How AI Can Degrade Human Performance in High-Stakes Settings

Paper · Source
Knowledge After the Web

Source: Morey, Rayo, Woods (Ohio State) — AI Frontiers · 2025-07-15

Across disciplines, bad AI predictions have a surprising tendency to make human experts perform worse.

Last week, the AI nonprofit METR published an in-depth study on human-AI collaboration that stunned experts. It found that software developers with access to AI tools took 19% longer to complete their tasks, despite believing they had finished 20% faster. The findings shed important light on our ability to predict how AI capabilities interact with human skills.

Since 2020, we have been conducting similar studies on human-AI collaboration, but in contexts with much higher stakes than software development. Alarmingly, in these safety-critical settings, we found that access to AI tools can cause humans to perform much, much worse.

A 19% slowdown in software development can eat into profits. Reduced performance in safety-critical settings can cost lives.

Imagine that you’re aboard a passenger jet on its final approach into San Francisco. Everything seems ready for a smooth landing — until an AI-infused weather monitor misses a sudden microburst. Neither the crew nor the autopilot is warned that the aircraft is no longer configured to generate enough lift. By the time the crew notices the anomaly, the aircraft is losing altitude, and fast! Now the crew has twice the work to do in half the time. They throttle up aggressively to regain altitude while simultaneously redirecting the autopilot to fly a go-around. After a close call, when the weather risk is over, the jet lands safely.

Or picture being a nurse, working the night shift in the surgical wing of an understaffed hospital. As usual, alarms have been going off all night — most of them when nothing is wrong. An AI-infused dashboard helps you determine which alarms indicate serious danger, rating patient vitals by the second. Tonight, the dashboard tags one chart as “low risk.” You move on to other patients. Minutes later, an alarm tells you that the patient’s oxygen levels have plunged dangerously low. You scramble and manage to stabilize the patient. Afterward, you notice that the AI algorithm had missed a slow but steady increase in the patient’s heart rate over several hours: a subtle warning of impending collapse.

Lastly, envision that you are an engineer in the control room of a nuclear power plant. Staffing has been sharply reduced now that you work alongside an AI-augmented warning system. The AI warning system prioritizes the most critical alarms and filters out false or irrelevant alarms, which inadvertently hides an underlying problem: it mislabels a gradual drop in coolant pressure as benign. As the anomaly spreads, more subsystems begin to malfunction. You take actions, but they are ineffective. As the problem gets worse, you call for assistance. By the time help arrives, you’re rushing to avert a partial core meltdown. While you and your human teammates manage to prevent the meltdown, the damage sustained will delay the restart of the plant for weeks.

These snapshots from aviation, health care, and nuclear energy highlight a key fact: AI is never deployed in isolation. It’s integrated into existing technologies, processes, and — most importantly — human workflows.

Hidden risks in human-AI workflows. While AI infusions can match or even exceed unaided human performance, integrating these systems into real-world workflows also introduces hidden vulnerabilities. Standard guidance frameworks — like the NIST AI Risk Management Framework and Article 14 of the EU AI Act — call for human oversight, but they stop short of examining how AI shapes human decision-making in collaborative settings.

Our latest research, published last month in npj Digital Medicine, shows that even the most carefully designed human-AI collaborations can have unpredictable blind spots. In safety-critical settings such as aviation, health care, and nuclear energy, such blind spots can have catastrophic consequences.

Flawed metrics. Most safety evaluations fail by treating AI and humans separately, or they boil down the complex effects of collaboration into a single metric, like “average performance.” That approach hides blind spots, with outsized ramifications: average gains can mask rare but severe failures, while frequent small benefits can come at the cost of rare but catastrophic events.

We developed Joint Activity Testing to address the limitations of these standard methods for evaluating AI-infused technologies. Our method measures how AI impacts human performance across a range of escalating, domain-specific challenges. It provides decision-makers with data showing how strong, mediocre, and poor AI performance in a given task may impact the performance of human collaborators. This has led to a further, perhaps even more serious discovery: human experts often struggle to recognize and recover from AI mistakes, which is an especially critical capability in high-risk settings.

