From enriched teaching to didactic-disciplinary-cultural symbiogenesis: a care-centered framework for health professions education in the age of artificial intelligence

Digital technologies are no longer optional supports; they now shape how health knowledge is produced, communicated, assessed, and put into practice. This article articulates two qualitative theses conducted by the same author at different stages of this transformation. The 2015 master's thesis reconstructed three blended undergraduate courses in nursing, medicine, and nutrition at Universidad de la República, Uruguay. It showed that technology acquires greater educational value when its inclusion is pedagogically justified, reorganizes intellectual activity, promotes reflection and formative assessment, and is supported by institutional policies and collaborative teaching work. The 2023 doctoral thesis, whose fieldwork was conducted between 2018 and 2019 with fourteen Ibero-American health professionals and five cases studied in depth, conceptualized didactic-disciplinary-cultural symbiogenesis to explain reciprocal transformations among teaching, disciplines, culture, and professional practice. Through an interpretive synthesis that preserves the autonomy of both corpora, the article proposes a care-centered symbiogenetic framework organized into six interdependent domains: legitimate pedagogical design, curricular anticipation, epistemic verification, cultural displacement, networked knowledge, and equity and governance. Its central proposition is that articulating these domains may foster a responsible integration of generative artificial intelligence and digital health oriented toward learning, professional judgment, equity, and care. The framework is a historically situated theoretical proposal that has not yet been empirically validated. The source theses ground its generation, but they did not evaluate contemporary generative AI interventions or health outcomes attributable to these technologies. Six testable propositions and a prospective research agenda are formulated to examine the framework's scope, limitations, and potential educational, professional, care-related, and organizational effects.