scholarly journals Introducing Artificial Intelligence Training in Medical Education (Preprint)

2019 ◽  
Author(s):  
Ketan Paranjape ◽  
Michiel Schinkel ◽  
Rishi Nannan Panday ◽  
Josip Car ◽  
Prabath Nanayakkara

UNSTRUCTURED Health care is evolving and with it the need to reform medical education. As the practice of medicine enters the age of artificial intelligence (AI), the use of data to improve clinical decision making will grow, pushing the need for skillful medicine-machine interaction. As the rate of medical knowledge grows, technologies such as AI are needed to enable health care professionals to effectively use this knowledge to practice medicine. Medical professionals need to be adequately trained in this new technology, its advantages to improve cost, quality, and access to health care, and its shortfalls such as transparency and liability. AI needs to be seamlessly integrated across different aspects of the curriculum. In this paper, we have addressed the state of medical education at present and have recommended a framework on how to evolve the medical education curriculum to include AI.

10.2196/16048 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e16048 ◽  
Author(s):  
Ketan Paranjape ◽  
Michiel Schinkel ◽  
Rishi Nannan Panday ◽  
Josip Car ◽  
Prabath Nanayakkara

Health care is evolving and with it the need to reform medical education. As the practice of medicine enters the age of artificial intelligence (AI), the use of data to improve clinical decision making will grow, pushing the need for skillful medicine-machine interaction. As the rate of medical knowledge grows, technologies such as AI are needed to enable health care professionals to effectively use this knowledge to practice medicine. Medical professionals need to be adequately trained in this new technology, its advantages to improve cost, quality, and access to health care, and its shortfalls such as transparency and liability. AI needs to be seamlessly integrated across different aspects of the curriculum. In this paper, we have addressed the state of medical education at present and have recommended a framework on how to evolve the medical education curriculum to include AI.


2020 ◽  
Vol 18 (4) ◽  
pp. 2033
Author(s):  
Roxana De las Salas ◽  
Javier Eslava-Schmalbach ◽  
Claudia Vaca-González ◽  
Dolores Rodríguez ◽  
Albert Figueras

Objective: The aim of this study was to develop and validate a stepwise tool to aid primary health care professionals in the process of deprescribing potentially inappropriate medication in older persons. Methods: We carried out a systematic review to identify previously published tools. A composite proposal of algorithm was made by following the steps from clinical experience to deprescribe medications. A 2-round electronic Delphi method was conducted to establish consensus. Eighteen experts from different countries (Colombia, Spain and Argentina) accepted to be part of the panel representing geriatricians, internists, endocrinologist, general practitioners, pharmacologists, clinical pharmacists, family physicians and nurses. Panel members were asked to mark a Likert Scale from 1 to 9 points (1= strongly disagree, 9= strongly agree). The content validity‏ ratio, item-level content validity, and Fleiss’ Kappa statistics was measured to establish reliability. The same voting method was used for round 2. Results: A 7-question algorithm was proposed. Each question was part of a domain and conduct into a decision. In round 1, a consensus was not reached but statements were grouped and organized. In round 2, the tool met consensus. The inter-rater reliability was between substantial and almost perfect for questions with Kappa=0.77 (95% CI 0.60-0.93), for domains with Kappa= 0.73 (95%CI 0.60-0.86) and for decisions with Kappa= 0.97 (95%CI 0.90-1.00). Conclusions: This is a novel tool that captures and supports healthcare professionals in clinical decision-making for deprescribing potentially inappropriate medication. This includes patient’s and caregiver’s preferences about medication. This tool will help to standardize care and provide guidance on the prescribing/deprescribing process of older persons’ medications. Also, it provides a holistic way to reduce polypharmacy and inappropriate medications in clinical practice.


2020 ◽  
Vol 27 (12) ◽  
pp. 2011-2015 ◽  
Author(s):  
Tina Hernandez-Boussard ◽  
Selen Bozkurt ◽  
John P A Ioannidis ◽  
Nigam H Shah

Abstract The rise of digital data and computing power have contributed to significant advancements in artificial intelligence (AI), leading to the use of classification and prediction models in health care to enhance clinical decision-making for diagnosis, treatment and prognosis. However, such advances are limited by the lack of reporting standards for the data used to develop those models, the model architecture, and the model evaluation and validation processes. Here, we present MINIMAR (MINimum Information for Medical AI Reporting), a proposal describing the minimum information necessary to understand intended predictions, target populations, and hidden biases, and the ability to generalize these emerging technologies. We call for a standard to accurately and responsibly report on AI in health care. This will facilitate the design and implementation of these models and promote the development and use of associated clinical decision support tools, as well as manage concerns regarding accuracy and bias.


