Southern Medical Journal最新文献

{"title":"Where Are Future Doctors Who Southern Rural African Americans Will Trust? A Look Back into Rural Medical Scholars Data.","authors":"John R Wheat, Antonio J Gardner, Cynthia E Moore","doi":"10.14423/SMJ.0000000000001803","DOIUrl":"10.14423/SMJ.0000000000001803","url":null,"abstract":"<p><strong>Objectives: </strong>African Americans' distrust of institutions extends to southern US rural communities, limiting their use of healthcare resources. Local physicians are scarce, and treatable diseases accumulate. These communities want local doctors they can trust, consistent with research promoting culturally concordant doctor-patient relationships. African American student inclusion was a priority of the Rural Health Leaders Pipeline, which included precollege pipeline programs and a professional track (Rural Medical Scholars Program) of a master's degree program and medical education. The purpose of the present study was to review African American students' experience in the professional track to inform future efforts to produce rural African American physicians.</p><p><strong>Methods: </strong>We retrospectively tracked African Americans in the Rural Medical Scholars Program from 1996 to 2017. Data from pipeline and professional programs supplied racial identity, recruitment mechanism (from pipeline or general admissions), completion of a master's degree program, medical school matriculation, medical school attended, and medical school progression. We counted students for visual analysis with a table for students' distribution and graph for student progression.</p><p><strong>Results: </strong>In 21 years, 1045 students participated in the Rural Health Leaders Pipeline-380 (36%) were African American, including 195 high school, 169 posthigh school, and 16 professional track students. Ten (63%) of these African American Rural Medical Scholars had been earlier pipeline students compared with 15% of non-African American peers. All 16 African American Rural Medical Scholars completed the master's program, 12 entered medical school, and 10 progressed successfully, producing one rural African American physician every 2 years. These numbers were too small for statistical analysis.</p><p><strong>Conclusions: </strong>Enthusiasm among preprofessional students and academic success through the master's degree program but so few accessing medical education was the major finding, matching Association of American Medical Colleges' data showing fewer than 0.01% of US medical students are rural African Americans. Interventions beyond recruitment are needed to involve African American students in rural medicine programs to produce culturally concordant physicians whom their communities can trust.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"155-160"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the Good Physician: The Influence of Role Models in the Development of Virtues and Flourishing in Medical Students.","authors":"Ross A Oakes Mueller, Aaron B Franzen, Joel T Sagawa, G Michael Leffel, Farr A Curlin, John D Yoon","doi":"10.14423/SMJ.0000000000001804","DOIUrl":"10.14423/SMJ.0000000000001804","url":null,"abstract":"<p><strong>Objectives: </strong>A virtues-based model of character development for training future physicians may lead to increased flourishing in medical students through the influence of exemplary role models. This study aimed to analyze the association between caring virtues and measures of flourishing and to identify facilitators of physician flourishing.</p><p><strong>Methods: </strong>The authors used data from a 2011 nationally representative sample of 605 US medical students in which caring virtues (mindfulness, empathic compassion, and generosity) were measured using scales at two time points during the students' clinical years. Hypothesizing a mediated influence of role models in students' generosity and flourishing, the authors explored the interrelationship between measures of mindfulness, empathic compassion, and generosity, using latent variables within a structural equation model. Built into the model were paths to determine mechanisms by which virtues and flourishing are facilitated and/or inhibited.</p><p><strong>Results: </strong>Analyses supported the interrelationship between physician-specific measures of mindfulness, empathic compassion, and generosity. Findings were generally consistent with the hypothesized direction of relationships between these virtues of medical care and the effect of role models on student generosity and sense of calling. Experiences of positive character feedback from a supervisor did not directly predict the generous behavior of medical students as hypothesized, but there appeared to be an indirect effect on generosity through increased vocational satisfaction. When moral elevation was added to the structural model, data offered further support for mentors inspiring caring behavior. Findings from this study provide continued evidence in support of a virtues-based model of character education in medicine that theorizes the influence of role modeling on virtues development and flourishing, including evidence for moral elevation as a potential psychological mechanism.