Int. Med. Educ., Volume 4, Issue 3 (September 2025) – 4 articles

At the Michael G. DeGroote School of Medicine, a significant component of the MD curriculum involves written narrative reflections on topics related to professional identity in medicine, with written feedback provided by their in-person longitudinal facilitators (LFs). However, it remains to be understood how generative artificial intelligence chatbots, such as ChatGPT (GPT-4), augment the feedback process and how MD students perceive feedback provided by ChatGPT versus the feedback provided by their LFs. In this study, 15 MD students provided their written narrative reflections along with the feedback they received from their LFs. Their reflections were input into ChatGPT (GPT-4) to generate instantaneous personalized feedback. MD students rated both modalities of feedback using a Likert-scale survey, in addition to providing open-ended textual responses. Quantitative analysis involved mean comparisons and t-tests, while qualitative responses were coded for themes and representational quotations. The results showed that while the LF-provided feedback was rated slightly higher in six out of eight survey items, these differences were not statistically significant. In contrast, ChatGPT scored significantly higher in helping to identify strengths and areas for improvement, as well as in providing actionable steps for improvement. Criticisms of ChatGPT included a discernible “AI tone” and paraphrasing or misuse of quotations from the reflections. In addition, MD students valued LF feedback for being more personal and reflective of the real, in-person relationships formed with LFs. Overall, findings suggest that although skepticism regarding ChatGPT’s feedback exists amongst MD students, it represents a viable avenue for deepening reflective practice and easing some of the burden on LFs. Full article

To clarify the current status of physical assessment education in Japan, this study analyzed publicly available syllabi from nursing universities. Syllabi from 299 member universities of the Japan Association of Nursing Universities were analyzed, and data on course classification methods, learning content, and practice methods were tabulated. The Body System Approach was the most common classification (used by 244 universities). Implementation rates were high for core systems like the respiratory system (98.0%) and cardiovascular system (95.2%), but lower for others, such as the otolaryngology system (41.5%). The use of simulation was noted in 21.4% of courses, and in 71.0% of syllabi, the role of the patient in practice exercises was not described. A discrepancy exists between the implemented content and the Model Core Curriculum for Nursing Education, which includes a wider range of systems. Furthermore, few syllabi described specific teaching methods, indicating that future curriculum revisions will require re-evaluation to ensure educational quality. Full article

The objective structured clinical examination (OSCE) is a well-established tool for assessing clinical skills, providing reliability, validity, and generalizability for high-stakes examinations. Des Moines University College of Osteopathic Medicine (DMU-COM) adapted the OSCE for formative assessments in undergraduate medical education, focusing on interpersonal aspects in the primary care setting. Students are graded by standardized patients and faculty observers on interpersonal skills, history/physical examination, oral case presentation, and documentation. The purpose of the study is to establish the reliability and to identify sources of variation in the DMU-COM OSCE to aid medical educators in their understanding of the accuracy of clinical skills. We examined student performance data across five OSCE domains. We assessed intra- and inter-OSCE reliability by calculating KR20 values, determined sources of variation by multivariate regression analysis, and described relationships among observed variables through factor analysis. The results indicate that the OSCE captures student performance in three dimensions with low intra-OSCE reliability but acceptable longitudinal inter-OSCE reliability. Variance analysis shows significant measurement error in rubric-graded scores but negligible error in checklist-graded portions. Physical exam scores from patients and faculty showed no correlation, indicating value in having two different observers. We conclude that a series of formative OSCEs is a valid tool for assessing clinical skills in preclinical medical students. However, the low intra-assessment reliability cautions against using a single OSCE for summative clinical skills competency assessments. Full article

Background: Emergency medicine in Japan traditionally emphasizes critically ill patients, but recent trends show an increase in minor illness cases influenced by social factors. This study assessed integrating community nurse (CN) training into an emergency medicine elective to evaluate its effect on students’ self-achievement and communication skills. Methods: Medical students rotating in the emergency department participated. Those choosing the CN training spent one week in the community, while others remained hospital-based. Surveys evaluated self-achievement of Shimane University emergency medicine objectives and communication skills per the Model Core Curriculum. Analyses used t-tests. Results: Of 35 students, 21 (60%) completed surveys. Satisfaction levels did not differ significantly between CN and non-CN groups (4.0 ± 0.70 vs. 4.5 ± 0.63, p = 0.15). Regression analysis indicated satisfaction correlated only with online practice availability. No significant differences emerged for goals or communication items (all p > 0.05), although CN participants tended to rate higher on patient proximity, communication, and social engagement. Discussion: CN training maintained overall satisfaction and slightly enhanced communication and social aspects, aligning with shifts toward psychosocial care in emergency medicine. Conclusions: Integrating CN practice did not significantly impact emergency medicine knowledge or skill satisfaction but showed a trend toward improved communication and social purpose satisfaction. Larger-scale studies are needed for validation. Full article