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๐Ÿง‘๐Ÿผโ€๐Ÿ’ป Research - December 1, 2024

Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial.

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โšก Quick Summary

A recent study demonstrated that Large Language Models (LLMs) can significantly enhance the clinical decision-making (CDM) skills of medical students through patient simulations and structured feedback. The feedback group outperformed the control group, achieving a mean CRI-HTI score of 3.60 compared to 3.02 after just four training sessions.

๐Ÿ” Key Details

  • ๐Ÿ‘ฉโ€โš•๏ธ Participants: 21 medical students (mean age 22.10 years)
  • ๐Ÿ“Š Methodology: Double-blind randomized controlled trial
  • ๐Ÿง  Technology: AI-generated patient simulations and feedback
  • ๐Ÿ“ˆ Evaluation Tool: Clinical Reasoning Indicator – History Taking Inventory (CRI-HTI)
  • ๐Ÿ” Analysis Method: ANOVA for repeated measures

๐Ÿ”‘ Key Takeaways

  • ๐Ÿ’ก AI feedback significantly improved CDM performance in medical students.
  • ๐Ÿ“ˆ Feedback group scored higher in creating context and securing information.
  • ๐Ÿ”ฌ Control group did not show significant improvement in focusing questions.
  • ๐Ÿ“… Training duration: Only four sessions were needed to observe improvements.
  • ๐Ÿ’ฐ Cost-effective training method that can supplement traditional approaches.
  • ๐ŸŒ Study published in BMC Medical Education.
  • ๐Ÿ†” PMID: 39609823.

๐Ÿ“š Background

Clinical decision-making (CDM) is a crucial skill for physicians, involving the ability to gather, evaluate, and interpret diagnostic information effectively. Traditionally, medical history conversations are practiced with real or simulated patients. The integration of AI technologies, particularly LLMs, presents an innovative approach to enhance this training, offering realistic simulations and structured feedback to improve learning outcomes.

๐Ÿ—’๏ธ Study

This study aimed to assess the effectiveness of LLMs in simulating patient interactions and providing feedback to medical students. Conducted with a sample of 21 medical students, the research utilized a double-blind randomized controlled trial design, comparing a control group that engaged in simulated conversations with an intervention group that received AI-generated feedback on their performance.

๐Ÿ“ˆ Results

The results indicated that the feedback group significantly outperformed the control group after just four training sessions, achieving a mean CRI-HTI score of 3.60 compared to 3.02. The statistical analysis revealed a significant effect (F (1,18) = 4.44, p = .049) with a strong effect size (partial ฮท2 = 0.198). Improvements were particularly noted in the subdomains of creating context (p = .046) and securing information (p = .018).

๐ŸŒ Impact and Implications

The findings from this study suggest that AI-simulated medical history conversations can serve as a valuable tool in CDM training for medical students. By incorporating structured feedback, this training method not only enhances learning but also prepares students more effectively for real-world patient interactions. This approach could lead to improved patient care and outcomes, making it a promising addition to medical education.

๐Ÿ”ฎ Conclusion

This study highlights the transformative potential of AI technologies in medical education, particularly in enhancing clinical decision-making skills. The use of LLMs for patient simulations, combined with structured feedback, offers a novel and effective training method. As we continue to explore the integration of AI in healthcare, further research is encouraged to optimize these educational tools for future medical professionals.

๐Ÿ’ฌ Your comments

What are your thoughts on the use of AI in medical education? Do you believe it can significantly enhance the training of future healthcare professionals? ๐Ÿ’ฌ Share your insights in the comments below or connect with us on social media:

Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial.

Abstract

BACKGROUND: Clinical decision-making (CDM) refers to physicians’ ability to gather, evaluate, and interpret relevant diagnostic information. An integral component of CDM is the medical history conversation, traditionally practiced on real or simulated patients. In this study, we explored the potential of using Large Language Models (LLM) to simulate patient-doctor interactions and provide structured feedback.
METHODS: We developed AI prompts to simulate patients with different symptoms, engaging in realistic medical history conversations. In our double-blind randomized design, the control group participated in simulated medical history conversations with AI patients (control group), while the intervention group, in addition to simulated conversations, also received AI-generated feedback on their performances (feedback group). We examined the influence of feedback based on their CDM performance, which was evaluated by two raters (ICCโ€‰=โ€‰0.924) using the Clinical Reasoning Indicator – History Taking Inventory (CRI-HTI). The data was analyzed using an ANOVA for repeated measures.
RESULTS: Our final sample included 21 medical students (agemean = 22.10 years, semestermean = 4, 14 females). At baseline, the feedback group (meanโ€‰=โ€‰3.28โ€‰ยฑโ€‰0.09 [standard deviation]) and the control group (3.21โ€‰ยฑโ€‰0.08) achieved similar CRI-HTI scores, indicating successful randomization. After only four training sessions, the feedback group (3.60โ€‰ยฑโ€‰0.13) outperformed the control group (3.02โ€‰ยฑโ€‰0.12), F (1,18)โ€‰=โ€‰4.44, pโ€‰=โ€‰.049 with a strong effect size, partial ฮท2โ€‰=โ€‰0.198. Specifically, the feedback group showed improvements in the subdomains of CDM of creating context (pโ€‰=โ€‰.046) and securing information (pโ€‰=โ€‰.018), while their ability to focus questions did not improve significantly (pโ€‰=โ€‰.265).
CONCLUSION: The results suggest that AI-simulated medical history conversations can support CDM training, especially when combined with structured feedback. Such training format may serve as a cost-effective supplement to existing training methods, better preparing students for real medical history conversations.

Author: [‘Brรผgge E’, ‘Ricchizzi S’, ‘Arenbeck M’, ‘Keller MN’, ‘Schur L’, ‘Stummer W’, ‘Holling M’, ‘Lu MH’, ‘Darici D’]

Journal: BMC Med Educ

Citation: Brรผgge E, et al. Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial. Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial. 2024; 24:1391. doi: 10.1186/s12909-024-06399-7

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