Medicine Education Research Articles

The Intersection of ChatGPT, Clinical Medicine, and Medical Education.

As we progress deeper into the digital age, the robust development and application of advanced artificial intelligence (AI) technology, specifically generative language models like ChatGPT (OpenAI), have potential implications in all sectors including medicine. This viewpoint article aims to present the authors' perspective on the integration of AI models such as ChatGPT in clinical medicine and medical education. The unprecedented capacity of ChatGPT to generate human-like responses, refined through Reinforcement Learning with Human Feedback, could significantly reshape the pedagogical methodologies within medical education. Through a comprehensive review and the authors' personal experiences, this viewpoint article elucidates the pros, cons, and ethical considerations of using ChatGPT within clinical medicine and notably, its implications for medical education. This exploration is crucial in a transformative era where AI could potentially augment human capability in the process of knowledge creation and dissemination, potentially revolutionizing medical education and clinical practice. The importance of maintaining academic integrity and professional standards is highlighted. The relevance of establishing clear guidelines for the responsible and ethical use of AI technologies in clinical medicine and medical education is also emphasized.

Medicine education in a pediatric oncology setting: What can we do better?

BackgroundWhen patients feel more involved in their care, there tends to be a higher rate of adherence and improved health outcomes. This can be more difficult to achieve in pediatric care since children have varying levels of medicine comprehension and parents are an integral component of the child's learning. ObjectivesThis study aimed to determine the satisfaction of children and families being treated for cancer with their medicine education and determine areas for improvement. MethodsSemi-structured interviews were conducted over six months (2016/2017) with families and children with cancer, ages 7 to 19 years, (n = 6) and healthcare providers (n = 9) to assess the current method of medicine education delivery. ResultsFamilies reported increased stress and anxiety levels at the time of diagnosis, negatively impacting their information retention. Patients, families, and healthcare providers reported inconsistent education delivery, including varying amounts of information throughout the treatment and inconsistencies between providers, such as medication names. Parents mentioned a desire for a more consistent and standardized delivery of medicine education, which was found to be helped by a pharmacist-led approach. Receiving supplemental written materials to support verbal education helped with learners' understanding and information retention. Ensuring that the parents are comfortable and familiar with the medicines is a significant component of medicine teaching in pediatric care because they are often responsible for the child's medications and their children see them as a trusted source of information. Ensuring parents' needs are met translates to improved medicine adherence for children with cancer. ConclusionMedicine education should occur sometime post-diagnosis once the patient/family has had time to adjust and the anxiety lessens. Medicine education should be given as consistently as possible by a recurring member of the care team, ideally the pharmacist. The learners' ability to understand and retain information should be individually assessed to determine the delivery of medicine education. Motivating and empowering learners, including children, through frequent medicine encounters could help improve adherence, patient health outcomes, and quality of life and make them more self-managing throughout life.

Perceptions of Nigerian medical students regarding their preparedness for precision medicine: a cross-sectional survey in Lagos, Nigeria

