Artificial Intelligence-Powered Training Database for Clinical Thinking: App Development Study

Abstract

Background: With the development of artificial intelligence (AI), medicine has entered the era of intelligent medicine, and various aspects, such as medical education and talent cultivation, are also being redefined. The cultivation of clinical thinking abilities poses a formidable challenge even for seasoned clinical educators, as offline training modalities often fall short in bridging the divide between current practice and the desired ideal. Consequently, there arises an imperative need for the expeditious development of a web-based database, tailored to empower physicians in their quest to learn and hone their clinical reasoning skills.

Objective: This study aimed to introduce an app named "XueYiKu," which includes consultations, physical examinations, auxiliary examinations, and diagnosis, incorporating AI and actual complete hospital medical records to build an online-learning platform using human-computer interaction.

Methods: The "XueYiKu" app was designed as a contactless, self-service, trial-and-error system application based on actual complete hospital medical records and natural language processing technology to comprehensively assess the "clinical competence" of residents at different stages. Case extraction was performed at a hospital's case data center, and the best-matching cases were differentiated through natural language processing, word segmentation, synonym conversion, and sorting. More than 400 teaching cases covering 65 kinds of diseases were released for students to learn, and the subjects covered internal medicine, surgery, gynecology and obstetrics, and pediatrics. The difficulty of learning cases was divided into four levels in ascending order. Moreover, the learning and teaching effects were evaluated using 6 dimensions covering systematicness, agility, logic, knowledge expansion, multidimensional evaluation indicators, and preciseness.

Results: From the app's first launch on the Android platform in May 2019 to the last version updated in May 2023, the total number of teacher and student users was 6209 and 1180, respectively. The top 3 subjects most frequently learned were respirology (n=606, 24.1%), general surgery (n=506, 20.1%), and urinary surgery (n=390, 15.5%). For diseases, pneumonia was the most frequently learned, followed by cholecystolithiasis (n=216, 14.1%), benign prostate hyperplasia (n=196, 12.8%), and bladder tumor (n=193, 12.6%). Among 479 students, roughly a third (n=168, 35.1%) scored in the 60 to 80 range, and half of them scored over 80 points (n=238, 49.7%). The app enabled medical students' learning to become more active and self-motivated, with a variety of formats, and provided real-time feedback through assessments on the platform. The learning effect was satisfactory overall and provided important precedence for establishing scientific models and methods for assessing clinical thinking skills in the future.

Conclusions: The integration of AI and medical education will undoubtedly assist in the restructuring of education processes; promote the evolution of the education ecosystem; and provide new convenient ways for independent learning, interactive communication, and educational resource sharing.

Keywords: online learning; artificial intelligence; clinical thinking ability; distance education; medical education; virtual medical records.

Figure 1.. Flow chart of the program design from data collection to interaction between students and teachers in the XueYiKu app.

Figure 2.. Changes in the number of student users of the XueYiKu app from May 2019 to February 2023.

Figure 3.. Radar chart with specific scores of clinical thinking evaluation for the XueYiKu app by difficulty in learning cases.

Figure 4.. Self-assessment and satisfaction of 70 students towards the learning outcomes for the XueYiKu app.