Journal of Advances in Medical Education & Professionalism

Review article

ChatGPT and Medical Research: A Meta-Synthesis of Opportunities and Challenges

AHMAD KEYKHA; SARA BEHRAVESH; FERESHTEH GHAEMI

Volume 12, Issue 3 , July 2024, Pages 135-147

https://doi.org/10.30476/jamp.2024.101068.1910

Abstract

Introduction: The utility of ChatGPT in research is ambiguous, serving as both a boon and bane and presenting challenges and opportunities. Accordingly, this study aimed to delineate ... Read More Introduction: The utility of ChatGPT in research is ambiguous, serving as both a boon and bane and presenting challenges and opportunities. Accordingly, this study aimed to delineate themerits and demerits of ChatGPT within the realm of research.Methods: A meta-synthesis methodology involving a seven-step process was adopted to pursue the research objectives. Data were collected from comprehensive studies across specialized research databases, such as Science Direct, Springer, Eric, Emerald, Sage Journals, Wiley Online Library, PubMed, and Google Scholar, within the time frame spanning from 2022 to 2023. A total of 57 articles were meticulously chosen for analysis through judgmental sampling. Subsequently, key concepts were distilled from these articles and categorized using the thematic analysis approach while considering Karl Llewellyn’s octagonal model from 1963.Results: The outcomes underwent scrutiny employing the thematic analysis strategy devised by Wolcott. The results about the capabilities and constraints of ChatGPT encompass eight dimensions, including formulating the research problem, reviewing relevant literature, selecting an appropriate research design, defining the population and choosing the sample, collecting data, analyzing data, interpreting data, and discussing and drawing conclusions. The credibility of these dimensions was substantiated through adherence to the criteria established by Lincoln and Guba. Conclusion: ChatGPT manifests myriad potentialities and constraints within the research purview based on the results. In light of the expeditious progression of artificial intelligence acrossmultifarious domains, integrating this technological paradigm in research becomes an inexorable imperative, and excluding its use in research is untenable. Thus, policymakers and higher education strategists should devise policies that harness ChatGPT’s potential in research endeavors, engendering many opportunities.

Review article

Study of Deep Learning in Medical Education: Opportunities, Achievements and Future Challenges

HOSSEIN MORADIMOKHLES; GWO-JEN HWANG; HOSSEIN ZANGENEH; MARYAM POURJAMSHIDI; AMIR HOSSEIN AMOOEIRAZANI

Volume 12, Issue 3 , July 2024, Pages 148-162

https://doi.org/10.30476/jamp.2024.99740.1853

Abstract

Introduction: In this era of progress, interest has developed regarding advancing deep learning (DL) in medicine. However, there has been reluctance to use deep learning, particularly ... Read More Introduction: In this era of progress, interest has developed regarding advancing deep learning (DL) in medicine. However, there has been reluctance to use deep learning, particularly among medical educators. The limitations of previous research were examined in this study, along with the extent to which DL can be used in medical education and its potential impact on educational quality. We were interested in discussing DL’s prospects, and determining whether we could benefit from it in medical education.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used to manage this review procedure. Six databases were searched carefully to obtain relevant studies. Our search identified 981 articles from the database based on our standards. After filtering the duplicated articles, 11 studies were included in the systematic review. Results: The results showed that DL applications attracted researchers’ attention in the medical and education technology owing to their effectiveness to provide the personalized assistanceand feedback. Furthermore, the majority of research concentrated on teaching medical students how to utilize DL applications in the classroom, and all of them tried to improve medical students’proficiency with DL instruments in practical applications. Deep learning components in medical learning environments have two segments—in the educational settings like speech recognitionor Video content analysis for affecting students’ learning, and in the medical settings, applying deep learning from diagnosis to prevention. An integration of them can work better in medicaleducation.Conclusion: Medical education uses DL to improve the students’ education. DL is a powerful instrument which has become more famous in terms of superb outcomes. Besides, using DL in medical education is likely to continue as a hotly debated area of research and a well-known classroom strategy.

