic AI, characterized by goal-directedness, multi-step reasoning, and dynamic tool use. A structured narrative review was conducted. PubMed, Google Scholar, Scopus, and IEEE Xplore were searched systematically using terms such as agentic AI, autonomous AI in education, large language models in medical education, and LMIC medical education AI, and included publications published from January 2018 to March 2026. After applying pre-specified inclusion and exclusion criteria, 35 sources were included. We present a novel five-dimensional taxonomy of agentic AI in CBME that includes the level of autonomy, instructional role, specificity to clinical domain, assessment modality, and deployment context. Its applications in personalized curriculum design, clinical simulation, formative assessment, and faculty augmentation are examined. Prevalent issues such as algorithmic bias, the risk of hallucination, lack of data privacy, inadequate infrastructure, and regulatory uncertainty are discussed, with a particular focus on low- and middle-income countries (LMICs), specifically Pakistan. To successfully implement agentic AI in healthcare education, it is necessary to have evidence-based frameworks, institutional readiness strategies, and coordinated national policy. We suggest an organized research agenda to fill in important evidentiary gaps.

Keywords:

Agentic artificial intelligence, competency-based medical education, AI tutors, healthcare education.

Published

2026/08/21

Issue

Vol. Volume 7-issue 3

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