Effect of Agent-assisted, LLM-assisted and Traditional Workflows on Physician Admission Diagnosis

Inclusion criteria

• Hold a Medical Practitioner Qualification Certificate and/or Medical License, or be a recognized standardized resident physician; able to independently read electronic medical records, laboratory and imaging reports on an HIS.
• Currently engaged in clinical work in internal medicine or surgery at one of the 15 participating hospitals.
• Able to complete the 1-hour case assessment and the preceding training module and qualification test.
• Able to participate remotely under video proctoring, with a stable internet connection and a working camera.
• Voluntarily agree to participate and sign the informed consent form, including the declaration not to use unauthorized AI tools during the assessment.
• Have not participated in case drafting, review, rubric development, or any activity that may leak the reference standard.
• Stratified enrollment by hospital tier (provincial tertiary, municipal, primary care), specialty (internal medicine, surgery) and seniority (senior = Associate Chief Physician or above; junior-to-mid-level = below Associate Chief Physician, prioritizing residents, attending physicians and those with ≤ 8 years of practice).

Exclusion criteria

• Have previously accessed the official test cases or reference standard of this study.
• Unable to complete the training module, qualification test, or all experimental tasks.
• Have conflicts of interest, e.g. participation in developing core algorithms of the tested system.
• Unwilling to comply with remote proctoring, including keeping the camera on throughout.
• Violate study rules during the assessment (unauthorized AI tools, discussing cases, copying answers).
• Judged unsuitable by the investigators.