Journal of Advances in Medical Education & Professionalism

Abstract Introduction: ChatGPT serves as a double-edged sword in education, offering either constructive information or potential challenges. Its impact ranges from being a transformative tool to a disruptive force, making it difficult to evaluate its educational efficacy comprehensively. In light of this complexity, the primary aim of this research was to investigate the opportunities and challenges associated with the integration of ChatGPT into the domain of medical education.
Methods: The study utilized the Interaction Equivalency Theorem as its conceptual framework to guide the investigation. To achieve the research objectives, a meta-synthesis of the literature was
conducted to systematically integrate the findings of selected studies. Data collection involved comprehensive searches across specialized academic databases, including Science Direct, Springer, ERIC, Emerald, SAGE, Wiley Online Library, PubMed, and Google Scholar, focusing on publications from 2022 to 2024. 88 articles were meticulously selected based on their relevance
to the research topic. The data were then subjected to thematic analysis, facilitating the extraction of key insights and patterns to address the study objectives.
Results: The findings were organized into four primary subthemes highlighting the opportunities presented by ChatGPT in medical education. These sub-themes encompassed benefits for educators, learners, curriculum development, and the learning process. Similarly, the challenges related to the integration of ChatGPT were categorized into four primary sub-themes: addressing the difficulties experienced by educators, learners, curriculum development, and the learning process. Together, these challenges were further delineated into 11 secondary sub-themes,
offering a comprehensive analysis of the complexities involved.
Conclusion: The findings suggest that improving educational efficiency, assisting with self-development, enhancing communication skills, creating and expanding curriculum, and improving the learning environment are opportunities for utilizing ChatGPT. The study outcomes also reveal that lack of technological knowledge, negative attitudes, reduction in education quality, diminishing students’ capabilities, reducing learning quality, flaws in learning development, difficulties in designing educational content, and bias in learning evaluation are challenges of applying ChatGPT in medical education.

Abstract Introduction: Using Intelligent Assessment Systems (IAS) in medical education has garnered attention as an advanced tool for enhancing educational processes and student evaluation. These systems leverage advanced algorithms to rapidly assess the students’ performance and learning progress. This systematic review aimed to examine the role and impact of Intelligent Assessment Systems in improving educational processes, academic evaluation, and learning progress in medical students compared to traditional assessment methods.
Methods: This study was conducted using the PRISMA framework for reporting systematic review articles. Databases such as Embase, PubMed, ProQuest, Web of Science, and Scopus up to March 2024 were reviewed using relevant keywords. Eligible articles were selected and evaluated based on predefined inclusion and exclusion criteria.
Results: Out of 2741 articles identified, 10 studies were selected for final analysis. This systematic review analyzed 10 studies, demonstrating that interactive assessment systems (IAS) can enhance learning outcomes by up to 40% in certain settings. The findings emphasized the benefits of immediate feedback and reduced instructor workload. The significant role of IAS in enhancing student performance, providing immediate feedback and reducing the workload of instructors was indicated. These systems, through the use of machine learning algorithms and virtual reality simulators, enable more accurate and comprehensive assessment of students’ clinical and cognitive skills.
Conclusion: Intelligent Assessment Systems (IAS) significantly improve educational processes and academic evaluation by providing immediate and precise feedback, enhancing student self-efficacy and self-awareness and reducing the training time and costs. The successful implementation of IAS requires careful system design, user training, and continuous technical support. Further studies are recommended to explore the advantages and challenges of these systems and to optimize their implementation in medical education. The long-term impacts of IAS and scalability across educational contexts require further studies. In conclusion, IAS offers transformative potential in medical education globally, provided that challenges are addressed.

Abstract Introduction: This study addresses this gap by assessing the relationship of VR simulation with improving clinical decisionmaking, confidence, and anxiety reduction among nursing students. The aim of this study is the relationship between virtual reality simulation and their clinical decision-making, confidence, and anxiety reduction using a cross-sectional study from the perspectives of nursing students.
Methods: This cross-sectional study surveyed 200 nursing students enrolled in clinical courses utilizing virtual reality (VR) simulation for educational purposes. A structured questionnaire
was used to assess their clinical decision-making, confidence, and anxiety reduction following the VR simulation course. The survey included scales validated through a panel of experts and
questionnaire validation methodologies, using a 5-point Likert scale. Descriptive statistics were used to summarize the data, and inferential statistical tests, including Pearson’s correlation and independent-sample t-tests, were conducted to examine the associations. Multiple linear regression analysis was performed to assess the predictive value of confidence and anxiety on clinical decision-making while controlling demographic variables.
Results: A total of 200 nursing students participated in the study. The mean (SD) clinical decision-making score was 3.16 (1.23) out of 5, while confidence and anxiety reduction scores were 2.64 (1.34) and 2.49 (1.32), respectively. No significant correlation was found between decision-making and confidence (r=-0.079, p=0.264) or anxiety scores (r=0.121, p=0.088), but confidence and anxiety scores showed a weak direct correlation (r=0.180, p=0.011). Multiple linear regression analysis revealed that confidence and anxiety were not significant predictors of decision-making, but gender was a significant predictor, with males scoring higher (β=0.19, p=0.041).
Conclusions: While VR directly influences decision-making, it has a limited association with changes in nursing students’ confidence and anxiety levels. These findings suggest that VR
simulation alone may not be sufficient for enhancing confidence and reducing anxiety and should be integrated with other instructional strategies to maximize its effectiveness in nursing education. Future studies should explore complementary training methods to improve clinical preparedness.