2015 ◽  
Vol 95 (10) ◽  
pp. 1387-1396 ◽  
Author(s):  
Pat G. Camp ◽  
W. Darlene Reid ◽  
Frank Chung ◽  
Ashley Kirkham ◽  
Dina Brooks ◽  
...  

Background Exercise is recommended for people with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet there is little information to guide safe and effective mobilization and exercise for these patients. Objectives The purpose of this study was to develop a clinical decision-making tool to guide health care professionals in the assessment, prescription, monitoring, and progression of mobilization and therapeutic exercise for patients with AECOPD. Design and Methods A 3-round interdisciplinary Delphi panel identified and selected items based on a preselected consensus of 80%. These items were summarized in a paper-based tool titled Mobilization in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD-Mob). Focus groups and questionnaires were subsequently used to conduct a sensibility evaluation of the tool. Results Nine researchers, 13 clinicians, and 7 individuals with COPD identified and approved 110 parameters for safe and effective exercise in AECOPD. These parameters were grouped into 5 categories: (1) “What to Assess Prior to Mobilization,” (2) “When to Consider Not Mobilizing or to Discontinue Mobilization,” (3) “What to Monitor During Mobilization for Patient Safety,” (4) “How to Progress Mobilization to Enhance Effectiveness,” and (5) “What to Confirm Prior to Discharge.” The tool was evaluated in 4 focus groups of 18 health care professionals, 90% of whom reported the tool was easy to use, was concise, and would guide a health care professional who is new to the acute care setting and working with patients with AECOPD. Limitations The tool was developed based on published evidence and expert opinion, so the applicability of the items to patients in all settings cannot be guaranteed. The Delphi panel consisted of health care professionals from Canada, so items may not be generalizable to other jurisdictions. Conclusions The AECOPD-Mob provides practical and concise information on safe and effective exercise for the AECOPD population for use by the new graduate or novice acute care practitioner.


2017 ◽  
Vol 7 (4) ◽  
pp. 82-88 ◽  
Author(s):  
Larysa Dudikova

Abstract The materials presented in this article are the result of a documentary-bibliographic study, which is based on the use of methods of analysis, synthesis, comparison and generalization. The results of the study have shown that the problem of professional ethics and culture of health care professionals is of significant interest. Problems of ethics, culture and deontology are the subject of consideration by scholars from the countries of Europe and the United States. There have been defined the main modern tendencies of training doctors for their professional activity in the leading countries of the world in the context of the professional and ethical competence formation. It has been found out that the development of higher medical education is carried out on the basis of the Bologna process principles, which involves introduction of two degrees (Bachelor and Master of Science), implementation of the ECTS system, introduction of the single diploma supplement, etc. It has been estimated that the educational programs for future doctors' training are aimed at the development of the students’ analytical and critical thinking; behavioral and social sciences, medical ethics, bioethics, provide knowledge, skills and abilities in the field of communication, clinical decision making, application of ethical norms, work in the multi-staff teams etc. The integrated programs play an important role in the educational process. Over the last decades studying bioethics is a compulsory component of the medical education. However, not only bioethics is the basis for the formation of future doctors’ professional and ethical competence at medical Universities abroad. The Oath of Hippocrates is of great significance for the students who devote themselves to medicine. In various countries it has been transformed into codes, oaths, etc., and now it is carried out by the students (future physicians) during their studies at higher medical educational institutions.


2021 ◽  
Vol 109 (3) ◽  
Author(s):  
Rebecca Jean Scott

Background: Over a decade ago, the Hill report argued that a shift in vision was required to change the perception of National Health Service (NHS) Library and Knowledge Services (LKS) in England from “book repositories” to essential services that underpin clinical decision-making by patients, carers, and health care professionals. Health Education England’s Knowledge for Healthcare: A Development Framework for Library and Knowledge Services in England 2015–2020 advocates embedding librarians within clinical and management teams in order to provide access to high-quality evidence at the point of need.Case presentation: In April 2019, Royal Papworth Hospital relocated twelve miles from its historic village location in Papworth Everard to its new state-of-the-art hospital on the Cambridge Biomedical Campus. The design for this new hospital did not accommodate a traditional library space and therefore necessitated a transformation of the LKS. The organization opted to embed the LKS staff into the clinical setting and relegate 80% of the print collection to off-site storage. This project and its associated steps are presented as an example of health care library transformation.Conclusion: Embedding the LKS team in the clinical setting, engaging in proactive outreach activity, and improving our marketing led to a 44% increase in literature searches requested compared to the same eleven-month period in the previous year. A 40% decrease in our print book loans indicates additional barriers to using a click-and-collect service and the need for greater investment in our e-book provision. However, early outcomes for our best-fit service transformation are positive. Having an open, dual mindset has enabled the service to embrace change and maximize emerging opportunities to collaborate with clinical staff on new projects.


Author(s):  
Gabriella Negrini

Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.