BackgroundAdvances in precision medicine in Nigeria suggest improving genomics education and competency among healthcare practitioners to facilitate clinical translation. Due to the scarcity of research in this area, this study aimed to assess Nigerian medical students’ perceptions about their preparedness to integrate precision medicine into their future clinical practice.MethodsThis was an institution-based cross-sectional study of medicine and surgery students in their clinical years attending the two fully accredited colleges of medicine in Lagos, Nigeria, between April and October 2022 using an adapted tool administered via Google Forms. The survey assessed their awareness, perceptions about knowledge, ability, and attitudes toward precision medicine, ethical concerns, and perceptions about their education in precision medicine. Multivariate linear regression models were used to assess factors associated with students’ perceptions of their knowledge, ability, and attitudes.ResultsA total of 300 students completed the questionnaires with a response rate of 40%. Awareness of genomic medicine terminology was high (92.0%). Responses to knowledge and ability questions revealed notable gaps, however, respondents had positive attitude scores overall. Higher medical school year was independently associated with lower knowledge (ptrend = 0.003) and ability (ptrend = 0.005) scores, and knowledge score was independently associated with a higher ability score (β: 0.76 95%CI: 0.67, 0.84; p < 0.001). Attitude scores significantly increased with increasing medical school year (ptrend = 0.04). The respondents mostly indicated concerns about government and corporate bodies’ misuse of genomic data (35.7%) and the widening of socioeconomic disparities (34.0%). Although 65.0% of the respondents thought it important to learn about precision medicine, only 11.3% felt that their education had adequately prepared them for precision medicine, knew who to ask questions regarding genomic testing (10.7%), and felt their professors had encouraged the use of precision medicine (10.3%).ConclusionDespite high awareness of precision medicine terminology and overall positive attitudes, our findings highlight gaps in knowledge and ability to integrate genomics into the care of patients and a need to improve precision medicine education among Nigerian medical students.

Evaluation of Medical Education: A Comprehensive Approach with the VIKOR Method

A successful lesson introduction requires establishing a connection with the audience, encouraging participation, and conveying key concepts to facilitate learning. Teaching is the application of knowledge, skills, and qualities to provide specialized education to meet both societal and individual needs. The ultimate goal of education is to empower students to become lifelong learners who can prepare for the future, express their thoughts, and learn new skills, knowledge, and moral principles. While learning can be a self-driven process, formal education can make it more accessible. Improving one's writing skills can expedite the learning process. Maintaining student engagement depends on a positive attitude towards teaching and a passion for the subject, which can inspire students. It's important to recognize that individuals have different learning styles. Clinical research empowers healthcare professionals to make optimal patient care choices. It serves as the foundation for developing innovative therapies, protocols, and medical tools. The evaluation of new medications against current ones through clinical trials is crucial for assessing their superiority. Similarly, educational research equips educators and leaders with the evidence needed to enhance teaching and learning methods more strategically and efficiently. The VIKOR method emerged as a multi-attribute decision-making approach designed to address discrete decision problems characterized by non-commensurable criteria and conflicting priorities. It was introduced as a valuable tool for tackling Multi-Criteria Decision Making (MCDM) challenges. This method encompasses the process of ranking and selecting sample sets with conflicting criteria to facilitate decision-making among available alternatives. VIKOR stands out as a multi-criteria decision-making technique that centers on choosing the optimal solution based on its proximity to the ideal outcome. Alternative taken as Teaching and learning in medicine. Evaluation preference taken as Effectiveness, Engagement, Clinical Skills, Communication. From the result Teaching and Learning 4 got the first rank whereas is the Teaching and Learning 5 having the Lowest rank.

Diabetes Mellitus across the Arabo-Islamic World: A Revolution.

Mankind continues to suffer from the ever-growing diabetes epidemic and the rapid rise of type 2 diabetes mellitus (T2DM). This metabolic disease has been studied since ancient civilizations. The Arabo-Islamic civilization excelled in establishing some of the most notable discoveries and teachings that remained the blueprint for years to come in the field of diabetology. This article aimed to review the ancient history of diabetes mellitus, with its main focus on the Arabo-Islamic civilization, and to report our subjective views and analysis of some of the past recommendations based on modern-day findings. Discussion. It is natural to have the teachings of medicine dynamically inspired by one civilization to another, as various fields continue to expand and evolve. This also applies to diabetology as the Arabo-Islamic world used the outlines of prior civilizations to revolutionize the understanding of the disease. Al-Razi and Ibn Sina are probably two of the most renowned polymaths in history, and their contributions to diabetology are well documented. Ibn Maymun's postulation about the higher prevalence of diabetes in Egypt as compared to Andalusia is something to be carefully studied. It could be that diabetes mellitus' underdiagnosis and late-stage detection are some of the major reasons for the disparity between the two mentioned regions. Modern-day Arabo-Islamic scholars continue to excel in revolutionizing diabetology. The Arabo-Islamic world houses an impressive bout of scholars who have contributed since the ancient times to diabetology. This scientific locomotion shows no signs of stopping, as it continues to shine during the present day, and likely in the future.

