CAIHL read · Jun 7, 2026
The MCAT requirement persists as a norm, not as a tool
Framework
What CAIHL does
Critical AI Health Literacy (CAIHL) is an analytical lens — Hugo Campos and Liz Salmi's 2025 National Academy of Medicine commentary, "Critical AI Health Literacy as Liberation Technology." It applies Paulo Freire's theory of critical literacy to health AI.
The central question CAIHL asks is whose interests does this AI actually serve? Four dimensions answer it: who is the primary user, where is it hosted, whose interests does it advance, and does it expand or constrain patient agency.
This deep-read separates the four dimensions on a single item from the day's scan, so you can see the specific structural shape of the AI in question — not just the bucket it landed in.
The four dimensions
How this item reads through CAIHL
Primary user
clinician
Clinicians or care teams are the primary users. Patients are affected downstream.
Hosting
institutional
Hosted inside a health system, insurer, or large employer. Access controlled by the institution.
Interests
institutional
Prioritizes institutional efficiency, compliance, risk management, or revenue.
Agency
constraining
Channels patients toward predetermined pathways or substitutes for patient capabilities.
Editor's CAIHL read
One-sentence synthesis
Critique of institutional norm-as-tool; same failure mode that produces patient-side AI overrides.
In the scan
How this item appeared in the daily scan
Editor's note: Institutional persistence is the failure mode that produces structural overrides. The MCAT is one example; the institutional AI tool deployed without patient-side accountability is another.
Summary: KevinMD: Essay arguing the MCAT persists as institutional norm rather than as a useful screening tool — the same critique CAIHL surfaces when AI tools persist as institutional fixtures despite weak patient-outcome evidence.
methodology
Limitations
CAIHL is a lens, not a verdict. The four dimensions are conditions of use — reassess them when a tool's business model, deployment context, or patient behavior changes. See the NAM commentary for the full framework.