Original Article

Empowering Medical Education: Unveiling the Impact of Reflective Writing and Tailored Assessment on Deep Learning

PUJA DULLOO; NEERAJ VEDI; MINAL PATEL; SUMAN SINGH

Volume 12, Issue 3 , July 2024, Pages 163-171

https://doi.org/10.30476/jamp.2024.101594.1938

Abstract

Introduction: Reflective thinking offers learners insight and encourages deeper understanding by leveraging past experiences. This study explores the impact of reflective writing, a ... Read More

Original Article

A Four-Axis-Method to Evaluate a Part of an Undergraduate Medical Students’ Curriculum

MONA MLIKA; SARRA CHEIKHROUHOU; ABDERRAOUF BEN MANSOUR; FAOUZI MEZNI; MOHAMED HÉDI LOUESLATI; IHEB LABBENE; MOHAMED JOUINI

Volume 12, Issue 3 , July 2024, Pages 172-179

https://doi.org/10.30476/jamp.2023.100837.1901

Abstract

Introduction: The evaluation of programs in faculties of medicine enables them to adequately reach their mission objectives, and social responsibilities and to correct their potential ... Read More Introduction: The evaluation of programs in faculties of medicine enables them to adequately reach their mission objectives, and social responsibilities and to correct their potential lacune. Fewpublications have described the process of internal evaluation of a program performed by the organizational members. The authors aimed to describe a practical method called the four-axis method to assess curriculum using a practical example.Methods: The authors performed a descriptive study, highlighting the application of a particular method of evaluation of a program called the four-axis method. It consisted of the assessment of the pedagogical alignment [1], teaching techniques and evaluation tests [2], students’ viewpoints and needs [3], and the teachers’ opinions and needs [4]. To contextualize this method, the authors described a practical experience of the assessment of a multidisciplinary theme (theme 16), which is taught during the second year of medical education. Was performed the evaluation from January 2020 to January 2021. The population studied consisted of the tutors implicated in the teaching of the theme and the students in the second year of medical education who accepted to answer the satisfaction questionnaires. The students and tutors who did not fill out the questionnaires were excluded. No statistical tests were needed because of the descriptive nature of the study. Results: The most relevant results highlighted that 48.4% of the teachers did not systematically use bioclinical cases involving interactions between students; also, 42.4% of the students believedthat the teaching sessions didn’t introduce practical examples giving rise to interactions between them. Therefore, the 4-axisbased analysis indicated that weaknesses were mostly attributedto the lack of homogeneity in the teaching methods and techniques which showed the teachers’ difficulties in integrating clinical data into their teaching so that they can help the students to assimilate the fundamental data.Conclusion: The authors’ used a particular approach since it focused both on an objective evaluation of the teaching methods and the evaluation tests and the students’ and teachers’ viewpoints and needs. The major limitation of this approach was the fact that itcould not integrate the educational environment that could impact the students’ performances.

Original Article

Roles of Two Learning Methods in the Perceived Competence of Surgery and Quality of Teaching: A Quasi-experimental Study among Operating Room Nursing Students

SINA GHASEMI; BEHZAD IMANI; ALIREZA JAFARKHANI; HOSSEIN HOSSEINEFARD

Volume 12, Issue 3 , July 2024, Pages 180-188

https://doi.org/10.30476/jamp.2024.101481.1932

Abstract

Introduction: Nowadays, Clinical courses are meticulously structured to give students essential opportunities to elevate their professional qualifications, so that the patients’ ... Read More Introduction: Nowadays, Clinical courses are meticulously structured to give students essential opportunities to elevate their professional qualifications, so that the patients’ safety is protected and their conditions improve. Given the many challenges in the clinical environment of the operating room, this study was conducted to compare the impact of team-based and task-based learning methods in the clinical settings on the perceived competence of surgery and the quality of training from the operating room nursing students’ point of view∙Methods: This quasi-experimental study was conducted on fifty 5th semester operating room technology students at Hamadan University of Medical Sciences in 2023. In this study, studentswere selected using the convenience sampling method and placed in two educational groups (team-based and task-based) of 25 subjects using the matching method. After implementing thetraining process in the operating room setting, the data related to the study were collected using the valid questionnaires of perceived competence in surgery (Cronbach’s alpha=0.86) andquality of education (Cronbach’s alpha=0.94). Also, the data analysis was conducted at the descriptive and inferential (included independent t-test and analysis of covariance) statistics level using SPSS version 16 software. Results: Findings showed that the mean clinical training quality score was significantly higher in the team-based learning group than in the other group (P=0.014). Also, after the medianintervention, the perceived competence score of surgery was higher in the task-based learning group than in the team-based group, and the difference in the average change of the competence score between the two groups was statistically significant (P<0.001).Conclusion: Based on the results, it is suggested that a task-based learning method should be used for the clinical instructors to increase level of the perceived competence of the surgery among operating roon nursing students.

