A scoping review of artificial intelligence in medical education: BEME Guide No. 84.

BACKGROUND: Artificial Intelligence (AI) is rapidly transforming healthcare, and there is a critical need for a nuanced understanding of how AI is reshaping teaching, learning, and educational practice in medical education. This review aimed to map the literature regarding AI applications in medical education, core areas of findings, potential candidates for formal systematic review and gaps for future research. METHODS: This rapid scoping review, conducted over 16 weeks, employed Arksey and O'Malley's framework and adhered to STORIES and BEME guidelines. A systematic and comprehensive search across PubMed/MEDLINE, EMBASE, and MedEdPublish was conducted without date or language restrictions. Publications included in the review spanned undergraduate, graduate, and continuing medical education, encompassing both original studies and perspective pieces. Data were charted by multiple author pairs and synthesized into various thematic maps and charts, ensuring a broad and detailed representation of the current landscape. RESULTS: The review synthesized 278 publications, with a majority (68%) from North American and European regions. The studies covered diverse AI applications in medical education, such as AI for admissions, teaching, assessment, and clinical reasoning. The review highlighted AI's varied roles, from augmenting traditional educational methods to introducing innovative practices, and underscores the urgent need for ethical guidelines in AI's application in medical education. CONCLUSION: The current literature has been charted. The findings underscore the need for ongoing research to explore uncharted areas and address potential risks associated with AI use in medical education. This work serves as a foundational resource for educators, policymakers, and researchers in navigating AI's evolving role in medical education. A framework to support future high utility reporting is proposed, the FACETS framework.

Kawasaki disease: a prospective population survey in the UK and Ireland from 2013 to 2015.

OBJECTIVE: Kawasaki disease (KD) is an increasingly common vasculitis with risk of coronary artery aneurysms (CAAs). The last UK survey was in 1990, whereas current epidemiology, treatment patterns and complication rates are unknown. The aim of this study was to address this knowledge gap. METHODS: A British Paediatric Surveillance Unit survey in the UK and Ireland from 1 January 2013 to 28 February 2015 ascertained demographics, ethnicity, seasonal incidence, treatment and complication rates. RESULTS: 553 cases were notified: 389 had complete KD, 46 had atypical KD and 116 had incomplete KD; 2 were diagnosed at postmortem with an incidence of 4.55/100 000 children under 5 years, with a male to female ratio of 1.5:1 and a median age of 2.7 years (2.5 months-15 years). Presentation was highest in January and in rural areas. Most were white (64%), and Chinese and Japanese Asians were over-represented as were black African or African mixed-race children. 94% received intravenous immunoglobulin (IVIG). The overall CAA rate was 19%, and all-cardiac complications affected 28%. Those with CAA received IVIG later than in those without (median 10 days vs 7 days). Those under 1 year had fewer symptoms, but the highest CAA rate (39%). Overall 8 of 512 cases (1.6%) had giant CAA, and 4 of 86 cases (5%) under 1 year of age developed giant CAA. Mortality from KD was 0.36%. CONCLUSIONS: The UK and Ireland incidence of KD has increased and is more frequently seen in winter and rural areas. Delayed IVIG treatment is associated with CAA, suggesting earlier and adjunctive primary treatment might reduce complications to prevent CAA, particularly in the very young.

Surveillance of rare diseases: a public health evaluation of the British Paediatric Surveillance Unit.

BACKGROUND: The British Paediatric Surveillance Unit (BPSU), a joint undertaking between the Royal College of Paediatrics and Child Health, Institute of Child Health and Health Protection Agency, undertakes nationwide surveillance of rare paediatric disorders. In 2007-09, formal evaluation to examine its effectiveness commenced. METHODS: Centres of Disease Control guidelines for appraising public health surveillance systems were applied. Data sources included BPSU databases, published and unpublished reports. Questionnaires were sent to 600 participating paediatricians and 27 researchers. Half of the questionnaires were administered online to assess the feasibility of electronic reporting. RESULTS: Three thousand UK paediatricians report monthly to the BPSU (94% return) and eighty BPSU studies have been published. These studies have influenced immunization and screening policy, altered clinical practice and informed health service configuration. Surveillance operations are simple, stable, representative and responsive to changing demands. Returns from the paediatricians' survey were 75%; investigators 89%. Paediatricians valued the BPSU and did not find participation burdensome. Most supported online questionnaires (56%) but not monthly electronic reporting (35%). CONCLUSIONS: Evaluation demonstrated the effectiveness of the BPSU as a valuable resource for clinicians and policy-makers. Opportunities identified for future development include secure online reporting, improved responsiveness to urgent health threats and promoting public involvement.

