From Cognitive Substitution to Cognitive Amplification: Artificial Intelligence, Higher-Order Learning and Real-World Readiness in Online Postgraduate Public Health Education—A Scoping Review

Background: Online postgraduate (PG) public health education must develop higher-order competence and readiness for practice. Generative artificial intelligence (genAI) may enhance feedback, simulation and scaffolding, but may also substitute for learner reasoning. This review examined pedagogical conditions supporting higher-order learning and how AI interacts with them to influence competence and real-world readiness in online PG public health education. Methods: Following JBI guidance and PRISMA-ScR, PubMed and Scopus were searched for literature published from 2010 to 2026, with the final search conducted on 20 August 2026. Eligible sources addressed higher-order learning, authentic learning, competence or professional readiness in PG public health education, or provided transferable evidence from health professions and higher education settings. Of 5777 records identified, 253 duplicates were removed and 5524 screened. Data were charted using a structured evidence matrix and stratified into direct, transferable, synthesis, and contextual evidence layers. Results: Of 401 records undergoing detailed eligibility and analytic-role assessment, 338 were retained. Core evidence comprised 92 studies: 27 direct and 65 transferable; 32 syntheses provided triangulation. AI featured in 11.1% of direct versus 87.7% of transferable studies. Applied competence/skills occurred in 59.8%, synthesis/integration in 44.6%, critical thinking in 26.1%, and real-world cases/scenarios in 51.1%. Practice/workplace transfer was more prominent in direct than in transferable evidence (66.7% vs. 13.8%). Direct AI evidence in PG public health was limited, and heterogeneity across studies constrained direct comparison and precluded quantitative pooling. Conclusions: Higher-order learning depended more on pedagogical architecture than modality or AI adoption. AI may amplify cognition when preserving learner reasoning, verification, and judgement, but may substitute for cognition when generated outputs replace these processes. No external funding was received for this review.