Original Article

Design and Effect of Neurosurgical Educational Software Using Gamification on Students’ Learning and Motivation

SEDIGHEH HANNANI; MAHDIEH SALEHI; FARDIN AMIRI; NEMAM ALI AZADI

Volume 12, Issue 3 , July 2024, Pages 189-198

https://doi.org/10.30476/jamp.2024.101115.1917

Abstract

Introduction: Gamification is an innovative learning approach that, when combined with technology, aligns well with students’ preferences. Recognizing the necessity of employing ... Read More

Original Article

Investigating the Effect of Online Gamification on Electrocardiogram Interpretation and Self-Directed Learning in Nursing Students

HAMID TAGHINEJAD; MOSAYEB MOZAFARI; AMIRREZA BAZHDAN; ALIREZA VASIEE

Volume 12, Issue 3 , July 2024, Pages 199-207

https://doi.org/10.30476/jamp.2024.101396.1925

Abstract

Introduction: Knowing and interpreting the Electrocardiogram correctly and taking care based on it is one of the most important ways to save the patient’s life. Therefore, this ... Read More Introduction: Knowing and interpreting the Electrocardiogram correctly and taking care based on it is one of the most important ways to save the patient’s life. Therefore, this study aimed toinvestigate the effect of online gamification on the ability to interpret Electrocardiograms and Self-Directed Learning in nursing students.Methods: The present study was carried out quasi-experimentally on 44 nursing students (22 participants for each group) in the fifth semester in Ilam city in 2023 using a convenience sampling method by four permutations balanced block randomization to control and intervention groups. During four sessions in four weeks, the participants in the intervention group receivedElectrocardiogram interpretation as training on the Storyline platform and playing games in the Socrative software. The control group received the same content in the form of education from the same lecturer. ECG Interpretation Learning Test, Self-Directed Learning, Mini-Mental Status Examination, and demographic questionnaires were filled out before the intervention (pre-test).Then, Electrocardiogram Interpretation Learning Test and Self-Directed Learning questionnaires were completed two weeks after the end of the intervention (post-test), and the data were analyzed in the standard error of 0.05 using Shapiro-Wilk, independent t-test, paired t-test, chi-square, and multiple linear regression tests in SPSS V.16. Results: The mean and standard deviation of the participants’age was 21.35±1.02, and 59% of the samples were male. Before the intervention, no significant difference was observed between the two groups, but after the intervention, the mean and standard deviation of the ECG interpretation scores in the intervention group increased significantly (14.1±2.94) compared to the control group (8.8±1.36) (P=0.007). Also, Self-Directed Learning in the intervention group (168±10.42) compared to the control group (125±4.3) showed a statistically significant difference (P=0.003).Conclusion: Using online gamification as a new educational method in nursing students improves the ability to interpret Electrocardiograms and Self-Directed Learning. It is suggested that this method should be used to teach lessons that are more useful and important at the hospital.

Commentary

The Transformative Impact of Stealth Assessment on Medical Education

AMIN HABIBI; EHSAN TOOFANINEJAD; SEYED AHMAD RAHIMI; MASOMEH KALANTARION

Volume 12, Issue 3 , July 2024, Pages 208-210

https://doi.org/10.30476/jamp.2024.101479.1931

Abstract

This Letter explores the transformative impact of stealth assessment on medical education and its potential to enhance learning outcomes. Stealth assessment, an innovative approach, ... Read More

Letter to Editor

Expressing degrees of uncertainty in medical discourse: Hedging revisited

FARZANEH SHOMOOSSI; NASRIN SHOKRPOUR

Volume 12, Issue 3 , July 2024, Pages 211-213

https://doi.org/10.30476/jamp.2024.101282.1919

Abstract

Effectiveness of Gamification in Enhancing Learning and Attitudes: A Study of Statistics Education for Health School Students