Abstract Introduction: Medical students’ performance is influenced by metacognitive awareness and regulation, alongside selfdetermination or motivation. Understanding these elements is crucial for creating a curriculum that enhances learning outcomes and academic achievement. This study aimed to assess metacognitive awareness and academic motivation among medical undergraduate (UG) students and to determine the association between metacognitive awareness, academic motivation, and academic performance.
Methods: A cross-sectional study was carried out at a medical college on 140 medical undergraduate (UG) students. The data were collected using self-administered questionnaires using Metacognition Awareness Inventory (MAI) and Academic Motivation Scale (AMS). The scores obtained were compared with their academic performance. The data were analyzed using IBM SPSS 20.0. The chi-square test, Mann–Whitney U test, Kruskal–Wallis test, and post-hoc Dunn’s test were used for statistical analysis.
Results: The participants included 54.3% males and 45.7% females (age 20.4±0.9 years). High performers scored significantly higher on total (43.14±8.2) and domain-wise MAI scores compared to average and low performers. Female students scored better in all metacognitive domains (40.4±8.0) and had higher motivation scores than males (42.9±10.35). Academic performance was significantly correlated with metacognition regulation subscale scores (r=0.293, p=0.001) and intrinsic motivation scores (r=0.284, p=0.002). Also, metacognition regulation was significantly correlated with intrinsic motivation scores (r=0.376, p=0.00001) as well as extrinsic motivation scores (r=0.223, p=0.01). Intrinsic motivation scores correlated significantly with academic performance, metacognition knowledge subscale scores (r=0.406, p=0.00001), regulation scores,
and extrinsic motivation scores (r=0.695, p=0.00001).
Conclusions: High performers demonstrate superior metacognitive awareness and intrinsic motivation, especially females. Significant correlations between metacognition, motivation, and academic performance stress the importance of integrating metacognitive regulation strategies into teaching methods to improve the outcomes and motivation.

Abstract Introduction: Effective medical history-taking is a cornerstone of clinical practice, yet medical students often struggle due to inadequate structured training and feedback. Standardized patients (SPs) play a crucial role in early clinical exposure (ECE) by providing controlled, realistic patient interactions. However, optimizing SP effectiveness requires a systematic assessment of their competencies.
Methods: This study employed a cross-sectional survey design to identify competency gaps in SPs and key areas for improvement to enhance their role in medical training during ECE. A stratified random sampling method was used to recruit 315 medical students from both preclinical (Years 1–3) and clinical (Years 4–6) cohorts at the Faculty of Medicine, Siriraj Hospital, Mahidol University. Data were collected using a structured questionnaire comprising 36 items across three competency domains: ability, suitability, and credibility. Each item utilized a dualresponse 5-point Likert scale to assess both current SP performance and expected competency levels. The instrument demonstrated high content validity, as assessed by three experts (IOC=0.67–1.00), and excellent internal consistency (Cronbach’s alpha=0.976). Data analysis included descriptive statistics to summarize the responses and calculate the Modified Priority Needs Index (PNImodified) to prioritize competency gaps. All analyses were performed using SPSS Statistics Version 30.0.
Results: Preclinical students identified realistic role portrayal (PNImodified=0.445), adherence to structured guidelines (PNImodified=0.395), and accurate past medical history portrayal
(PNImodified=0.371) as the most critical competency gaps. Clinical students emphasized SPs’ ability to observe non-verbal cues (PNImodified=0.143), provide structured feedback (PNImodified=0.141), and give appropriate feedback to the students (PNImodified=0.126). Across both groups, the three most significant competency gaps were structured feedback on history-taking (PNImodified=0.186), realistic role portrayal (PNImodified=0.181), and appropriate feedback delivery (PNImodified=0.180).
Conclusion: Addressing these competency gaps through structured standardized patient (SP) training programs will enhance the effectiveness of medical history-taking education in early clinical exposure (ECE). Future research should prioritize the development of competency-based SP training frameworks and structured feedback models that support both learning outcomes and clinical preparedness. These findings underscore the need for targeted training strategies which aim at strengthening SP competencies, particularly in realistic role portrayal and high-quality feedback delivery, which are essential for improving student engagement, clinical reasoning, and overall performance in simulated patient encounters.

