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Lin KC, Chen TA, Lin MH, Chen YC, Chen TJ. Integration and Assessment of ChatGPT in Medical Case Reporting: A Multifaceted Approach. Eur J Investig Health Psychol Educ 2024; 14:888-901. [PMID: 38667812 PMCID: PMC11049282 DOI: 10.3390/ejihpe14040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
ChatGPT, a large language model, has gained significance in medical writing, particularly in case reports that document the course of an illness. This article explores the integration of ChatGPT and how ChatGPT shapes the process, product, and politics of medical writing in the real world. We conducted a bibliometric analysis on case reports utilizing ChatGPT and indexed in PubMed, encompassing publication information. Furthermore, an in-depth analysis was conducted to categorize the applications and limitations of ChatGPT and the publication trend of application categories. A total of 66 case reports utilizing ChatGPT were identified, with a predominant preference for the online version and English input by the authors. The prevalent application categories were information retrieval and content generation. Notably, this trend remained consistent across different months. Within the subset of 32 articles addressing ChatGPT limitations in case report writing, concerns related to inaccuracies and a lack of clinical context were prominently emphasized. This pointed out the important role of clinical thinking and professional expertise, representing the foundational tenets of medical education, while also accentuating the distinction between physicians and generative artificial intelligence.
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Affiliation(s)
- Kuan-Chen Lin
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; (K.-C.L.); (T.-A.C.); (M.-H.L.)
| | - Tsung-An Chen
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; (K.-C.L.); (T.-A.C.); (M.-H.L.)
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; (K.-C.L.); (T.-A.C.); (M.-H.L.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan
| | - Yu-Chun Chen
- Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; (K.-C.L.); (T.-A.C.); (M.-H.L.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan
- Institute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan
- Big Data Center, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital Hsinchu Branch, No. 81, Sec. 1, Zhongfeng Road, Zhudong Township, Hsinchu 310403, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, No. 145, Xingda Road, South District, Taichung 402202, Taiwan
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Meng L, Liu X, Ni J, Shen P, Jiao F. An investigation for the efficacy of teaching model of combining virtual simulation and real experiment for clinical microbiology examination. Front Med (Lausanne) 2024; 11:1255088. [PMID: 38449889 PMCID: PMC10915005 DOI: 10.3389/fmed.2024.1255088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Background As a convenient teaching tool, virtual simulation experiment technology had been widely utilized in the field of medical education. However, virtual learning could not fully replace the benefits of in-person instruction. Therefore, finding ways to integrate both methods was crucial for achieving optimal educational outcomes. The objective of this study was to compare the effectiveness of the self-built virtual simulation and design experiment combining teaching mode and the traditional experimental teaching mode in the clinical microbiology examination experiment teaching. Methods This study was conducted at Shandong First Medical University in China. The experimental group consisted of 100 third-year students from the grade 2020 majoring in medical examination technology, who underwent an innovative teaching model combining virtual and real experiments. The control group comprised of 100 third-year students from the grade 2019 in the same major, who received traditional experimental teaching model. In this study, we referred to grade 2020 as cohort 2020 and grade 2019 cohort 2019. The performance of both groups was assessed via experimental and theoretical testing. Meanwhile, survey questionnaires were administered to evaluate the efficacy of the innovative experimental teaching model and students' level of satisfaction with it. Cohort 2020 conducted a survey for modules 1 to 4, while cohort 2019 only conducted a survey for module 4, as detailed in the Appendix. Results The majority of students in the experimental group expressed satisfaction with the teaching model that combined virtual and real experiments, as evidenced by their superior performance on both experimental operational skills (87.54 ± 8.93 vs. 82.39 ± 10.55) and theoretical knowledge tests (83.65 ± 9.02 vs. 80.18 ± 8.24) compared to those in the control group. Conclusion The combination of virtual simulation experiment and design experiment in the microbiological examination of clinical specimens represented an effective pedagogical approach. The instructional approach had the potential to incite a passion for learning, enhance proficiency in standardized experimental techniques, foster the ability to integrate theory with practice, and cultivate clinical reasoning skills.
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Affiliation(s)
| | | | | | | | - Fengping Jiao
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
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Hou XS, Yuan F, Sun JQ, Wang SS, Ji X, Tian HF, Tan C. [Constructing of clinical thinking of acupuncture and moxibustion, improving the medical record writing ability of standardized training physicians: teaching experience of the standardized training textbook Acupuncture and Moxibustion for national TCM resident physicians]. Zhongguo Zhen Jiu 2022; 42:1306-1310. [PMID: 36397231 DOI: 10.13703/j.0255-2930.20211106-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
To explore the methods of cultivating the clinical thinking ability of acupuncture and moxibustion in the standardized training of resident physicians, so as to improve the medical record writing ability of the regular training physicians. The clinical diagnosis and treatment of acupuncture and moxibustion has its own characteristics and can't copy the syndrome differentiation and treatment mode of TCM internal medicine. In the treatment section, Acupuncture and Moxibustion, a standardized training textbook for national TCM resident physicians, takes clinical cases as the breakthrough point and uses the problem as the guide, guides the training physicians to cultivate acupuncture and moxibustion clinical diagnosis and treatment from three aspects: disease diagnosis, syndrome diagnosis, and treatment ideas, forms a complete understanding of the disease, and improves the standardization, logicality and systematicness of medical record writing through repeated practical training.