Continuing medical education in China: evidence from primary health workers’ preferences for continuing traditional Chinese medicine education

BackgroundContinuing Medical Education (CME) is an important part of the training process for health workers worldwide. In China, training in Traditional Chinese Medicine (TCM) not only improves the expertise of medical workers, but also supports the Chinese Government’s policy of promoting TCM as an equal treatment to western medicine. CME, including learning Traditional Chinese Medicine Technologies (TCMTs), perform poorly and research into the motivation of health workers to engage in CME is urgently required. Using a discrete choice experiment, this study assessed the CME learning preferences of primary health workers, using TCMT as a case study of CME programs.MethodsWe conducted a discrete choice experiment among health workers in Shandong Province, Guizhou Province, and Henan provinces from July 1, 2021 to October 1, 2022 on the TCMT learning preferences of primary health workers. The mixed logit model and latent class analysis model were used to analyze primary health workers’ TCMT learning preferences.ResultsA total of 1,063 respondents participated in this study, of which 1,001 (94.2%) passed the consistency test and formed the final sample. Our key finding was that there were three distinct classes of TCMT learners. Overall, the relative importance of the seven attributes impacting the learning of TCMTs were: learning expenses, expected TCMT efficacy, TCMT learning difficulty, TCMT mode of learning, TCMT type, time required to learn, and expected frequency of TCMT use. However, these attributes differed significantly across the three distinct classes of TCMT learners. Infrequent users (class 1) were concerned with learning expenses and learning difficulty; workaholics (class 2) focused on the mode of learning; and pragmatists (class 3) paid more attention to the expected TCMT efficacy and the expected frequency of TCMT use. We recommend targeted strategies to motivate TCMT learning suited to the requirements of each class of TCMT learners.ConclusionRather than a single TCMT medical education program for primary health workers, CME programs should be targeted at different classes of TCMT learners.

Impact of COVID-19 on American Family Physicians' Intent to Retreat from Clinical Care.

This survey evaluated whether the COVID-19 pandemic was a traumatic stress event for family physicians associated with burnout, changes in life priorities, and intentions to retreat from clinical practice. We report on 683 clinically active family physicians surveyed through the Council of Academic Family Medicine's Educational Research Alliance (CERA) in the fall of 2021. Overall, 35.2% of family physicians experienced the pandemic as a traumatic stress like event. This was associated with changing life priorities (OR 2.6, CI 1.8-3.9), burnout (OR 1.6, CI 1.1 to 2.4), and withdrawal from clinical practice in various ways. Those who changed their priorities in life were more likely to restrict scope of practice (OR 3.9, CI 2.6-5.9), reduce clinical work effort (OR 3.4, 2.3 to 5.1), relocate (OR 3.1, CI 2.0 to 4.8), retire (OR 2.7, CI 1.4-4.9), reroute their career away from patient care (OR 2.1, CI 1.4-3.1) and less likely to avoid redesigning the practice to improve well-being (OR 0.3, CI 0.2-0.7). Those who experienced burnout were more likely to retire (OR 5.5, CI 2.8 to 10.5), reduce clinical work effort (OR 4.2, CI 2.9-6.1), reroute their career away from patient care (OR 3.9, CI 2.6-5.8), relocate (OR 3.8, CI 2.4 to 5.9), and restrict scope of practice (OR 3.3, CI 2.3 to 4.9). Overall, 48.5% of family physicians expressed some intention to retreat from clinical practice. The COVID-19 pandemic impacted family physician's career plans. Remedying burnout is a high-yield opportunity for retaining clinically active family physicians. Physicians retreating from clinical medicine related to changing life's priorities needs further exploration.

