ChatGPT 与专家对临床推理问题的反馈及其对学习的影响:随机对照试验。

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Postgraduate Medical Journal Pub Date : 2024-12-05 DOI:10.1093/postmj/qgae170
Feray Ekin Çiçek, Müşerref Ülker, Menekşe Özer, Yavuz Selim Kıyak
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引用次数: 0

摘要

目的:评价chatgpt生成的反馈与专家书面反馈在提高一年级医学生临床推理技能方面的有效性。方法:这是一项在一所医学院进行的随机对照试验,涉及129名一年级医学生,他们被随机分为两组。两组都完成了三次形成性测试,包括对尿路感染(uti)的反馈;作为间隔重复,接受专家书面反馈(对照组,n = 65)或chatgpt生成的反馈(实验,n = 64)。临床推理能力在干预后立即和10天后使用关键特征问题(KFQs)进行评估。在披露AI参与反馈生成之前和之后,还测量了学生对人工智能(AI)的批判性方法。结果:对照组(即刻组:78.5±20.6,延迟组:78.0±21.2)与试验组(即刻组:74.7±15.1,延迟组:76.0±14.5)在关键特征题(满分120分)的整体表现上即刻(P = 0.26)和10天后(P = 0.57)的平均得分无显著差异,且效应量较小。然而,在复杂的尿路感染病例中,对照组的表现优于ChatGPT组(P结论:ChatGPT生成的反馈可以有效地替代专家反馈,提高医学生的临床推理技能,特别是在资源受限、专家可用性有限的情况下。然而,人工智能生成的反馈可能缺乏更复杂情况所需的细微差别,强调了专家审查的必要性。此外,了解人工智能生成的反馈的缺点可以增强学生对人工智能生成的教育内容的批判性态度。
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ChatGPT versus expert feedback on clinical reasoning questions and their effect on learning: a randomized controlled trial.

Purpose: To evaluate the effectiveness of ChatGPT-generated feedback compared to expert-written feedback in improving clinical reasoning skills among first-year medical students.

Methods: This is a randomized controlled trial conducted at a single medical school and involved 129 first-year medical students who were randomly assigned to two groups. Both groups completed three formative tests with feedback on urinary tract infections (UTIs; uncomplicated, complicated, pyelonephritis) over five consecutive days as a spaced repetition, receiving either expert-written feedback (control, n = 65) or ChatGPT-generated feedback (experiment, n = 64). Clinical reasoning skills were assessed using Key-Features Questions (KFQs) immediately after the intervention and 10 days later. Students' critical approach to artificial intelligence (AI) was also measured before and after disclosing the AI involvement in feedback generation.

Results: There was no significant difference between the mean scores of the control (immediate: 78.5 ± 20.6 delayed: 78.0 ± 21.2) and experiment (immediate: 74.7 ± 15.1, delayed: 76.0 ± 14.5) groups in overall performance on Key-Features Questions (out of 120 points) immediately (P = .26) or after 10 days (P = .57), with small effect sizes. However, the control group outperformed the ChatGPT group in complicated urinary tract infection cases (P < .001). The experiment group showed a significantly higher critical approach to AI after disclosing, with medium-large effect sizes.

Conclusions: ChatGPT-generated feedback can be an effective alternative to expert feedback in improving clinical reasoning skills in medical students, particularly in resource-constrained settings with limited expert availability. However, AI-generated feedback may lack the nuance needed for more complex cases, emphasizing the need for expert review. Additionally, exposure to the drawbacks in AI-generated feedback can enhance students' critical approach towards AI-generated educational content.

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来源期刊
Postgraduate Medical Journal
Postgraduate Medical Journal 医学-医学:内科
CiteScore
8.50
自引率
2.00%
发文量
131
审稿时长
2.5 months
期刊介绍: Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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