MEHRNOOSH KHOSHNOODIFAR; ASIEH ASHOURI; MAHDOKHT TAHERI

Volume 11, Issue 4 , October 2023, , Pages 230-239

https://doi.org/10.30476/jamp.2023.98953.1817

Abstract

Introduction: Gamification is the use of game design elements in non-game contexts. It is considered a student-centeredinstructional design to motivate student learning and academic ... Read More Introduction: Gamification is the use of game design elements in non-game contexts. It is considered a student-centeredinstructional design to motivate student learning and academic behavior. In this study, the effects of gamification on learning statistics (hypothesis testing issue) and attitude toward statistics in comparison with the common e-learning approach were investigated. The students’ experience and critical elements of gamification on learning statistics were assessed, too.Methods: In a before and after trial, in a census manner, 64 health faculty students of Guilan University of Medical Sciences, Rasht, Iran, non-randomly were assigned to the intervention (n=42) and control (n=22) groups. Learning activities were gamified in the intervention group, while the control group received traditional problem-solving in the learning management system. Narrative, avatar, level, point, progress bar, scoreboard, challenge and feedback elements were used in the game experience. The implementation of gamification was applied based on Landers’ theory of gamified content. Valid and reliable Persian version of the Survey Attitude toward Statistics questionnaire measuredthe students’ attitude before and after the intervention. The EGameFlow questionnaire and a valid and reliable researchermade exam measured the users’ experience of gamified content and learning hypothesis testing after the intervention. The independent samples T-test, analysis of covariance and the partial eta-squared effect size were calculated by SPSS software, version 26.Results: Compared to the control group, the intervention group had a more positive attitude toward learning difficulty (moderate partial eta-squared 0.099), value and cognitive competency (weak partial eta-squared=0.01 and 0.05). Learning between the two groups was not different (P=0.522). There was a significant correlation between learning and the students’ perceived experience with feedback (r=0.583, P<0.001), concentration (r=0.509, P=0.005), and challenge (r=0.421, P=0.023) of the gamified content.Conclusion: It suggests using gamification on learning statistics while optimizing the design with more focus on the feedback, challenge and concentration elements.

Factors Influencing the Implementation of Interprofessional Collaborative Practice in Teaching Hospital Setting: A Mixed-Method Study

IRAWATY DJAHARUDDIN; IRWIN ARAS; RINA MASADAH; IRAWAN YUSUF; IRFAN IDRIS; HAERANI RASYID; BERTY NELWAN

Volume 11, Issue 4 , October 2023, , Pages 213-221

https://doi.org/10.30476/jamp.2023.98987.1821

Abstract

Introduction: Health service in the current global era requires health workers to provide qualified service, this also applies to teaching hospitals. Collaboration between several professions ... Read More Introduction: Health service in the current global era requires health workers to provide qualified service, this also applies to teaching hospitals. Collaboration between several professions involved (doctors, nurses, and pharmacists) in an interprofessional collaboration system is needed in providing such service. Factors influencing interprofessional collaboration is unique to each health care center. The purpose of this study was to determine the factors that influence the implementation of interprofessional collaborative practice among health workers in Dr. Wahidin Sudirohusodo General Hospital.Methods: This is a mixed-method explanatory sequential design study, utilizing quantitative and qualitative data. Quantitative data were obtained from the Indonesian-validated Collaborative Practice Assessment Tool (CPAT) questionnaire. CPAT in Indonesian language has been validated in previous research by Findyartini, et al. in 2019 in Indonesian population. The questionnaire was internally validated with the study population with Cronbach alpha of 0.812. All health care professionals meeting the selection criteria were enrolled for the quantitative study. Thequestionnaire was given to 152 health professionals enrolled as research subjects, including nutritionists, nurses, doctors, pharmacists, and medical rehabilitation specialists serving in Dr. Wahidin Sudirohusodo Hospital for >3 years. Five participants with highest and lowest CPAT score from each profession were invited for FGD entitled “Exploring factors involved in interprofessional collaboration in Wahidin Sudirohusodo General Hospital” and divided into 2 groups according to the CPAT score. The score from each subscale in the questionnaire is obtained for each research subjects and the median is compared among each profession group using Kruskall-Wallis test significant to a p-value of <0.05. Qualitative data as recording transcript is acquired from FGD; the transcript was then coded into several general themes by 2 of the authors and was discussed using thematic analysis using MaxQDA.Results: Research subjects were predominantly women (121 respondents (79.6%)), 32.9% were nurses, and most of the healthcare professional (81 subjects (55.1%)) have been working for >10 years. Among profession groups (Doctors, Pharmacists, Medical Rehabilitation Specialists, Nutritionists, and Nurses), difference in score distribution (P<0.05) wasfound in relationships among team members (40 vs 39 vs 39.5 vs 36 vs 42, P<0.001), barriers to team collaboration (10 vs 18.5 vs 14 vs 18 vs 10, P<0.001), and leadership (20 vs 20 vs 23 vs 20 vs 20, p 0.045). From the FGD, factors influencing interpersonal collaborative practice are leadership factors, system/rule factors, and personal factors.Conclusion: This research showed that personal, system/organizational and leadership factors influence the implementation of interprofessional collaboration. In this study, there is a different perception regarding relationships among team members, barriers to team collaboration, and leadership among profession group.