Advancing equity in cancer care through community-academic partnerships: Results from the addressing Latinx cancer care equity—Program for long-term united skills building (ALCANCE-PLUS).

77 Background: Addressing Latinx CANcer Care Equity - Program for Long-term United Skills Building (ALCANCE-PLUS) is an ongoing community-academic partnership between the Stanford University School of Medicine Partnerships to Advance Care and Pacific Cancer Care (PCC). The partnership began in 2019 and is comprised of several community-identified multi-level interventions to improve cancer health equity in an undeserved, rural migrant farm-working community. The intervention components are delivered by trained community health workers to low-income and racial and ethnic minoritized patients receiving active cancer treatment and include: 1) precision medicine education using literacy- and language-concordant educational tools; 2) food insecurity screening and intervention with plans to cross-train &gt;150 CHW's across the county to expand cancer screening and care delivery in the county. Here, we describe the characteristics of participants and the program's impact to date on metrics identified by the community. Methods: ALCANCE-PLUS eligibility includes: all patients with cancer actively receiving cancer-directed treatment at PCC who are ≥ 18 years old and speak English or Spanish. Community identified metrics of success include: % treatment adherence (completion), no-show rate, days from diagnosis to treatment, and % who received clinical trials education as compared to baseline (prior to program start). We used descriptive statistics and chi-squared tests to compare metrics of participants in the program to baseline. Results: At baseline, 62% of low-income and racial and ethnic minoritized patients in the county completed treatment, 35% had no-shows to clinic or infusion appointments with an average of 82.7 days from diagnosis to treatment and only 15% received clinical trial education. As of program start in July 2022, a total of 143 patients participated in the program. Mean ages were 58.6 ± 14.53, 77 (57%) identified as male, 91 (63%) as Hispanic or Latino, 1 (0.7%) African American or Black, 11 (8%) Asian American, 1 (0.7%) Native Hawaiian or Other Pacific Islanders, and 48 (36%) White with 108 (75%) insured by Medicaid or Medicare or uninsured. As of June 26, 2023, there were statistically significant improvements in treatment completion (p&lt;0.001) with 140 (98%) completed treatment; reductions in no show with only 3 (2%) participants with a no-show for their clinical or infusion appointments, average time from diagnosis to treatment was halved to 42.5 days (p&lt;0.001) and all participants received clinical trial education (p&lt;0.001) with 48 (34%) actively participating in a clinical trial. Conclusions: Community-academic partnerships to co-design and implement approaches to overcome community-identified needs for marginalized populations are essential to achieve cancer health equity.

Effect of Eight Weeks of Aerobic Exercise on Selected Blood ‏Biomechanical Variables in the Bilateral Femoral Artery of Middle-aged Men

Background and Aims A sedentary lifestyle can lead to cardiovascular diseases such as atherosclerosis. Despite the use of therapeutic interventions such as angioplasty in patients with atherosclerosis, the recurrence of stenosis is possible. Rehabilitation exercises can improve the function and structure of blood vessels by improving the biomechanics of the blood flow. In this study, we aim to assess the effect of eight weeks of aerobic exercise on selected blood biomechanical variables in the bilateral femoral artery of middle-aged men up to seven days after coronary angioplasty. Methods In this quasi-experimental study, participants were 30 men with coronary angioplasty aged 45-60 years, referred to the cardiac rehabilitation clinic of Tehran Heart Hospital. They were assigned to two exercise and control groups. Their systolic and diastolic blood velocity, pressure, and intensity were first measured. The aerobic exercise program was then performed according to the American College of Sports Medicine instructions. Analysis of covariance, paired t-test, or Wilcoxon test were used based on their results. The significance level was set at 0.05. Results The resting heart rate and systolic and diastolic blood pressures were at the same level in both groups, but the maximum heart rate of the control group was lower. The results showed no significant difference between two groups in any blood variables. Conclusion The effect of aerobic exercise was not confirmed in this study, may be due to heart disease or structural changes in the arteries (increased arterial stiffness and decreased arterial elasticity, especially in peripheral arteries). To increase the effect of rehabilitation exercises on peripheral arteries rather than central arteries, more intensity and duration of exercises are recommended to achieve the desired result.

