Mixed-methods study on GenAI Usage, dependence behaviors, and standardized application paths among Chinese medical students

Generative artificial intelligence (GenAI) is reshaping medical education while fostering technological dependence among students. This study employed an explanatory sequential mixed-methods design. In the quantitative phase, an empirical analysis was conducted using survey data collected from a sample of 1295 Chinese medical students. The subsequent qualitative phase involved thematic analysis of interview transcripts from 16 medical educators to elucidate the underlying mechanisms. Findings reveal that GenAI was deeply integrated into medical students' daily learning routines. Tool selection favored general-purpose platforms, whereas specialist medical tools exhibited exceptionally low utilization rates. The clinical application possibilities remained below 20% across all situations. With an overall dependency score of 21.91 ± 6.75, over 60% of students reported dependence on GenAI. Multivariate linear regression analysis indicated performance expectancy, academic pressure, and social influence showed significant positive correlations with GenAI dependency. Conversely, critical thinking exhibited a significant negative correlation. Future medical education should strategically reposition GenAI as a "cognitive scaffold" by reinforcing critical thinking and establishing standardized usage guidelines to facilitate high-quality development.