Exploring the use of AI-generated counterfactual chest X-rays to enhance diagnostic learning in medical education.

Diagnostic education often lacks exposure to rare, subtle, or easily confused imaging findings. This UK experimental educational study evaluates AI-generated counterfactual chest X-rays—real patient images digitally transformed to depict alternative conditions while preserving anatomy. Among 42 medical students and physicians, counterfactual comparisons improved learning and confidence calibration, although real images produced higher raw diagnostic accuracy. The findings support cautious exploration of AI as an educational supplement, not a replacement for authentic cases.