Large Language Models in Medical Education: Opportunities, Challenges, and Future Directions.

The integration of large language models (LLMs), such as those in the Generative Pre-trained Transformers (GPT) series, into medical education has the potential to transform learning experiences for students and elevate their knowledge, skills, and competence. Drawing on a wealth of professional and academic experience, we propose that LLMs hold promise for revolutionizing medical curriculum development, teaching methodologies, personalized study plans and learning materials, student assessments, and more. However, we also critically examine the challenges that such integration might pose by addressing issues of algorithmic bias, overreliance, plagiarism, misinformation, inequity, privacy, and copyright concerns in medical education. As we navigate the shift from an information-driven educational paradigm to an artificial intelligence (AI)-driven educational paradigm, we argue that it is paramount to understand both the potential and the pitfalls of LLMs in medical education. This paper thus offers our perspective on the opportunities and challenges of using LLMs in this context. We believe that the insights gleaned from this analysis will serve as a foundation for future recommendations and best practices in the field, fostering the responsible and effective use of AI technologies in medical education.

Using Automated Scoring to Evaluate Written Responses in English and French on a High-Stakes Clinical Competency Examination.

We present a framework for technology-enhanced scoring of bilingual clinical decision-making (CDM) questions using an open-source scoring technology and evaluate the strength of the proposed framework using operational data from the Medical Council of Canada Qualifying Examination. Candidates' responses from six write-in CDM questions were used to develop a three-stage-automated scoring framework. In Stage 1, the linguistic features from CDM responses were extracted. In Stage 2, supervised machine learning techniques were employed for developing the scoring models. In Stage 3, responses to six English and French CDM questions were scored using the scoring models from Stage 2. Of the 8,007 English and French CDM responses, 7,643 were accurately scored with an agreement rate of 95.4% between human and computer scoring. This result serves as an improvement of 5.4% when compared with the human inter-rater reliability. Our framework yielded scores similar to those of expert physician markers and could be used for clinical competency assessment.

Automated essay scoring and the future of educational assessment in medical education.

CONTEXT: Constructed-response tasks, which range from short-answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students' ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed-response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as 'automated essay scoring' (AES). METHODS: An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed-response prompt that has been pre-scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. RESULTS: Automated essay scoring provides a method for scoring constructed-response tests that complements the current use of selected-response testing in medical education. The method can serve medical educators by providing the summative scores required for high-stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. CONCLUSIONS: Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed-response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed-response tasks.