</p><p><strong>Conclusions: </strong>Medical schools may consider adopting a virtues-based model of character education in which supervisors are selected based on their capacity to exemplify virtuous care in their professional life.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"141-149"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Prophylactic Policy-Driven Tranexamic Acid Administration during Cesarean Delivery in a Rural Healthcare Setting.","authors":"Manuel C Vallejo, Anna L Zukowski, Jamie M Long, Christa L Lilly, Linda S Nield, Mark I Zakowski","doi":"10.14423/SMJ.0000000000001796","DOIUrl":"10.14423/SMJ.0000000000001796","url":null,"abstract":"<p><strong>Objectives: </strong>Postpartum hemorrhage (PPH) is a major contributor to maternal mortality worldwide and is a leading cause of pregnancy-related mortality in the United States. The American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, and the World Health Organization advocate for the early use of tranexamic acid (TXA) in the prevention of PPH. The purpose of this study was to determine the efficacy and patient characteristics of the use of prophylactic TXA administration during cesarean delivery (CD) as part of a newly instituted policy to reduce blood loss and PPH rates in a tertiary care regional rural and underserved maternal care center.</p><p><strong>Methods: </strong>An electronic quality assurance chart review from February 2020 through October 2021 of more than 2705 patients was conducted, comparing two groups after implementation of a TXA protocol for all CDs. In total, four CD groups were analyzed (control group without TXA before policy, PPH group without TXA before policy, TXA control group after policy, and PPH group with TXA after policy).</p><p><strong>Results: </strong>PPH rates decreased with TXA use (9.7% vs 1.5%). TXA use was more likely to be given to patients with one or more of the following characteristics: commercial insurance, self-identified Asian race, admission from a doctor's office, urgent CD delivery, fetal distress, abruptio placenta/placenta previa, and extended hospital length of stay with increased hospitalization cost. Subset analysis of 720 patients revealed decreased blood loss (896.4 ± 521.0 mL vs 771.1 ± 405.6 mL, <i>P</i> = 0.0004) and fewer blood transfusions with TXA use (6.7% vs 1.1%, <i>P</i> = 0.0001).</p><p><strong>Conclusions: </strong>Prophylactic policy-driven TXA administration during CD protocol-driven TXA administration decreases PPH.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"196-200"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Gastroenterologists' Fear When Performing Endoscopies during the COVID Pandemic: Results of a US National Survey.","authors":"Reem Q Al Shabeeb, Esther Lee, Muhammad El Shatanofy, Erika Pashai, Ivy Benjenk, Marian Sherman, Eric Heinz, David Yamane, Marie L Borum","doi":"10.14423/SMJ.0000000000001795","DOIUrl":"10.14423/SMJ.0000000000001795","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus disease 2019 (COVID-19) pandemic affected the practice of gastroenterology. Endoscopic procedures are aerosolizing procedures that carry the risk of COVID-19 transmission. Our national survey examined factors affecting gastroenterologists' fear of contracting COVID-19 during endoscopy.</p><p><strong>Methods: </strong>An institutional review board-approved multicenter cross-sectional study used a snowball sample approach to disseminate a 42-question survey to gastroenterologists during a 3-month period in 2021, during the height of the pandemic. Physician demographics, information about personal protective equipment (PPE), negative pressure rooms, and COVID-19 vaccination status was collected. Likert scales were used to evaluate gastroenterologists' fear when performing endoscopy. Analysis was performed using Pearson's χ², Mann-Whitney <i>U</i>, and Wilcoxon rank tests, with significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Results from 69 respondents showed that 91.3% believed that PPE was adequate, 52.2% had PPE education and training, and 47.8% reported that PPE education decreased their fear of contracting COVID-19 during endoscopy. Fear decreased from first to subsequent endoscopies (<i>P</i> < 0.0005) and after COVID-19 vaccination (<i>P</i> < 0.0005). Higher levels of fear were associated with having comorbid conditions (<i>P</i> = 0.048), being the primary caregiver for or living with a person 65 years old or older (<i>P</i> = 0.041), having had to quarantine during the pandemic (<i>P</i> = 0.017), having not performed a procedure because of infectious risks (<i>P</i> = 0.005), and living with someone with comorbid conditions (<i>P</i> = 0.001).