The VALUE of AI-Guided Communication: Enhancing Shared Decision-Making in Bariatric Surgery Consultations Through a Metacognitive Framework

This study investigates the effectiveness of an AI-guided metacognitive framework (VALUE) in improving shared decision-making (SDM) and communication quality during bariatric surgery consultations. Surgical residents often lack structured training in patient-centered communication, which is critical for long-term adherence and treatment success. We conducted a prospective, randomized controlled trial with 40 surgical residents, comparing an AI-guided preparation group (using the VALUE framework via a large language model) with a self-directed learning group. Participants conducted simulated consultations with standardized patients from a case library. Outcomes included patient-reported SDM (SDM-Q-9), decisional conflict (DCS), observed communication skills (4HCS), surgeon self-efficacy (SSI-BS), and quality of consultation outlines (CQS). Results showed that the AI-guided group achieved significantly higher SDM-Q-9 scores (84.7 vs. 71.3, p