Author(s):  
Hao WANG

LANGUAGE NOTE | Document text in Chinese; abstract also in English.即將到來的新世紀,使中國醫院經營面臨著許多新的問題和嚴峻挑戰。首先,醫學教育與知識經濟的發展很不適應。其次,醫院設備與社會需要很不適應。第三,醫院經營模式與市場運行很不適應。第四,醫療服務模式與人口結構變化很不適應。第五,醫務勞動補償模式與醫務勞動消耗很不適應。醫院經營面臨的上述問題是涉及國家與醫院兩個方面多層次的發展戰略與策略的問題,也是涉及全國各行各業和廣大人民切身利益的問題。解決問題的根本出路在於改革。首先,應真正解放思想和更新概念,擺正衛生事業在國民經濟和社會發展中的地位。第二,應改革醫學教育制度和內容,把醫學高科技教育作為學位教育和繼續教育的重點;同時搞好人事制度改革。第三,應積極地引進高新技術設備,努力提高醫院基本設施和診療儀器的現代化水平。第四,應盡快改革醫院經營體制,建立和完善新的經營模式與經營機制。為此,應着重搞好醫院布局和組織結構調整,以及醫療服務結構的調整;實行醫院的所有權與經營權分離,讓醫院法人組織和法定代表依法自主經營;按照市場經濟規律的要求,建立和完善醫院經營的動力機制、醫療技術機制、自我約束調控機制、法人領導機制。第五,應改革醫療衛生服務體制,建立適應人口結構和疾病譜變化的新的防治服務模式。為此,應擴大預防工作範圍和擴大保健人群範間,建立醫院、社區、家庭相結合的醫療衛生保健服務模式。At the threshold of a new millennium, China's hospitals face a series of problems in their management. This essay attempts to analyze these problems and explore appropriate solutions to them.First, the contemporary Chinese pattern of medical education is not suitable to the rapid growth of medical knowledge. Ever increasing new theories, methods, and technologies in diagnosis, therapeutics, and prognosis promote the quality of medical care tremendously. However, most health care professionals in China's hospitals are unable to follow up-to-date developments of medical information. Very few medical scientist s or physicians in China's medical care field are recognized as leading or authoritative in the world. The solution to this problem calls for an emphasis on and respect for the values of human resources in medicine, improvement of current medical education, and establishment of a mechanism for reeducating medical professionals.Second, the current pattern of hospital management is not suitable to the market. The manner of hospital management in China is the product of China's central-planning mode of economy. Each hospital belongs to a central or local government, or to a state-owned enterprise.It does not have power to make decisions about its own management. Neither does it care about cost-benefit balancing because hospital financing relics entirely on government revenue. However, new problems have occurred during Chin's transition to a free market economy from the centrally-planned economy since the 1980s. Though many enterprises have been allowed to manage themselves according to the circumstances of the market, hospitals have been emphasized as welfare providers that cannot be allowed to make money. The government continues to set strict low prices for medical services and, at the same time, does not provide sufficient financing to hospitals. As a result, hospitals have to make their ends meet by increasing unnecessary medication prescriptions and overusing high-technology diagnostic and therapeutic instruments. Overtreatment and waste in hospital care have generated universal complaints. Accordingly, serious reform must be made in the direction of appropriately adjusting the ownership of hospitals as well as changing the ways of hospital management so that they can adapt themselves to the need of the health care market.Finally, there are other serious problems involved in China's hospital management. These problems are multi-faceted. For instance, medical facilities and instruments have not been up-to--dated and cannot meet the needs of patients in medical care, the structure of hospital services does not suit the need of the ever-increasing numbers of senior citizens in China, etc. The only way to resolve these problems is reform. This requires ordinary Chinese citizens as well as Chinese leadership to free themselves from the restrictions of the previous centrally-planned economic theory and to seek a new health care model.DOWNLOAD HISTORY | This article has been downloaded 15 times in Digital Commons before migrating into this platform.


2020 ◽  
pp. 277-288
Author(s):  
Pat Croskerry

In the past two decades, there has been growing interest in the process of clinical decision making (CDM). Importantly, a strong interest has flourished in the process of diagnosis, particularly its failure rate. Two major strategies have been proposed to ameliorate diagnostic failure: minimizing system error and strategies to promote optimal clinical decision making. Many health care environments are not optimal. A variety of factors have been identified that influence the safe operation of the system, and clinicians need to be cognizant of them. In this chapter, a number of strategies are reviewed to optimize the CDM that occurs within the system, including the promotion of rationality, metacognition, thinking skills, flexibility, innovation and creativity in thinking, lateral thinking, cognitive bias mitigation, the incorporation of artificial intelligence, and distributed cognition. Instead of assuming that competence in CDM will be tacitly acquired in the course of medical education, clinicians need to advocate for explicit interventions that are known to raise the caliber of CDM.


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