</p><p><strong>Conclusions: </strong>Multiple factors affect gastroenterologists' fear of contracting COVID-19 during endoscopic procedures. Lessons learned during the COVID-19 pandemic about mitigating gastroenterologists' fear are potentially applicable to future circumstances that may be associated with significant infectious concerns.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"181-183"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Cost-Effectiveness of Hospital at Home in Patients with COVID-19.","authors":"David W Walsh, Anthony Daniels, Stephen Looney, Christy Ledford, Thad Wilkins","doi":"10.14423/SMJ.0000000000001797","DOIUrl":"10.14423/SMJ.0000000000001797","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus disease 2019 (COVID-19) pandemic significantly affected the capacity of health systems across the United States. Although not widely used before the pandemic, the hospital-at-home (HaH) model emerged as a potential strategy to alleviate hospital burden by providing hospital-level care in the home setting. This study aims to evaluate the safety, clinical effectiveness, and cost-efficiency of a HaH program for patients with COVID-19, comparing these outcomes with those of traditional in-hospital care.</p><p><strong>Methods: </strong>A retrospective matched case-control study was conducted at a major academic medical center in the southeastern United States. The study included 200 patients with confirmed COVID-19, 100 of whom were enrolled in the HaH program between February 1, 2021 and January 31, 2022, and 100 served as matched controls who received conventional hospital care. Matching criteria included age, sex, and admission to the intensive care unit. The primary outcomes assessed were 30-day readmission rates and inpatient length of stay (iLOS). Secondary outcomes included total length of stay (tLOS), emergency department visits within 30 days, and detailed cost analysis, including fixed and variable costs.</p><p><strong>Results: </strong>The analysis included 200 patients (mean age 50.4 years, standard deviation 14.2; 55% female). There were no significant differences between the HaH and control groups in terms of age, sex, or intensive care unit admission rates. The study found no statistically significant differences in 30-day readmissions (11% vs 14%, <i>P</i> = 0.48), days to readmission (9.0 vs 11.8, <i>P</i> = 0.32), or 30-day emergency department visits (18% vs 20%, <i>P</i> = 0.72) between the HaH and control groups. The HaH group had a significantly shorter iLOS (5.7 vs 9.4 days, <i>P</i> = 0.04), however, although tLOS was longer (13.0 vs 9.4 days, <i>P</i> < 0.001). The HaH program also demonstrated cost benefits, with significantly lower inpatient fixed costs ($675,668 vs $1,469,098, <i>P</i> = 0.02) and total inpatient costs ($1,268,944 vs $2,995,512, <i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>The HaH program for COVID-19 patients offered a safe alternative to traditional hospitalization, with similar clinical outcomes and significant reductions in inpatient costs. The shorter iLOS suggests potential benefits in hospital resource management during surge periods, while the longer tLOS highlights the need for optimized patient selection and care strategies in the home setting. Further research is warranted to explore the long-term economic implications and patient outcomes of HaH programs, particularly during heightened demand, on healthcare systems.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"177-180"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Systolic Ejection Time and Inflammation in End-Stage Heart Failure.","authors":"Joel Gutovitz, Jonathan Kutcher, David Z Cherney, Yael Schiller, Itzhak Gabizon, Eran Keshet, Jordan Rimon, David Koren, Vivek Rao, Liza Grosman-Rimon","doi":"10.14423/SMJ.0000000000001801","DOIUrl":"10.14423/SMJ.0000000000001801","url":null,"abstract":"<p><strong>Objectives: </strong>Systolic ejection time (SET) and systemic inflammation are two essential indicators of heart failure (HF) progression. We aimed to evaluate the associations between SET and inflammatory mediators in end-stage HF.