Abstract Introduction: Entering College is an important transition from adolescence to young adulthood, with significant changes in habits and learning methods. These changes can cause social anxiety, especially in competitive fields of study such as medical education. Similar results were found in interviews with first-year medical students at Hasanuddin University, who faced the pressure of adaptation and learning materials. Therefore, social problem-solving skills are needed so that students do not experience social anxiety. Social problem-solving skills are one form of coping that can help adolescents adapt to a new environment. Social problem-solving skills, as one form of coping strategy, are very important for students in dealing with various daily problems and have the potential to cause stress (daily life stressors of problems), especially in the first year of college. This study aimed to examine the magnitude of the influence of social problem-solving skills training on reducing social anxiety in first-year students at Hasanuddin University, Faculty
of Medicine.
Methods: This study used a quasi-experimental method with a Pretest-Posttest Control Group Design. The respondents in this study were 250 first-year students at the Faculty of Medicine, Hasanuddin University, Makassar. The sample selection in this study was carried out using a
purposive sampling method; the experimental and control groups were selected and then categorized into experimental and control groups with low and medium scores on social problem solving skills and high and medium scores on social anxiety as one of the subject criteria. The
instrument used in the research was the social anxiety scale developed by Liebowitz. The statistical test was an independent sample t-test using IBM Statistics SPSS 26 edition.
Results: The results indicated that training in social problem-solving skills influenced the reduction of social anxiety in first-year medical students. The higher the student’s social problem-solving skills, the lower the level of social anxiety, with a mean value for the experimental group pretest of 55.4 and posttest of 46.92. However, for the control group, the mean values of pretest and posttest were 34.0 and 36.6, respectively. The SD values of the experimental group pretest and
posttest were 14.84 and 14.69, while for the control group; the SD values of pretest and posttest were 17.2 and 17.9, respectively. While the lower the student’s social problem-solving skills, the higher the level of social anxiety, with a p-value (sig. (2-tailed) of 0.001 or p<0.001).
Conclusion: Social problem-solving skill training gives a significant impact in reducing anxiety in first-year medical students.

Abstract Introduction: Nursing teachers influence their students’ views and values, creating Compassionate Competence (CC) and Clinical Belonging Sence (CBS). Their work extends beyond technical abilities, as they foster empathy and community in order to provide good patient care. The purpose of this study was to examine the link between CC and CBS and Nursing Clinical Teacher Effectiveness (NCTE).
Methods: This cross-sectional correlation study was conducted on 237 nursing students (response rate of 94.5%) selected using census sampling; the Belongingness Scale-Clinical Placement
Experience (BES-CPE), Compassionate Competence Scale, and Nursing Clinical Teacher Effectiveness Inventory were used to collect the data. The data were analyzed using descriptive
statistics, the Chi-square test, the Pearson correlation test, and the linear regression test in SPSS (ver.16).
Results: Both discovered factors account for 21.4% of CC, with a positive connection with NCTE (r=0.392, P=0.001) and CBS (r=0.564, P=0.001). CBS and CC also showed a strong positive connection (r=0.424, P=0.001). NCTE can explain why CBS (31.42%) is nearly twice as high as CC (16.06%) among nursing students. NCTE teaching skill was positively connected with selfesteem
(r=0.544, P=0.001), CBS efficiency (r=0.528, P=0.001), continuity (r=0.367, P=0.001), and CC insight (r=0.374, P=0.001). Interpersonal communication and personality qualities in NCTE had a moderate connection with efficiency (r=0.491, P=0.001) and self-esteem (r=0.468, P=0.001) in CBS. Furthermore, female students received considerably higher NCTE scores than male students (P=0.012).
Conclusions: Continuous training for clinical faculty is essential for mentoring nursing students, improving their skills and attitudes toward quality patient care and instilling a sense of belonging and compassion.