Applying Sequential Pattern Mining to Investigate the Temporal Relationships between Commonly Occurring Internal Medicine Diseases and Intervals for the Risk of Concurrent Disease in Canine Patients.

Sequential pattern mining (SPM) is a data mining technique used for identifying common association rules in multiple sequential datasets and patterns in ordered events. In this study, we aimed to identify the relationships between commonly occurring internal medicine diseases in canine patients. We obtained medical records of dogs referred to the Konkuk University Veterinary Medicine Teaching Hospital. The data used for SPM included comorbidities and intervals between the diagnoses of internal medicine diseases. Additionally, we estimated the 3-year risk of developing an additional disease after the initial diagnosis of a commonly occurring veterinary internal medicine disease using logistic regression. We identified 547 canine patients diagnosed with ≥ 1 internal medicine disease. The SPM-based analysis assessed comorbidities and intervals for each of the five most common internal medical diseases, including hyperadrenocorticism, myxomatous mitral valve disease, canine atopic dermatitis, chronic kidney disease, and chronic pancreatitis. The highest values of the association rule were 3.01%, 6.02%, 3.9%, 4.1%, and 4.84%, and the shortest intervals were 1.64, 13.14, 5.37, 17.02, and 1.7 days, respectively. This study proposes that SPM is an effective technique for identifying common associations and temporal relationships between internal medicine diseases, and can be used to assess the probability of additional admission due to the development of the subsequent disease that may be diagnosed in canine patients. The results of this study will help veterinarians suggest appropriate preventive measures or other medical treatments for canine patients with medical conditions that have not yet been diagnosed, but are likely to develop in the short term.

Can ChatGPT follow an algorithm for ethical decision-making in public health?

Abstract Background With the rapid development of AI, especially chat bots based on Large Language Models like OpenAI ChatGPT and Google Bard, the question of the day is can AI replace (partially or entirely) experts in certain fields - for example in Medical Ethics. The aim of this work is to test the application of ChatGPT to public health ethics (PHE) cases. Methods ChatGPT was given the task to analyse Ebola quarantine case in Sierra Leone by applying methodology for ethical analysis of its own choice and by applying a 4-step model for ethical analysis developed in Medical University - Pleven. The tests were done with simple and detailed tasks. No additional plugins to ChatGPT were included. Results Given a simple task ChatGPT applied 4-step model to the case - Facts, Stakeholders, Ethical principles (Autonomy, Non-maleficence, Beneficence, Justice), Potential consequences. A brief argumentation was provided for each point. ChatGPT identified key ethical concepts for the case (limiting autonomy and freedom, limiting access to resources). When asked to analyse the case with the principles of PHE as defined in The Cambridge Textbook of Bioethics, ChatGPT still used Beauchamp and Childress principles of bioethics. When introduced to PHE principles ChatGPT identified limiting access to resources, creating social and economic hardship for those affected by quarantine as key issues. ChatGPT managed to apply the 4-step model for ethical analysis developed in Medical University - Pleven to some degree. It produced detailed discussion but didn't use any ethical standards, patient's rights or public health policies that could help with decision-making. Individual autonomy was disregarded by ChatGPT in the most detailed analysis. Conclusions ChatGPT has basic knowledge of methodologies for ethical case analysis. With proper guidance and detailed instructions, it could follow complex methodologies and produce a decision. Key messages • AI will continue to develop and its inclusion in medicine and public health practice and teaching is inevitable. • Public health professionals should always be critical of AI decisions and double check the information that was provided by AI.

Importance of Inclusive Education in General Medicine Through the Perception of Medical Trainees: A Thematic Analysis.