Prevalence of Persons with Disability Enrolled in Undergraduate Medical Schools in Brazil, 2019

MARIA NASCIMENTO; RHIAN TORRES; AMANDA HOROCHOVSKI; BRUNO BIRMANN; BRUNO TAKAHARA; LUIS SOUZA; KLYNSMAN RIBEIRO; BILLY MCBENEDICT

Volume 11, Issue 4 , October 2023, , Pages 205-212

https://doi.org/10.30476/jamp.2023.99332.1840

Abstract

Introduction: The affirmative policies in Brazil guarantee the provision of undergraduate medical education to People with Disability (PWD). The objective was to estimate the prevalence ... Read More Introduction: The affirmative policies in Brazil guarantee the provision of undergraduate medical education to People with Disability (PWD). The objective was to estimate the prevalence of PWD undergraduate medical students in Brazil in 2019.Methods: This is an exploratory, descriptive study that used census data from the total population of the undergraduatemedical students (N=183,646) who were enrolled at the Brazilian medical schools, in 2019. The data are secondary, unidentified and accessed online, and were originally collected by the Higher Education Census conducted by Anísio Teixeira National Institute of Educational Studies and Research (INEP), which used a questionnaire designed to capture information from students and medical courses. The descriptive analysis was based on absolute and relative frequencies.Results: The prevalence of medical students that were PWD was 0.80% (1,460/183,646), and this includes both Brazilian and foreign students. The latter includes people from 76 different countries. Foreign students who are PWD came from eight different countries: Bolivia, Burundi, Cabo Verde, Republic of Congo, Paraguay, Philippines, Singapore and Spain. Most of the PWD were male (51.37%), aged 20 to 24 years (46.78%) and of non-white ethnicity (52.26%). Most students were enrolled in public medical schools (73.97%). A fraction of PWD students (6.51%) was enrolled in medical schools with no specific resource or assistance for PWD. The highest prevalence was the physical disability (39.11%), followed by low vision accuracy (24.45%), intellectual (15.41%), low hearing (14.11%), blindness (3.97%), multiple disabilities (2.47%) and deafness (1.51%).Conclusions: The prevalence of PWD medical students in Brazil is low, and is dominated by students with physical and sensory disabilities but lacks the deaf-blind. Despite the existence of legal regulations favoring PWD to study medicine, some medical schools have not done adequate adjustments to accommodate them. This suggests that affirmative policies for the inclusion of PWD in higher education, particularly in medicine, still need improvement.

