{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:49:45Z","timestamp":1791362985807,"version":"4.3.1"},"reference-count":20,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":279,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2026,9,13]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Artificial intelligence (AI) is rapidly entering orthopedic practice, offering efficiency gains while risking cognitive deskilling, particularly among trainees who may shift from generating clinical judgments to passively verifying algorithmic recommendations. Drawing on foundational automation-bias literature, cognitive-load theory, deliberate-practice principles, and Miller\u2019s pyramid of competence, this editorial argues that orthopedic education must explicitly cultivate \u201cAI independence\u201d alongside AI fluency. We propose periodic AI-off assessments, a structured competency framework aligned with entrustable professional activities, and calibrated reliance modeled on aviation safety practices, so that future surgeons retain the capacity to reason, override, and remain accountable when intelligent systems are unavailable or incorrect.<\/jats:p>","DOI":"10.1051\/sicotj\/2026077","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:54:33Z","timestamp":1791359673000},"page":"E5","source":"Crossref","is-referenced-by-count":0,"title":["AI-induced deskilling in orthopedic surgery: Preserving judgment in the age of intelligent decision support"],"prefix":"10.1051","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-9533","authenticated-orcid":false,"given":"Raju","family":"Vaishya","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Indraprastha Apollo Hospitals","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Vaish","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Indraprastha Apollo Hospitals","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"crossref","first-page":"e26.00023","DOI":"10.2106\/JBJS.OA.26.00023","volume":"11","author":"Schneider","year":"2026","journal-title":"JBJS Open Access"},{"key":"R2","doi-asserted-by":"crossref","first-page":"100693","DOI":"10.1016\/j.esmorw.2026.100693","volume":"12","author":"Heudel","year":"2026","journal-title":"ESMO Real World Data Digit Oncol"},{"key":"R3","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s10462-025-11352-1","volume":"58","author":"Natali","year":"2025","journal-title":"Artif Intell Rev"},{"issue":"7","key":"R4","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s00264-022-05454-6","volume":"46","author":"Vaishya","year":"2022","journal-title":"Int Orthop"},{"issue":"4","key":"R5","doi-asserted-by":"crossref","first-page":"100257","DOI":"10.1016\/j.jham.2025.100257","volume":"17","author":"Vaishya","year":"2025","journal-title":"J Hand Microsurg"},{"key":"R6","doi-asserted-by":"crossref","first-page":"106223","DOI":"10.1016\/j.ijmedinf.2025.106223","volume":"207","author":"K\u00fccking","year":"2026","journal-title":"Int J Med Inform"},{"issue":"2","key":"R7","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1518\/001872097778543886","volume":"39","author":"Parasuraman","year":"1997","journal-title":"Hum Factors"},{"issue":"1","key":"R8","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1518\/hfes.46.1.50.30392","volume":"46","author":"Lee","year":"2004","journal-title":"Hum Factors"},{"issue":"3","key":"R9","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1518\/001872008X288547","volume":"50","author":"Lee","year":"2008","journal-title":"Hum Factors"},{"issue":"5","key":"R10","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1006\/ijhc.1999.0252","volume":"51","author":"Skitka","year":"1999","journal-title":"Int J Hum Comput Stud"},{"issue":"2","key":"R11","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1207\/s15516709cog1202_4","volume":"12","author":"Sweller","year":"1998","journal-title":"Cogn Sci"},{"issue":"11","key":"R12","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1097\/ACM.0000000000000939","volume":"90","author":"Ericsson","year":"2015","journal-title":"Acad Med"},{"issue":"3","key":"R13","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1037\/0033-295X.100.3.363","volume":"100","author":"Ericsson","year":"1993","journal-title":"Psychol Rev"},{"issue":"9 Suppl","key":"R14","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1097\/00001888-199009000-00045","volume":"65","author":"Miller","year":"1990","journal-title":"Acad Med"},{"key":"R15","doi-asserted-by":"crossref","first-page":"109849","DOI":"10.1016\/j.surg.2025.109849","volume":"190","author":"Kewalramani","year":"2026","journal-title":"Surgery"},{"key":"R16","unstructured":"Federal Aviation Administration. (2013) Safety alert for operators (SAFO) 13002: Manual flight operations. Washington, DC, FAA. Available at: https:\/\/drs.faa.gov\/browse\/excelExternalWindow\/FAA00000000000000000SAFO13002PDF.0001?modalOpened=true"},{"key":"R17","unstructured":"Federal Aviation Administration (2017) Advisory circular 120-71B: Standard operating procedures and pilot monitoring duties for flight deck crewmembers. Washington, DC, FAA. Available at: https:\/\/www.faa.gov\/regulations_policies\/advisory_circulars\/index.cfm\/go\/document.information\/documentid\/1030486"},{"key":"R18","unstructured":"Federal Aviation Administration (2022) Advisory circular 120-123: Flightpath management. Washington, DC, FAA. Available at: https:\/\/www.faa.gov\/regulations_policies\/advisory_circulars\/index.cfm\/go\/document.information\/documentID\/1041433"},{"issue":"11","key":"R19","doi-asserted-by":"crossref","first-page":"e0000651","DOI":"10.1371\/journal.pdig.0000651","volume":"3","author":"Cross","year":"2024","journal-title":"PLOS Digit Health"},{"issue":"4","key":"R20","doi-asserted-by":"crossref","first-page":"320","DOI":"10.2106\/JBJS.25.00971","volume":"108","author":"Sweeney","year":"2026","journal-title":"J Bone Joint Surg (Am)"}],"container-title":["SICOT-J"],"original-title":[],"link":[{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2026077\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:54:36Z","timestamp":1791359676000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2026077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":20,"alternative-id":["sicotj260225"],"URL":"https:\/\/doi.org\/10.1051\/sicotj\/2026077","relation":{},"ISSN":["2426-8887"],"issn-type":[{"value":"2426-8887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}