Stanislaw Gorski

In this study, we conducted a descriptive study to evaluate the quality of KFQs generated by OpenAI's o3 model. We developed a reusable generic prompt for KFQ generation, designed in alignment with the Medical Council of Canada's KFQ development guidelines. We also created an evaluation metric to systematically assess the quality of the KFQs based on the KFQ development guideline. Twenty unique cardiology-focused KFQs were created using recent European Society of Cardiology guidelines as reference. Each KFQ was independently assessed by two cardiology experts using the quality checklist, with disagreements resolved by a third reviewer. Descriptive statistics were used to summarize checklist compliance and final acceptability ratings. Of the 20 KFQs, 3 (15%) were rated 'Accept as is' and 17 (85%) 'Accept with minor revisions'; none required major revisions or were rejected. The overall compliance rate across checklist criteria was 93.7%, with perfect scores in domains such as key feature definition, scenario plausibility, and alignment between questions and scenarios. Lower performance was observed for inclusion of genuinely harmful 'killer' responses (50%), plausibility of distractors (77.8%), and active language use in phrasing the question (80%). The findings showed that an LLM, guided by a structured prompt, can generate KFQs that closely adhere to established quality standards, with most requiring only minor refinements. While expert review remains essential to ensure clinical accuracy and patient safety, AI-assisted workflows have strong potential to streamline KFQ development and enhance the scalability of CDM assessment in medical education.

Objective: This study has two main aims. (1) To generate multiple-choice questions (MCQs) using template-based automatic item generation (AIG) in Polish and to evaluate the appropriateness of these MCQs in terms of assessing clinical reasoning skills in medical education; (2) to present a method for using artificial intelligence (AI) to generate new item models based on existing models for template-based AIG in medical education. Methods: This was a methodological study. For the first aim, we followed Gierl’s three-step template-based AIG method to generate MCQ items in Polish. The quality of the generated MCQs were evaluated by two experts using a structured form. For the second aim, we proposed a four-step process for using a parent template in English to transform it into new templates. We implemented this method in ChatGPT and Claude by using two medical MCQ item models. Results: Both experts found the automatically generated Polish questions clear, clinically sound, and suitable for assessing clinical reasoning. Regarding the template transformation, our findings showed that ChatGPT and Claude are able to transform item models into new models. Conclusions: We demonstrated the successful implementation of template-based AIG in Polish for generating case-based MCQs to assess clinical reasoning skills in medical education. We also presented an AI-based method to transform item models for enhancing diversity in template-based AIG. Future research should integrate AI-generated models into AIG, evaluate their exam performance, and explore their use in various fields.

Objective. While simulated patients (SPs) are considered a standard tool in communication skills training, there is no evidence thus far of their comparative benefit to the more cost‐effective option of student role playing. We compared the effectiveness of both approaches in developing patient‐centred attitudes in students. Methods. We retrospectively compared students who participated in the clinical communication course (CCC), based on student role playing (CCCsp‐, n = 160), to students who participated in the CCC with SPs (CCCsp+, n = 146), and students with no formal CCC (CCC‐, n = 122). We used validated questionnaires to assess patient centredness. We also conducted focus group interviews (FGI) to better understand the impact of CCC with sp. Results. Students after the CCC with simulated patients achieved a significantly higher score in the patient‐practitioner orientation scale than other groups (p < 0.001). Conclusions. There is a strong positive correlation between the implementation of simulated patients and patient‐centred attitudes among students. Data from the FGI revealed that students perceived training with SP as more realistic, safe, and engaging than student role playing. Practice Implications. Our research provides evidence to justify costs and resources invested in simulated patient programs.

The aim of this study was to analyze the relationship between the qualitative abnormalities on nailfold videocapillaroscopy (NVC), and the concentrations of selected biomarkers (sE-selectin, endothelin-1, high-sensitivity c-reactive protein (hsCRP)) and lipid metabolism parameters in children and adolescents with Raynaud’s phenomenon (RP). Raynaud’s phenomenon, to assess whether nailfold capillary changes may reflect the degree of systemic blood vessel abnormalities. The study group included 66 patients (34 undifferentiated—uRP and 32 secondary—sRP) aged 6–19 years and the control group. In both groups, NVC was performed and the selected biomarkers were measured (sE-selectin, endothelin-1, hsCRP) and lipid profile. Endothelin-1, sE-selectin and hsCRP concentrations in patients from both RP groups were significantly higher; concentration of HDL fraction was significantly lower compared with the control group. The analysis of multiple linear regression demonstrated that megacapillaries most strongly determine the sE-selectin value (p = 0.04) and hsCRP (p = 0.03). Both the total cholesterol and low-density lipoprotein (LDL) fraction concentrations were determined by the presence of avascular areas (p = 0.02). In conclusion, specific pathologic NVC changes were associated with higher endothelial damage biomarkers concentration and adverse changes in the lipid profile.

Patient-centered care (PCC) is associated with better relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors influencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA). We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) after the CCC and upperclassmen Polish-speakers without it (CCC-, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian - MotHUM, financial - MotFIN, combination - MotMIX) and considered specialization - coded as with more human contact (family medicine, psychiatry, pediatrics - SpecHUM) and others (SpecNHUM). Statistics were prepared in R. CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC- and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant. CCC improved PCA in CCC+. They showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.

Introduction. The sedentary lifestyle is defined as prolonged sitting both at work and during leisure time, with energy expenditures of below 600 MET · min/week. The sedentary lifestyle is a well-known predictor of obesity and other components of the metabolic syndrome. The influence of the sedentary lifestyle and associated factors on nsLBP is still being discussed. Aim. The aim of this study was to assess the influence of a sedentary lifestyle and its associated metabolic predictors on the prevalence of nsLBP in nurses and paramedics. Materials and Methods. The study included 609 participants, aged 30-60 years, who were residents of north-east Poland. Data was collected using a questionnaire (based, in part, on the Nordic Musculoskeletal Questionnaire), and included details of sociodemographic profile, chronic illnesses, and a short version of the International Physical Activity Questionnaire (IPAQ). Results. Nearly half (49.59%) of the respondents reported decreased physical activity, and in the group with recurring nsLBP this figure was 67.59%. Univariate logistic regression modelling found that leading a sedentary lifestyle caused a 3.5-fold increase in the incidence of recurring nsLBP (p Conclusions. A sedentary lifestyle significantly increased the incidence of recurring low back pain, while increased physical activity had a significant effect on the presence of chronic low back pain. In the sedentary lifestyle group, conditions classified within metabolic syndrome were found to significantly increase the chances of developing nonspecific low back pain.

Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland.Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards). Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization), received standard care.Outcome Measures.Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation.Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group.Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.