Teaching Professionalism during and Posta Pandemic to Surgical Trainees: A Survey of the Impact of a Workshop on Trainers and Trainees

NEIL ASHWOOD; EDWARD STANHOPE; IAN LAHART; ANDREW P DEKKER; JAMIE HIND; AMTUL CARMICHAEL

Volume 11, Issue 4 , October 2023, , Pages 193-204

https://doi.org/10.30476/jamp.2023.98395.1800

Abstract

Introduction: Focussed professionalism training improves surgical trainees’ communication, information gathering, and counselling skills. This study reviews the impact of a professionalism ... Read More Introduction: Focussed professionalism training improves surgical trainees’ communication, information gathering, and counselling skills. This study reviews the impact of a professionalism workshop for surgical trainees within a large trust in the United Kingdom developed during the pandemic to support the trainees and help them develop resilienceand appropriate behaviours during the time of increased pressure.Methods: A workshop involving case-based discussions and reflections on professionalism was developed from the themes and methods of training noted to be effective on a literature search of Medline, EMBASE, and PsycINFO databases carried out in May 2020. The impact of Covid on surgical trainees and educator’s professionalism training and the techniques of training preferred by trainees was evaluated by a survey of trainees and trainers after the intervention to evolve future training initiatives. During the workshop, a behavioural marker checklist was used to improve feedback on the observed behaviours.Results: 83 trainers and trainees were surveyed following a professional behaviour workshop training 63 surgeons at various stages of training. Surgical list availability had reduced by at least 5-10 a month for all the trainees within the trust during the pandemic. Most trainees surveyed (49 (60%)) felt that this had reduced the opportunities to train technical skills and develop professional non-technical skills like teamwork and communication skills, adversely impacting the trainee’s clinical performance. The increased support offered by the workshop helped 50 trainees (80%) to improve non-technical skill performance objectively by referencing to behavioural markers and this was felt to have become embedded in practice when surveyed 4 weeks later in 38 trainees (60%). The majority of those surveyed (47 (75%)) felt trainers and trainees had acted professionally during the pandemic and subsequently. The workshop discussions also helped (56 (67%)) trainers and trainees to consider how best to engage professionally with new ways of working as work, and training switched to virtual or telemedicine platforms during the pandemic.Conclusion: Professionalism-based education facilitates surgical trainee development, making them stronger team members and helping to restore team working skills and embrace new working practices.

The Effect of Mentoring Novice Clinical Educators on the Perception of Nursing Students from the Clinical Learning Environment

FATEMEH HESHMATI NABAVI; FATEMEH SHARIAT SAFA; MOHAMMAD RAJABPOUR

Volume 11, Issue 4 , October 2023, , Pages 252-261

https://doi.org/10.30476/jamp.2023.99480.1844

Abstract

Introduction: Creating a supportive clinical learning environment (CLE) is one of the characteristics of an effective clinical instructor in nursing. Perhaps empowering novice clinical ... Read More Introduction: Creating a supportive clinical learning environment (CLE) is one of the characteristics of an effective clinical instructor in nursing. Perhaps empowering novice clinical educators using mentorship method can reduce or resolve this problem. The aim of this study was to determine the impact of the mentorship program for novice clinical educators on the nursing students’ actual and preferred understanding of CLE.Methods: This quasi-experimental study on three groups was conducted as post-intervention with the participation of 139 undergraduate nursing students of Mashhad University of Medical Sciences. Sampling was done via stratified and multistage method. Students were placed in three groups: expert clinical educator (n=47), novice clinical educator (n=51), and mentorship (n=41). In the novice and expert clinical educator groups, training was conducted through the conventional method. In the mentorship group, a novice clinical educator (mentee) and an expert clinical educator (mentor) had a mentoring relationship for two weeks. The Chan (2001) CLE inventory was completed at the end of the first and second weeks of externship. Data were analyzed through SPSS v. 16 software using one-way ANOVAand paired t-tests.Results: The students of the three groups were homogeneous in terms of gender (P=0.101) and level of interest in the field (P=0.278). According to the result of the paired t-test, the difference in the mean score of the actual and preferred CLE at the end of the first week was statistically significant in the novice clinical educators (P=0.008) and the mentorship group (P=0.04); however, after the implementation of mentorship program (at the end of the second week), the difference was significant only in the novice educators group (P=0.001).Conclusion: The implementation of the mentorship program for novice clinical educators (as with the expert educators group) could lead to a reduction in the mismatch between the actual and preferred views of students about the CLE. Thus, it is recommended that this method should be used under conditions of shortage of expert educators to create a supportive CLE.