The use of AI in exam development is intriguing, exciting, and evolving. While the potential for increasing the volume and pace of item and exam development is alluring, decisions regarding use of AI must be thoroughly informed. This session will highlight the continued essential role of human subject-matter experts (SMEs) in exam development, and provide participants with opportunities to share and provide feedback on strategies for use of AI in exam development. Key discussion points may include the following: contextual understanding (human nuance, relevance), creativity (innovative question design), critical thinking (varied assessment methods), ethics, fairness (bias, inclusive , quality assurance, validation, adaptability, responsiveness.