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The competence of ChatGPT (Chat Generative Pre-Trained Transformer) in non-English languages is not well studied. This study compared the performances of GPT-3.5 (Generative Pre-trained Transformer) and GPT-4 on the Japanese Medical Licensing Examination (JMLE) to evaluate the reliability of these models for clinical reasoning and medical knowledge in non-English languages. This study used the default mode of ChatGPT, which is based on GPT-3.5; the GPT-4 model of ChatGPT Plus; and the 117th JMLE in 2023. A total of 254 questions were included in the final analysis, which were categorized into 3 types, namely general, clinical, and clinical sentence questions. The results indicated that GPT-4 outperformed GPT-3.5 in terms of accuracy, particularly for general, clinical, and clinical sentence questions. GPT-4 also performed better on difficult questions and specific disease questions. Furthermore, GPT-4 achieved the passing criteria for the JMLE, indicating its reliability for clinical reasoning and medical knowledge in non-English languages. GPT-4 could become a valuable tool for medical education and clinical support in non-English-speaking regions, such as Japan.

The COVID-19 pandemic has brought virtual web-based learning to the forefront of medical education as training programs adapt to physical distancing challenges while maintaining the rigorous standards of medical training. Social media has unique and partially untapped potential to supplement formal medical education. The aim of this review is to provide a summary of the incentives, applications, challenges, and pitfalls of social media-based medical education for both trainees and educators. We performed a literature review via PubMed of medical research involving social media platforms, including Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts. Papers were reviewed for inclusion based on the integrity and power of the study. The unique characteristics of social media platforms such as Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts endow them with unique communication capabilities that serve different educational purposes in both formal and informal education settings. However, contemporary medical education curricula lack widespread guidance on meaningful use, application, and deployment of social media in medical education. Clinicians and institutions must evolve to embrace the use of social media platforms for medical education. Health care professionals can approach social media engagement in the same ethical manner that they would with patients in person; however, health care institutions ultimately must enable their health care professionals to achieve this by enacting realistic social media policies. Institutions should appoint clinicians with strong social media experience to leadership roles to spearhead these generational and cultural changes. Further studies are needed to better understand how health care professionals can most effectively use social media platforms as educational tools. Ultimately, social media is here to stay, influencing lay public knowledge and trainee knowledge. Clinicians and institutions must embrace this complementary modality of trainee education and champion social media as a novel distribution platform that can also help propagate truth in a time of misinformation, such as the COVID-19 pandemic.

Background:\\nIn Japan, some residents develop mental health problems. In previous studies, it was reported that\\nlong working hours might be a cause of stress reaction such as depression. There were some reports that\\ncompared residents with 80 or more working hours with those with less than 80 working hours. However, many\\nresidents are practically detained for extra-long time, designated as 100 h or more per week, for medical practice,\\ntraining, self-study, etc. There have been few reports on extra-long hours of work. This study evaluated the working\\nenvironment and the amount of stress experienced by first-year residents, and examined the relationship between\\nlong working hours and depression, especially in the group of extra-long working hours.\\n\\nMethods:\\nThe study included 1241 first-year residents employed at 250 training hospitals in 2011. A self-report questionnaire was administered at the beginning of the residency and 3 months later to collect data on\\ndemographics, depressive symptoms, and training conditions (e.g., duration of work, sleep, disposable time, and\\nnight shift). Depressive symptoms were rated using the Center for Epidemiologic Studies Depression Scale.\\n\\nResults:\\nThe mean duration of work per week was 79.4 h, with 97 residents (7.8%) working 100 h or more. At\\n3 months, clinically significant depressive symptoms were reported by 45.5% of residents working 100 or more h\\nper week, which proportion was significantly greater than that for respondents working less than 60 h (P< 0.001).\\nMultivariate logistic regression analysis showed that a working week of 80 to 99.9 h was associated with a 2.83 fold\\nhigher risk and 100 h or more was associated with a 6.96-fold higher risk of developing depressive symptoms\\ncompared with a working week of less than 60 h.\\n\\nConclusion:\\nWorking excessively long hours was significantly associated with development of depressive\\nsymptoms. Proper management of resident physicians\\n'working hours is critical to maintaining their physical and\\nmental health and to improve the quality of care they provide.