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Affiliation(s)
- Xue-Si Hou
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Fang Yuan
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Jing-Qing Sun
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Shao-Song Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Xu Ji
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM Affiliated to Capital Medical University, Beijing 100010, China
| | - Hong-Fang Tian
- Third Affiliated Hospital of Zhejiang Chinese Medical University
| | - Cheng Tan
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of CM, Beijing 100700
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Hou XS, Tan C, Ning BL, Fu WB, Zhao JP. [Consolidating the foundation, highlighting the practice and strengthening the training of clinical thinking of acupuncture and moxibustion: the thoughts of compiling the China national standardized training textbook Acupuncture and Moxibustion for residents of traditional Chinese medicine]. Zhongguo Zhen Jiu 2022; 42:834-838. [PMID: 35793898 DOI: 10.13703/j.0255-2930.20210612-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Based on the clinical needs and examination requirements of standardized training students, the China national standardized training textbook Acupuncture and Moxibustion for residents of traditional Chinese medicine has made innovations in the textbook content and form. In the part of meridians and acupoints, the classic original text is introduced and the main indications and operation methods of 200 commonly-used acupoints are summarized in the form of tables. In the part of acupuncture and moxibustion technique, the operating procedures are standardized and the core technical points of 20 commonly-used acupuncture and moxibustion techniques are summarized in the form of flow chart. In the part of acupuncture and moxibustion treatment, 48 typical diseases are introduced in the form of case discussion, highlighting the problem orientation and demonstrating the diagnosis and treatment procedures.
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Affiliation(s)
- Xue-Si Hou
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture for Neuromodulation, Beijing 100010, China
| | - Cheng Tan
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital of Beijing University of CM, Beijing 100700
| | - Bai-le Ning
- Department of Acupuncture and Moxibustion, Guangdong Hospital of TCM
| | - Wen-Bin Fu
- Department of Acupuncture and Moxibustion, Guangdong Hospital of TCM
| | - Ji-Ping Zhao
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital of Beijing University of CM, Beijing 100700
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Zhu X, Yang L, Lin P, Lu G, Xiao N, Yang S, Sui S. Assessing Nursing Students' Clinical Competencies Using a Problem-Focused Objective Structured Clinical Examination. West J Nurs Res 2016; 39:388-399. [PMID: 27586442 DOI: 10.1177/0193945916667727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objectives of this study were to develop, implement, and evaluate an innovative modified Objective Structured Clinical Examination (OSCE) model, and to compare students' performance of different clinical skills as assessed by standardized patients and OSCE examiners. Data were obtained from final year undergraduate students undergoing the modified OSCE as a graduation examination. Seventy-seven students rotated through four stations (nine substations). Standardized patients scored students higher than examiners in history taking (9.14 ± 0.92 vs. 8.42 ± 0.85), response to emergency event (8.88 ± 1.12 vs. 7.62 ± 1.54), executive medical orders (8.77 ± 0.96 vs. 8.25 ± 1.43), technical operation (18.21 ± 1.26 vs. 16.91 ± 1.35), nursing evaluation (4.53 ± 0.28 vs. 4.29 ± 0.52), and health education stations (13.79 ± 1.31 vs. 11.93 ± 2.25; p < .01). In addition, the results indicated that the difference between standardized patient and examiner scores for physical examination skills was nonsignificant (8.70 ± 1.18 vs. 8.80 ± 1.27; p > .05). The modified, problem-focused, and nursing process-driven OSCE model effectively assessed nursing students' clinical competencies, and clinical and critical thinking.
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Affiliation(s)
- Xuemei Zhu
- 1 School of Nursing, Harbin Medical University, China
| | - Li Yang
- 1 School of Nursing, Harbin Medical University, China
| | - Ping Lin
- 1 School of Nursing, Harbin Medical University, China
| | - Guizhi Lu
- 1 School of Nursing, Harbin Medical University, China
| | - Ningning Xiao
- 1 School of Nursing, Harbin Medical University, China
| | - Shufen Yang
- 1 School of Nursing, Harbin Medical University, China
| | - Shujie Sui
- 1 School of Nursing, Harbin Medical University, China
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Abstract
I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer much but are hampered by the ubiquity and flaws of meta-analysis. I explore views of evidence-based medicine among psychiatry residents, as well as capacity for critical thinking in residents before and after a course in philosophy. I discuss decision making by experienced doctors and suggest possible futures of this issue.