Background General medical education plays a pivotal role in ensuring holistic care in the context of rapidly aging populations. Japan's demographic trends underscore the significance of general medicine in elevating community care standards. Understanding and catering to the aspirations, perceptions, and ideals of medical students and residents can significantly augment the effectiveness of general medicine education. This research aimed to explore the perspectives of medical students on the ideal tenets of general medicine education in rural Japan. Method A qualitative approach was employed, focusing on medical students and residents with a keen interest in general medicine, all of whom underwent training at a rural-based Japanese hospital. Through semi-structured interviews, insightful data were garnered and subsequently subjected to a comprehensive thematic analysis. Results The thematic analysis unearthed three core themes: commitment of educators in valuing learner diversity, promotion and understanding of general medicine, and inclusivity and diversity in educational institutions. The first highlighted the centrality of educators' sincerity, emphasizing the importance of genuine, sustained interactions that foster mutual respect and collaborative learning. The second theme underscored the need to elucidate the intrinsic value and modern-day relevance of general medicine, emphasizing its deep roots in community-based practices and its continuity with long-standing medical traditions. The third theme spotlighted the crucial role of comprehensive medical education in fostering enriching dialogues, embracing varied learning experiences, and capitalizing on the distinctive strengths of educational institutions. Conclusion These findings underscore the pivotal shift required in pedagogical approaches to comprehensive medical education. A genuine collaborative educator-learner relationship, the reframing of general medicine's significance rooted in community welfare, and a strong emphasis on inclusivity and dialogue form the cornerstones of these insights. This study provides a touchstone for restructuring educational strategies, aiming for a more integrated, genuine, and encompassing framework that is particularly vital for the effective propagation of general medicine in regions such as Japan.

Adherence to the Mediterranean Diet and Urinary Sodium Excretion in people at high risk of dementia

Abstract Background Both adequate sodium intake and adherence to the Mediterranean Diet (MedDiet) are largely described as important factors for the prevention and control of hypertension and cerebrovascular diseases. However, data regarding sodium intake in the MedDiet is scarce. This study aims to quantify the association between the MedDiet adherence and sodium excretion. Methods This cross-sectional analysis was carried out under the MIND-Matosinhos randomized controlled trial, a community-based program for Portuguese adults at high risk of dementia. The adherence to the MedDiet was assessed through the Portuguese version of the Mediterranean Diet Adherence Screener questionnaire, and a score ≥10 indicated a high adherence. A 24h urine collection was used to evaluate creatinine and sodium excretion. Excessive sodium excretion was defined as ≥ 2000 mg/day. Sociodemographic, lifestyle and health-related data were obtained through structured questionnaires. The association between the adherence to the MedDiet and urinary sodium excretion (recoded into two categories by the median) was quantified by calculating Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) using a binary logistic regression. Results A total of 126 individuals (24 to 83 years old; median age of 70.0) was included in this study (58.7% female). High adherence to the MedDiet was observed among 15.9% of the sample whereas excessive sodium excretion was reported by 84.1%. After adjusting for confounders, participants with high adherence to the MedDiet showed a higher sodium excretion (OR = 4.05; 95% CI: 1.33-12.37). Conclusions A high adherence to the MedDiet was associated with a higher sodium excretion. Thus, an increased adherence to this dietary pattern seems to have limited effects on the adequacy of sodium intake. This highlights the importance of public health measures to reduce sodium intake when following a MedDiet namely by improving consumer empowerment. Key messages • Despite the well-known protective effect of the Mediterranean Diet on hypertension and cerebrovascular diseases, the role of sodium intake within this dietary pattern is still understudied. • The Mediterranean Diet can be an important source of hidden sodium, which enhances the need to invest in public health measures to reduce sodium intake, namely through culinary medicine education.

Shared Reading as a Community of Practice for Overcoming the Generation Gap and Improving Psychological Safety in Rural Family Medicine Education: A Grounded-Theory Approach.