BackgroundFew tools or rubrics exist to assess the quality of integrated STEM curricula, and existing tools focus on checklists of characteristics of integrated STEM. While such instruments provide important information about the presence and quality of certain curricular components, they do not assess the level and nature of integration of the curriculum as a whole. Thus, this study explores the development of a process focused to understand the nature of integration within a STEM curriculum unit.FindingsA conceptual flow graphic (CFG) was constructed for 50 integrated STEM curriculum units. Patterns in the nature of the interdisciplinary connections were used to categorize and understand the nature of integration and curricular coherence within each unit. The units formed four broad types of integrated STEM curricula: (i) coherent science unit with loosely connected engineering design challenge (EDC), (ii) engineering design-focused unit with limited connections to science content, (iii) engineering design unit with science content as context, and (iv) integrated and coherent STEM units. All physical science units were in the integrated and coherent category with strong conceptual integration between the main science concepts and the EDC. Curricula based in the Earth and life sciences generally lacked conceptual integration between the science content and the EDC and relied on the engineering design process to provide a coherent storyline for the unit.ConclusionsOur study shows that engineering practices can serve as a contextual integrator within a STEM unit. The utilization of an EDC also provides the potential for conceptual integration because engineering is grounded in the application of science and mathematics. Integrated STEM curricula that purposefully include science and mathematics concepts necessary to develop solutions to the EDC engage students in authentic engineering experiences and provide conceptual integration between the disciplines. However, the alignment of grade-level science standards with the EDC can be problematic, particularly in life science and Earth science. The CFG process provides a tool for determining the nature of integration between science and mathematics content and an EDC. These connections can be conceptual and/or contextual, as both forms of integration are appropriate depending on the instructional goals.

Background It is known that empathic communication is important for physicians to achieve higher patient satisfaction and health outcomes. Emotional intelligence (EI), empathy and personality in medical students predict students’ individual disposition and their emotional and empathic perceptions. This study aimed to investigate: 1) The association between empathy, EI and personality, and 2) Gender differences in the association between empathy, EI and personality. Method Participants were 357 1st year medical students from 2008 to 2011 at one medical school in Japan. Students completed self-report questionnaires comprising three validated instruments measuring EI: Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), empathy: Jefferson Scale of Physician Empathy- student version (JSPE) and personality: NEO-Five-Factor Inventory (NEO-FFI), which explores 5 dimensions of personality Neuroticism (N), Extraversion (E), Openness to experience (O), Agreeableness (A), and Conscientiousness (C). Results Pearson Correlations showed weak association between TEIQue-SF and JSPE. TEIQue-SF and NEO-FFI showed positive correlation for E and C, and strong negative correlation for N and weak positive correlation for A and O. Weak positive correlation between JSPE and the NEO-FFI were observed for E and A. Although effect sizes were small, N, A and empathy were significantly higher in females (unpaired t-test). However, hierarchical multiple-regression analysis when controlling for gender and personality showed no association between EI, empathy and gender. A, TEIQue-SF and N were found to make small contributions in respect of predictions for JSPE. Personality contributed significantly to the prediction of TEIQue-SF. N had the largest independent negative contribution (β = − 0,38). Conclusion In our study population of 1st year medical students, females had significantly higher N, A and empathy scores than males. Medical students’ N score was strongly negatively associated with EI. Empathy was weakly associated with EI and A. However, when controlling gender and personality in regression analysis, gender did not affect EI and empathy, rather personality is the most important factor. Our findings indicate that N is a major factor that negatively affects EI. It is important to mitigate N using thoughtful training, taking into account students’ personalities, to reduce N. In future studies, we will assess how communication trainings for students might enhance EI.

In inclusive education, students with different needs learn in the same context. With the advancement of artificial intelligence (AI) technologies, it is expected that they will contribute further to an inclusive learning environment that meets the individual needs of diverse learners. However, in Japan, we did not find any studies exploring current needs in an actual special needs context. In this study, we used the learning and evidence analysis framework (LEAF) as a learning analytics-enhanced learning environment and employed Active Reading as an example learning task to investigate the challenges and possibilities of applying AI to inclusive education in the future. Two students who attended a resource room formed the context. We investigated learning logs in the LEAF system while each student executed a given learning task. We detected specific learning behaviors from the logs and explored the challenges and future potential of learning with AI technology, considering human involvement in orchestrating inclusive educational practices.