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Affiliation(s)
- Lloyd A Wells
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Gehlhar K, Klimke-Jung K, Stosch C, Fischer MR. Do different medical curricula influence self-assessed clinical thinking of students? GMS Z Med Ausbild 2014; 31:Doc23. [PMID: 24872858 PMCID: PMC4027808 DOI: 10.3205/zma000915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 03/13/2014] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES As a fundamental element of medical practice, clinical reasoning should be cultivated in courses of study in human medicine. To date, however, no conclusive evidence has been offered as to what forms of teaching and learning are most effective in achieving this goal. The Diagnostic Thinking Inventory (DTI) was developed as a means of measuring knowledge-unrelated components of clinical reasoning. The present pilot study examines the adequacy of this instrument in measuring differences in the clinical reasoning of students in varying stages of education in three curricula of medical studies. METHODS The Diagnostic Thinking Inventory (DTI) comprises 41 items in two subscales ("Flexibility in Thinking" and "Structure of Knowledge in Memory"). Each item contains a statement or finding concerning clinical reasoning in the form of a stem under which a 6-point scale presents opposing conclusions. The subjects are asked to assess their clinical thinking within this range. The German-language version of the DTI was completed by 247 student volunteers from three schools and varying clinical semesters. In a quasi-experimental design, 219 subjects from traditional and model courses of study in the German state of North Rhine-Westphalia took part. Specifically, these were 5(th), 6(th) and 8(th) semester students from the model course of study at Witten/Herdecke University (W/HU), from the model (7(th) and 9(th) semester) and traditional (7(th) semester) courses of study at the Ruhr University Bochum (RUB) and from the model course of study (9(th) semester) at the University of Cologne (UoC). The data retrieved were quantitatively assessed. RESULTS The reliability of the questionnaire in its entirety was good (Cronbach's alpha between 0.71 and 0.83); the reliability of the subscales ranged between 0.49 and 0.75. The different groups were compared using the Mann-Whitney test, revealing significant differences among semester cohorts within a school as well as between students from similar academic years in different schools. Among the participants from the model course of study at the W/HU, scores increased from the 5(th) to the 6(th) semester and from the 5(th) to the 9(th) semester. Among individual cohorts at RUB, no differences could be established between model and traditional courses of study or between 7(th) and 9(th) semester students in model courses of study. Comparing all participating highest semester students, the 8(th) semester participants from the W/HU achieved the highest scores - significantly higher than those of 9(th) semester RUB students or 9(th) semester UoC students. Scores from the RUB 9(th) semester participants were significantly higher than those of the 9(th) semester UoC participants. DISCUSSION The German-language version of the DTI measures self-assessed differences in diagnostic reasoning among students from various semesters and different model and traditional courses of study with satisfactory reliability. The results can be used for discussion in the context of diverse curricula. The DTI is therefore appropriate for further research that can then be correlated with the different teaching method characteristics and outcomes of various curricula.
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Affiliation(s)
- Kirsten Gehlhar
- Carl von Ossietzky University of Oldenburg, School of Medicine and Health Sciences, Oldenburg, Germany
| | | | | | - Martin R Fischer
- Clinic of the Ludwig Maximilian University of Munich, Institute for Medical Education, Munich, Germany
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Conway JM, Ahmed GF. A pharmacotherapy capstone course to advance pharmacy students' clinical documentation skills. Am J Pharm Educ 2012; 76:134. [PMID: 23049106 PMCID: PMC3448472 DOI: 10.5688/ajpe767134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 04/29/2012] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To implement and assess the effectiveness of a capstone pharmacotherapy course designed to integrate in-class curriculum using patient cases and drug-information questions. The course was intended to improve third-year doctor of pharmacy (PharmD) students' clinical documentation skills in preparation for beginning advanced pharmacy practice experiences (APPEs). DESIGN This 2-credit, semester-long course consisted of 6 patient cases and 12 drug-information questions posted electronically on an Internet-based medical chart, a public health presentation, a knowledge examination, and an objective standardized performance assessment. In class, students engaged in active-learning exercises and clinical problem-solving. Students worked outside of class in small groups to retrieve and discuss assigned articles and review medication information in preparation for in-class discussions. ASSESSMENT A rubric was used to assess the patient cases and questions that students completed and submitted individually. Data for 4 consecutive course offerings (n=622) were then analyzed. A significant improvement was found in the "misplaced" but not the "missing" documentation ratings for both assessment and plan notes in the final assessment compared with baseline. In course evaluations, the majority of students agreed that the course integrated material across the curriculum (97%) and improved their clinical writing skills (80.5%). CONCLUSION A capstone pharmacy course was successful in integrating and reviewing much of the material covered across the PharmD curriculum and in improving students' clinical documentation skills.
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