Abstract Introduction: The COVID-19 pandemic has significantly transformed the educational landscape in Iraq, necessitating a rapid shift from traditional classroom settings to virtual education. This study aimed to examine the experiences of Arabic virtual education teachers in Iraq, with a focus on the challenges they faced and the implications of adopting online teaching methodologies.
Methods: A mixed-methods approach was applied, incorporating a qualitative-quantitative approach for tool development. The qualitative section dealt with content analysis, while the quantitative section followed a descriptive survey method. The study was performed in 2023. The qualitative sampling was purposeful, involving 15 experts in virtual education from Iraq, whereas the quantitative samples consisted of 368 teachers from 20 schools in Baghdad, Iraq, selected via cluster sampling. The qualitative tool was a semi-structured interview, whereas the quantitative tool was a researcher-made questionnaire consisting of 10 components and 66 items. For data analysis, exploratory factor analysis was carried out. The data were analyzed using SPSS 22 software.
Results: A total of 15 educational experts contributed to the qualitative analysis, while the opinions of 398 teachers were inspected through exploratory factor analysis for content analysis. The sample’s adequacy and the test’s suitability were validated using two indicators: Kaiser-Meyer-Olkin (KMO=0.684) and Bartlett’s Test of Sphericity, both being significant at >0.001. The
quantitative findings presented the extraction of 10 factors, which accounted for 85.823% of the total variance at the eigenvalue point. These factors included Utility (9 items), Implications (8 items), Flexibility and Adaptability (7 items), Equity (7 items), Balanced Infrastructure Development (7 items), Evaluation and Motivation Mechanisms (6 items), Management and Policy Making (8 items), Awareness and Empowerment (6 items), Educational Planning (4 items), and Technology Enhanced Learning (3 items).
Conclusion: The findings highlight the complex challenges encountered by Iraqi educators in virtual learning environments, underscoring the significance of addressing infrastructural gaps,
providing adequate training, and fostering equitable access to technology. By focusing on these domains, educational stakeholders can boost the effectiveness of online education in Iraq, ultimately improving educational outcomes for all students.

Abstract Introduction: Medical education is shifting from traditional didactic lectures to student-centered interacting learning methodologies. Experiential learning, through the usage of multimedia tools, has proven effective in enhancing engagement and learning outcomes. Kolb’s experiential learning theory was applied. The study explored the use of student-created videos as an experiential learning tool in first-year MBBS Physiology course. The aim of the study was to evaluate the experiential learning experience of the medical undergraduate students through their feedback.
Methods: The educational interventional study was conducted at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, from October 2021 to May 2022. All students of 2022 batch, that is, 150 first year MBBS students were divided into 30 small groups with 5 members in each group. Under the guidance of faculty members, the groups created short videos on the assigned physiological concepts, which were uploaded in Learning Management System (LMS)
for peer and faculty review. A 15-day period was given for video preparation. A pre-designed 10 questions, Likert scale questionnaire, based on Kirkpatrick’s Model (Level 1), was used to collect data about the students’ learning experience. Open-ended questions were also administered. The questionnaire was validated by experts, with a Cronbach’s alpha of 0.98, ensuring its reliability. Quantitative data were analyzed using OpenEpi version 7.0, measuring the consensus score, and manual content analysis was performed on open-ended responses.
Results: From 150 students, 30 videos were successfully submitted. The mean age of the participants was 18.23±0.87 years. Based on the consensus score for the feedback obtained by 138 students, it is reported that 84.22% of students felt more confident in their understanding of the physiological concepts they worked on, and 81.97% gave feedback that the video-making process allowed them to explore their topic deeply. The feedback highlighted the development of essential skills, including critical thinking, communication, and teamwork, with 79.82% recommending this method for future batches. Challenges included are the time-consuming
nature of the task and a lack of technical knowledge about video editing software. The consensus analysis indicated strong agreement, reflecting positive reception. This study aligns with Kolb’s experiential learning theory, as students were engaged in all stages of the learning cycle—concrete experience (video creation), reflective observation (peer and faculty feedback), abstract conceptualization (topic research and content structuring), and active experimentation (video sharing and refinement).
Conclusion: Student-created videos proved to be successful experiential learning strategy, enhancing both cognitive and practical skills. The activity promoted deeper engagement, critical thinking and facilitated deeper learning of the concepts. Despite few challenges, the method shows promise for wider adoption in medical curricula, supporting the ongoing transition to more interactive and student-centered learning approaches.

Abstract The medical education scenery is continually changing, calling for innovative ways to support learning processes and outcomes. This letter is devoted to introducing the potential of social network analysis (SNA) as an efficient educational innovation to support medical education. Through the investigation of the connections and interactions within a network, SNA brings to light complex social dynamics that can scaffold learning processes and outcomes in medical education. In this letter, we explain the role of SNA in fostering collaboration, engagement, knowledge sharing, and professionalized education among medical students and educators. We also talk about the role of node analysis (individuals) and edge analysis (relationships) to determine influential structures, knowledge brokers, and blocks in collaboration. We discuss that personalized insights gained from SNA can guide educators to provide timely and tailored interventions. In addition, SNA can reveal hidden curricula and informal networks of learning, and evaluate teamwork and communication skills efficiently. The letter also outlines how SNA can be used to deal with students’ loneliness in social learning settings and professional fatigue through the early establishment of supportive networks and peer mentoring occasions. Backed up with evidence from the relevant research, this letter accentuates the positive impact of SNA on medical education by capitalizing on the formation of interpersonal relationships and collaboration. We conclude that by gaining a deep insight into the social connection dynamics, educators can support the knowledge exchange and support the learning processes and outcomes of medical students and future health professionals.