Whether GPT-4, the conversational artificial intelligence, can accurately diagnose and triage health conditions and whether it presents racial and ethnic biases in its decisions remain unclear. We aim to assess the accuracy of GPT-4 in the diagnosis and triage of health conditions and whether its performance varies by patient race and ethnicity. We compared the performance of GPT-4 and physicians, using 45 typical clinical vignettes, each with a correct diagnosis and triage level, in February and March 2023. For each of the 45 clinical vignettes, GPT-4 and 3 board-certified physicians provided the most likely primary diagnosis and triage level (emergency, nonemergency, or self-care). Independent reviewers evaluated the diagnoses as \"correct\" or \"incorrect.\" Physician diagnosis was defined as the consensus of the 3 physicians. We evaluated whether the performance of GPT-4 varies by patient race and ethnicity, by adding the information on patient race and ethnicity to the clinical vignettes. The accuracy of diagnosis was comparable between GPT-4 and physicians (the percentage of correct diagnosis was 97.8% (44/45; 95% CI 88.2%-99.9%) for GPT-4 and 91.1% (41/45; 95% CI 78.8%-97.5%) for physicians; P=.38). GPT-4 provided appropriate reasoning for 97.8% (44/45) of the vignettes. The appropriateness of triage was comparable between GPT-4 and physicians (GPT-4: 30/45, 66.7%; 95% CI 51.0%-80.0%; physicians: 30/45, 66.7%; 95% CI 51.0%-80.0%; P=.99). The performance of GPT-4 in diagnosing health conditions did not vary among different races and ethnicities (Black, White, Asian, and Hispanic), with an accuracy of 100% (95% CI 78.2%-100%). P values, compared to the GPT-4 output without incorporating race and ethnicity information, were all .99. The accuracy of triage was not significantly different even if patients' race and ethnicity information was added. The accuracy of triage was 62.2% (95% CI 46.5%-76.2%; P=.50) for Black patients; 66.7% (95% CI 51.0%-80.0%; P=.99) for White patients; 66.7% (95% CI 51.0%-80.0%; P=.99) for Asian patients, and 62.2% (95% CI 46.5%-76.2%; P=.69) for Hispanic patients. P values were calculated by comparing the outputs with and without conditioning on race and ethnicity. GPT-4's ability to diagnose and triage typical clinical vignettes was comparable to that of board-certified physicians. The performance of GPT-4 did not vary by patient race and ethnicity. These findings should be informative for health systems looking to introduce conversational artificial intelligence to improve the efficiency of patient diagnosis and triage.

Generative artificial intelligence (GAI), represented by large language models, have the potential to transform health care and medical education. In particular, GAI's impact on higher education has the potential to change students' learning experience as well as faculty's teaching. However, concerns have been raised about ethical consideration and decreased reliability of the existing examinations. Furthermore, in medical education, curriculum reform is required to adapt to the revolutionary changes brought about by the integration of GAI into medical practice and research. This study analyzes the impact of GAI on medical education curricula and explores strategies for adaptation. The study was conducted in the context of faculty development at a medical school in Japan. A workshop involving faculty and students was organized, and participants were divided into groups to address two research questions: (1) How does GAI affect undergraduate medical education curricula? and (2) How should medical school curricula be reformed to address the impact of GAI? The strength, weakness, opportunity, and threat (SWOT) framework was used, and cross-SWOT matrix analysis was used to devise strategies. Further, 4 researchers conducted content analysis on the data generated during the workshop discussions. The data were collected from 8 groups comprising 55 participants. Further, 5 themes about the impact of GAI on medical education curricula emerged: improvement of teaching and learning, improved access to information, inhibition of existing learning processes, problems in GAI, and changes in physicians' professionality. Positive impacts included enhanced teaching and learning efficiency and improved access to information, whereas negative impacts included concerns about reduced independent thinking and the adaptability of existing assessment methods. Further, GAI was perceived to change the nature of physicians' expertise. Three themes emerged from the cross-SWOT analysis for curriculum reform: (1) learning about GAI, (2) learning with GAI, and (3) learning aside from GAI. Participants recommended incorporating GAI literacy, ethical considerations, and compliance into the curriculum. Learning with GAI involved improving learning efficiency, supporting information gathering and dissemination, and facilitating patient involvement. Learning aside from GAI emphasized maintaining GAI-free learning processes, fostering higher cognitive domains of learning, and introducing more communication exercises. This study highlights the profound impact of GAI on medical education curricula and provides insights into curriculum reform strategies. Participants recognized the need for GAI literacy, ethical education, and adaptive learning. Further, GAI was recognized as a tool that can enhance efficiency and involve patients in education. The study also suggests that medical education should focus on competencies that GAI hardly replaces, such as clinical experience and communication. Notably, involving both faculty and students in curriculum reform discussions fosters a sense of ownership and ensures broader perspectives are encompassed.

BackgroundCountries around the world have struggled to implement education policies and practices to encourage more female youths to pursue Science, Technology, Engineering, and Mathematics (STEM). This has resulted in a persistent and sizeable gender gap in science and mathematics subjects in some countries. Using mixed-methods sequential explanatory design, this paper explores an educational intervention—specifically, a 3-day design thinking workshop—in Japan, designed to change female youths’ perceptions regarding STEM topics. Framed using a constructivist approach to learning, the workshops aimed to engender creative confidence, empathy, and global competence among youths.ResultsThe findings show that female youths who participated in the workshop had increased interest in engineering, greater creative confidence, more positive perceptions of STEM, higher levels of empathy and pro-social factors, and a more varied outlook on career options. We argue that this short intervention had a strong influence on the female youths’ mindsets, self-images, and perceptions of STEM.ConclusionThis study provides empirical support that a short intervention can produce positive change in how female youths relate to STEM. In gendered societies, an innovative method like design thinking has the potential to revitalize education curriculum in ways that spur female youths’ confidence and creativity, enabling them to imagine a career in the field of STEM.