Background A community of practice (CoP) is essential for continuous professional development in family medicine. A CoP in medical education comprises a group of individuals who share common interests and learn and share knowledge, skills, and attitudes. The generation gap between teachers and learners can influence their effective collaboration in family medicine education. To address this issue, shared reading, which involves group discussions on medical texts, effectively promotes intergenerational learning within a CoP. Shared reading is particularly beneficial in rural contexts, where medical resources are scarce, and the generation gap between teachers and learners is wide. This study examines how shared reading facilitates learning and practice among family medicine trainees in rural areas. Methods This qualitative study utilized a grounded-theory approach. It involved the participation of eight family medicine residents, five junior residents, and seven medical students from Unnan City Hospital, Japan, in shared reading sessions between August 2022 and March 2023. Semi-structured interviews were conducted with all participants after the sessions. Results Data analysis using the grounded-theory approach yielded three themes: facilitating learning and motivation, respectful collaboration with teachers, and developing a relationship that fosters psychological safety. First, through shared reading, the participants had opportunities to learn about medical issues and engage in continual dialogues with colleagues and teachers. Second, the participants felt motivated to apply their newly acquired knowledge at work and collaborate with teachers. Third, they acquired self-regulated learning skills by adapting their motivations to their interests and experiences. Increased interaction between participants and teachers during the sessions helped mitigate the generation gap and enhanced psychological safety. Conclusions Shared reading effectively promotes continuous learning and motivates medical learners to apply their knowledge and collaborate with teachers. It facilitates the development of self-regulated learning skills, helps mitigate the generation gap, and enhances psychological safety among educators and learners in rural medical education.

What Do Medical Students Learn about Community Care from Discussions with General Physicians? A Thematic Analysis.

Background and Objectives: Sustainable healthcare is fundamentally rooted in community medicine education. The COVID-19 pandemic disrupted global advancement in integrating traditional teaching and experiential learning. Additionally, an alarming decline in interest in community care has been observed among senior medical students. Here, we examined the perspectives on community care obtained from conversations with general physicians in rural medical universities. Materials and Methods: Using a constructivist lens, a qualitative methodology was employed to examine the perceptions of second-year medical students from Shimane University Medical School regarding community care, informed by dialogues with general physicians. We conducted a thematic analysis at Shimane University, Japan, an area known for its aging population. In 2023, 116 second-year students participated, none of whom had prior formal training in community care. The study was structured into three phases: (1) Pre-education: Students wrote essays about their initial understanding of community care, its advantages, disadvantages, and potential improvements; (2) Dialogue: Grouped by topic, students engaged in discussions that culminated in a comprehensive session with general physicians; and (3) Reflection: After discussions, students wrote essays reflecting any shift in their views on community care. A thematic analysis of essays from the pre-education and reflection phases provided a comparative perspective on the students' understanding. Results: Five dominant themes emerged from the thematic analysis: (1) Re-evaluating community care: Recognizing diversity and addressing societal challenges; (2) Interdisciplinary collaboration: Promoting shared roles and teamwork; (3) Learning and practice: Emphasizing hands-on experience and self-reflection; (4) Technological influence: The mutual relationship between community care and technological advancements; and (5) Challenges and resolutions: Identifying problems and crafting solutions. Conclusions: This study sheds light on the evolution of medical students' views on community care and underscores the importance of continuous adaptation in medical education programs.

Practical tips for teaching the undifferentiated medical student in the emergency department.

Emergency medicine clerkships have become more prevalent in the third year of medical school, a time when students are immersed in the core clinical training of their undergraduate medical education. There is little guidance for clinician educators, however, on how to effectively scaffold learning for third-year medical students when rotating in the emergency department (ED) during core clerkships. The authors sought to provide best practices in teaching to leverage the rich learning environment of the ED - regardless of their specialty selections. Based on an extensive review of the literature spanning on-shift teaching, feedback, clinical medicine, and bedside teaching, the following twelve tips are offered to guide the instruction of the undifferentiated third-year medical student in the ED.