Our experiments with Joint Activity Testing have shown us how AI assistance can improve outcomes in some situations but degrade them in others. Unlike the overly broad assessments provided by existing frameworks, our findings offer clear, targeted feedback for redesign and improvement.

AI in healthcare case study. Since 2020, we’ve used Joint Activity Testing to stress-test human-AI teams in real-world scenarios. In our latest study, 450 nursing students and a dozen licensed nurses each reviewed 10 historical ICU cases, using an AI early warning tool in four configurations:

AI’s influence on human expertise. We found that AI predictions strongly influenced how the nurses assessed their patients, for better and for (much) worse. The nurses were asked to rate each ICU case on a scale of 1-10, based on how concerned they were about the patient’s well-being. Higher concern for emergency patients and lower concern for non-emergency patients indicated better performance. When AI predictions were most correct, nurses performed 53% to 67% better than when they worked without AI assistance. However, when AI predictions were most misleading, nurses performed 96% to 120% worse than when they worked without AI assistance. Adding annotations to AI predictions did not significantly alter results. Annotations alone had a similar but dampened effect.

These results are surprising because, when evaluated in isolation, nurses and AI appear to have complementary strengths and weaknesses. The algorithm struggled with cases that nurses without AI handled with ease. Yet when those routine cases were paired with misleading AI predictions, nurses consistently misclassified emergencies as nonemergencies (and vice versa). In short, poor AI performance counteracted nurses’ strengths relative to algorithms, resulting in net weakness on certain tasks.

AI changed how participants think in critical situations. Notably, our follow-on analyses suggest that the nurses in our studies did not reliably recognize when AI predictions were right or wrong; therefore, they became susceptible to AI mistakes. That is, these results do not stem from the nurses’ lack of effort or from their consciously offloading decision-making to the AI. Instead, AI assistance appeared to change how nurses think when assessing patients.

Need for nuanced testing. Operators must treat every AI-infused tool as a potential double-edged sword until they know exactly how it behaves in real-world hands. This latest study fits a clear pattern we’ve seen again and again in our Joint Activity Tests: AI boosts performance when it’s right. But, when it’s wrong, those gains quickly reverse and can even create new harms.

That means operators must test human-AI teams together, rather than evaluating the AI by itself or boiling results down to an average score. Isolated benchmarks miss the subtle ways that AI signals change human behavior, and aggregated metrics can mask conditions that lead to rare but catastrophic failures. Only by measuring people and AI side by side — across strong, mediocre, and poor AI performance — can organizations spot hidden risks before they cause harm.

AI must be tested in collaboration with people. Algorithm-only evaluations miss how AI signals reshape human decisions, and studies show that neither years of experience nor familiarity with AI tools reliably predict who may benefit from AI assistance or recover from AI mistakes. While this form of testing is more expensive than alternatives, it is currently the only reliable method for predicting real-world impacts of human-AI collaboration.

Evaluate a range of challenging cases with varied AI performance. If failure matters — as it always does in safety-critical settings — anything short of thorough testing prior to deployment is unacceptable. Scenarios where the AI excels, struggles, and fails should be considered independently. Averaging results can hide rare but severe errors, creating blind spots with potentially catastrophic consequences.

Patching alone does not make systems safer.

Lines of inquiry this paper opens 24

Research framings built by reading the notes related to this paper — the questions it feeds into.

How do users confuse explanation quality with actual system accuracy? How do clinicians calibrate trust in AI medical recommendations? Do individually safe AI actions create unsafe outcomes in integrated systems? What governance mechanisms can effectively constrain widely deployed AI systems? Why do standard evaluation practices obscure safety-critical AI failures? How does model capacity affect learning performance on diverse downstream tasks? How do multi-agent systems fail when coordination breaks down? Should governance of agentic AI systems be runtime or design-time? How do individually-safe actions create collectively-unsafe outcomes?