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      Applications and Challenges of Implementing Artificial Intelligence in Medical Education: Integrative Review

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          Abstract

          Background

          Since the advent of artificial intelligence (AI) in 1955, the applications of AI have increased over the years within a rapidly changing digital landscape where public expectations are on the rise, fed by social media, industry leaders, and medical practitioners. However, there has been little interest in AI in medical education until the last two decades, with only a recent increase in the number of publications and citations in the field. To our knowledge, thus far, a limited number of articles have discussed or reviewed the current use of AI in medical education.

          Objective

          This study aims to review the current applications of AI in medical education as well as the challenges of implementing AI in medical education.

          Methods

          Medline (Ovid), EBSCOhost Education Resources Information Center (ERIC) and Education Source, and Web of Science were searched with explicit inclusion and exclusion criteria. Full text of the selected articles was analyzed using the Extension of Technology Acceptance Model and the Diffusions of Innovations theory. Data were subsequently pooled together and analyzed quantitatively.

          Results

          A total of 37 articles were identified. Three primary uses of AI in medical education were identified: learning support (n=32), assessment of students’ learning (n=4), and curriculum review (n=1). The main reasons for use of AI are its ability to provide feedback and a guided learning pathway and to decrease costs. Subgroup analysis revealed that medical undergraduates are the primary target audience for AI use. In addition, 34 articles described the challenges of AI implementation in medical education; two main reasons were identified: difficulty in assessing the effectiveness of AI in medical education and technical challenges while developing AI applications.

          Conclusions

          The primary use of AI in medical education was for learning support mainly due to its ability to provide individualized feedback. Little emphasis was placed on curriculum review and assessment of students’ learning due to the lack of digitalization and sensitive nature of examinations, respectively. Big data manipulation also warrants the need to ensure data integrity. Methodological improvements are required to increase AI adoption by addressing the technical difficulties of creating an AI application and using novel methods to assess the effectiveness of AI. To better integrate AI into the medical profession, measures should be taken to introduce AI into the medical school curriculum for medical professionals to better understand AI algorithms and maximize its use.

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          Most cited references52

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          Artificial intelligence in medicine.

          Artificial Intelligence (AI) is a general term that implies the use of a computer to model intelligent behavior with minimal human intervention. AI is generally accepted as having started with the invention of robots. The term derives from the Czech word robota, meaning biosynthetic machines used as forced labor. In this field, Leonardo Da Vinci's lasting heritage is today's burgeoning use of robotic-assisted surgery, named after him, for complex urologic and gynecologic procedures. Da Vinci's sketchbooks of robots helped set the stage for this innovation. AI, described as the science and engineering of making intelligent machines, was officially born in 1956. The term is applicable to a broad range of items in medicine such as robotics, medical diagnosis, medical statistics, and human biology-up to and including today's "omics". AI in medicine, which is the focus of this review, has two main branches: virtual and physical. The virtual branch includes informatics approaches from deep learning information management to control of health management systems, including electronic health records, and active guidance of physicians in their treatment decisions. The physical branch is best represented by robots used to assist the elderly patient or the attending surgeon. Also embodied in this branch are targeted nanorobots, a unique new drug delivery system. The societal and ethical complexities of these applications require further reflection, proof of their medical utility, economic value, and development of interdisciplinary strategies for their wider application.
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            Medical Education Must Move from the Information Age to the Age of Artificial Intelligence

            Noteworthy changes coming to the practice of medicine require significant medical education reforms. While proposals for such reforms abound, they are insufficient because they do not adequately address the most fundamental change-the practice of medicine is rapidly transitioning from the information age to the age of artificial intelligence. Increasingly, future medical practice will be characterized by: the delivery of care wherever the patient happens to be; the provision of care by newly constituted health care teams; the use of a growing array of data from multiple sources and artificial intelligence applications; and the skillful management of the interface between medicine and machines. To be effective in this environment, physicians must work at the top of their license, have knowledge spanning the health professions and care continuum, effectively leverage data platforms, focus on analyzing outcomes and improving performance, and communicate the meaning of the probabilities generated by massive amounts of data to patients, given their unique human complexities. The authors believe that a "reboot" of medical education is required that makes better use of the findings of cognitive psychology and pays more attention to the alignment of humans and machines in education and practice. Medical education needs to move beyond the foundational biomedical and clinical sciences. Systematic curricular attention must focus on the organization of professional effort among health professionals, the use of intelligence tools involving large data sets, and machine learning and robots, all the while assuring the mastery of compassionate care.
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              Evolution and Revolution in Artificial Intelligence in Education

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                Author and article information

                Contributors
                Journal
                JMIR Med Educ
                JMIR Med Educ
                JME
                JMIR Medical Education
                JMIR Publications (Toronto, Canada )
                2369-3762
                Jan-Jun 2019
                15 June 2019
                : 5
                : 1
                : e13930
                Affiliations
                [1 ] Medical Education Scholarship and Research Unit Lee Kong Chian School of Medicine Nanyang Technological University Singapore Singapore
                [2 ] Mohammed Bin Rashid University of Medicine and Health Sciences Dubai United Arab Emirates
                Author notes
                Corresponding Author: Nabil Zary nabil.zary@ 123456icloud.com
                Author information
                http://orcid.org/0000-0001-9533-801X
                http://orcid.org/0000-0001-8999-6999
                Article
                v5i1e13930
                10.2196/13930
                6598417
                31199295
                e3885035-4ea2-4451-9407-a56014071631
                ©Kai Siang Chan, Nabil Zary. Originally published in JMIR Medical Education (http://mededu.jmir.org), 15.06.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Education, is properly cited. The complete bibliographic information, a link to the original publication on http://mededu.jmir.org/.as well as this copyright and license information must be included.

                History
                : 6 March 2019
                : 31 March 2019
                : 15 April 2019
                : 16 April 2019
                Categories
                Review
                Review

                medical education,evaluation of aied systems,real world applications of aied systems,artificial intelligence

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