A Novel Approach to Addiction Medicine Education for Undergraduate Medical Students

A virtual addiction medicine elective was developed using interactive multimedia modules, active learning strategies, and patient-based cases. Student had opportunities for professional networking and interacting with physicians and patients. The elective was successful in boosting Year-1 medical students’ confidence to screen, manage, and treat patients with substance abuse disorder.

GPT-4 in Nuclear Medicine Education: Does It Outperform GPT-3.5?

The emergence of ChatGPT has challenged academic integrity in teaching institutions, including those providing nuclear medicine training. Although previous evaluations of ChatGPT have suggested a limited scope for academic writing, the March 2023 release of generative pretrained transformer (GPT)-4 promises enhanced capabilities that require evaluation. Methods: Examinations (final and calculation) and written assignments for nuclear medicine subjects were tested using GPT-3.5 and GPT-4. GPT-3.5 and GPT-4 responses were evaluated by Turnitin software for artificial intelligence scores, marked against standardized rubrics, and compared with the mean performance of student cohorts. Results: ChatGPT powered by GPT-3.5 performed poorly in calculation examinations (31.4%), compared with GPT-4 (59.1%). GPT-3.5 failed each of 3 written tasks (39.9%), whereas GPT-4 passed each task (56.3%). Conclusion: Although GPT-3.5 poses a minimal risk to academic integrity, its usefulness as a cheating tool can be significantly enhanced by GPT-4 but remains prone to hallucination and fabrication.

Novel Lifestyle Medicine Virtual Referral Clinic: A Quality Improvement Initiative to Increase Value-Based Care

Lifestyle education is a key component of healthcare, particularly primary care. Multiple studies have shown that dedicated patient education on lifestyle topics, in addition to medication management, creates the most positive outcomes. Improving knowledge on health topics is critical for eliciting positive change in health behaviors. However, education takes time, and access to focused education outside of the office visit can be a challenge. We discuss here a quality improvement initiative to increase value-based care by utilizing telehealth to improve access to Lifestyle Medicine education during the COVID-19 pandemic. We focused on 4 primary objectives including creating a Lifestyle Medicine Virtual Referral Clinic (LMVRC) embedded within our Family Medicine Residency, determining payor mix of referred patients, utilizing a telehealth platform to provide lifestyle medicine education, and finally determining the influence of our services on patient’s perceived health. There were many key findings in the development, implementation, and evaluation of the LMVRC that could serve to assist others and our clinic in further development of lifestyle medicine education in the primary care setting. In our experience, a LMVRC embedded in a primary care setting proved to be an effective approach to provide access for patients and advancing value-based care.

Measuring radon concentration and investigation of it’s effects on lung cancer

The second most significant etiological factor contributing to the development of lung cancer, following tobacco smoking, is the presence of radon gas. Hence, the assessment of indoor radon levels within residential structures assumes paramount importance within the realm of public health. The primary objective of this investigation is to quantify the concentration of radon gas within the premises of Balikesir University Health Education and Research Hospital as well as the Faculty of Medicine Education building situated in the city of Balikesir. Furthermore, this research endeavors to ascertain the potential risk of lung cancer associated with these measured radon concentrations. To this end, an extensive, long-term (2–3 months) radon monitoring campaign was executed by strategically positioning Columbia Resin-39 (CR-39) solid-state nuclear track detectors at 28 distinct locations. The overarching aim of this effort is to comprehensively assess the health hazards posed to both staff and students and subsequently institute any requisite mitigating measures. The lowest measured value of the measured radon gas concentration is 6 Bq/m3, the highest measured value is 60 ± 8 Bq/m3. The average measurement value is 21.96 ± 3.16 Bq/m3. The measurement results were determined to be lower than the allowed radon activity concentration value in the “Radiation Safety Directive.