Mothers, babies and vitamin D: old disease, new problem.

Neonatologists and paediatricians have a crucial role working with mothers at the most nutritionally challenged point in their lives and that of their infants. This position of responsibility is particularly important in tackling the re-emerging problem of hypovitaminosis D. In this overview the role of vitamin D, its contribution to pathology in those to whom we provide a service and possible actions will be considered.

Managing vitamin D deficiency in children.

Vitamin D deficiency has been identified in many British children. This condition has many deleterious effects on their health. Taking vitamin D status into account needs to become a daily element of primary care practice, both in antenatal and postnatal situations. It is probable that a significant improvement in reducing chronic diseases in adulthood will result from a more proactive approach in children.

Toxic shock syndrome.

Toxic shock syndrome is outlined, paying particular attention to the important role of nurses in its diagnosis and early management

Behaviour sequelae following acute Kawasaki disease.

BACKGROUND: Kawasaki disease is a systemic vasculitis and may affect cerebral function acutely. The aim of the present study was to measure a number of behaviour and social parameters within a cohort of Kawasaki disease patients. METHODS: Parents of children with past diagnosis of Kawasaki disease were recruited to complete several behaviour screening questionnaires. Sixty five sets of questionnaires relating to the patient cohort received were eligible for inclusion. Two control groups were used, a hospital (HC) control and a sibling control (SC) group. RESULTS: 40% of the Kawasaki disease group showed elevated internalising scores in the clinical or borderline-clinical range. This compared with 18% of hospital controls and 13% of sibling controls. Additionally, the Kawasaki disease (KD) group were shown to be experiencing greater overall total difficulties when compared with the controls (KD 13.7, HC 8.6, SC 8.9). The KD group attained higher behavioural scores within the internalising sub-categories of somatic problems (KD 61, HC 57, SC 54) and withdrawn traits (KD 56, HC 53, SC 51). The KD group were also shown to be suffering more thought problems (KD 57, HC 53, SC 50) compared with the controls. Further difficulties relating to conduct (KD 3.3, HC 1.4) and social interactions (KD 6.7, HC 8.3) are also highlighted for the KD group compared with hospital controls. Positron emission tomograms were performed on nine patients to investigate severe behavioural problems. Three showed minor changes, possibly a resolving cerebral vasculopathy. CONCLUSION: Kawasaki disease can be associated with significant behavioural sequelae. This is an important consideration in the long-term follow up and referral to a clinical psychologist may be necessary in selected patients.

Managing toxic shock syndrome.

A recent case review showed that nurses play an important role in diagnosing toxic shock syndrome (TSS). It is a rare, and potentially fatal condition, which may develop in individuals of all ages. The average A&E nurse will probably only encounter a single case. However, front-line nurses will usually be the first to meet the patient with this condition. Some knowledge of TSS is important because early diagnosis and treatment may save lives.

Staphylococcal vaccines.

Vaccination has proved relatively unsuccessful against the common mammalian commensal bacteria Staphylococcus, despite almost a century of experimentation. Recent progress in clinical trials, animal models and molecular laboratories offers hope that these organisms might be partially or wholly controlled by augmenting host responses.

The use of herbal remedies in Jamaica

A survey of paediatric inpatients at the Tropical Metabolism Research Unit in the University Hospital, Kingston, Jamaica demonstrates that 71 percent had been treated with herbal remedies before their presentation to the medical services. The risks of the high prevalence of such medication in children are outlined, and two remedies in particular are highlighted because of their potential toxicity. (AU)

Frankincense and myrrh as remedies in children

Two cases of therapy with frankincense and myrrh in children are presented. The long history of this unusual treatment is outlined, demonstrating that for several millenia such agents have been employed in a number of medical contexts, as well as in the perfume and incence industries. Myrrh has found recent pharmacological application in the reduction of cholesterol and triglycerides, as predicted by several traditional therapies. (AU)