</p><p><strong>Methods: </strong>Participants included 16 patients with end-stage HF recruited from the Heart Failure Clinic at Toronto General Hospital and 16 healthy individuals free of any known cardiovascular disease. SET, end systolic pressure, and levels of inflammatory mediators were documented for each patient, and a Spearman rank correlation coefficient was performed to examine differences between patients with end-stage HF and healthy controls.</p><p><strong>Results: </strong>The mean SET in patients with HF was shorter than in the healthy controls (283.5 ± 34.3 ms vs 330.1 ± 19.0 ms, <i>P</i> < 0.001). C-reactive protein (<i>P</i> = 0.001), macrophage inflammatory protein-1β (<i>P</i> = 0.041), macrophage-derived chemokine (<i>P</i> = 0.007), and cyclic guanosine monophosphate (<i>P</i> < 0.001) levels were negatively correlated with SET. The levels of other inflammatory mediators-granulocyte-stimulating factor, granulocyte-macrophage colony-stimulating factor, interleukin-8, macrophage inflammatory protein-1, macrophage inflammatory protein-1α, and tumor necrosis factor α-were not significantly correlated with SET.</p><p><strong>Conclusions: </strong>We found that SET was significantly lower in patients with end-stage HF compared with healthy controls and that reduced SET correlated with increased levels of several inflammatory mediators in patients with HF. By better understanding the relationship between SET and inflammation in HF, a more thorough evaluation could lead to improved risk stratification among patients with HF. Future work should investigate the roles of SET and inflammation in HF.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"167-170"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Longitudinal Personal Finance Curriculum into Resident Medical Education.","authors":"Arohi Saxena, Rakhee K Bhayani, Fahd A Ahmad","doi":"10.14423/SMJ.0000000000001802","DOIUrl":"10.14423/SMJ.0000000000001802","url":null,"abstract":"<p><strong>Objective: </strong>Residents frequently graduate medical school with a significant amount of debt and low financial literacy. Historically, there has been a lack of standardized, longitudinal financial education curriculum to educate residents about important financial principles. Our objective was to design and implement a longitudinal curriculum to cover a variety of personal and professional finance topics relevant to Pediatrics and Internal Medicine residents.</p><p><strong>Methods: </strong>Beginning in 2016, we integrated four lectures per year on personal and professional finance into the noontime curriculum for Internal Medicine and Pediatrics residents at Washington University School of Medicine with topics repeating over a 3-year cycle. We distributed surveys to residents to evaluate the program during its first 4 years; however, we halted collection in 2020 with the transition to a virtual/hybrid model during the coronavirus disease 2019 pandemic. The knowledge and behavior survey contained both Likert scale questions (1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree) and dichotomous yes/no questions assessing certain behaviors and knowledge.</p><p><strong>Results: </strong>A mean of 80 out of 240 (33%) total residents (standard deviation 17) attended each lecture yearly between 2016 and 2020. The mean postlecture survey response rate was 16% (standard deviation 8.1%). Analysis of first-year survey data showed significant improvements in knowledge domains related to employment contracts, negotiation, and physician practice structures. The qualitative feedback was overall positive, and several trainees commented on the relevancy of the physician-led sessions.</p><p><strong>Conclusions: </strong>We successfully integrated a longitudinal personal finance curriculum into resident medical education to support personal and professional development throughout the stages of their career.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"150-154"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of the Intersection between Infant Feeding and Postpartum Contraception in Western North Carolina: Perspectives of Postpartum Individuals and Providers.","authors":"Liane M Ventura, Melissa White, Rebecca Strasser, Kate E Beatty","doi":"10.14423/SMJ.0000000000001798","DOIUrl":"10.14423/SMJ.0000000000001798","url":null,"abstract":"<p><strong>Objectives: </strong>Short interpregnancy intervals are associated with preterm births. Increasing access to postpartum contraception is a preventive intervention. Best practice recommendations suggest that postpartum individuals exclusively breastfeed for up to 6 months. Conversations about these two topics tend to occur simultaneously throughout the perinatal period. This study explores the intersection between infant feeding and postpartum contraception.</p><p><strong>Methods: </strong>Semistructured key informant interviews were conducted with postpartum individuals and providers from throughout western North Carolina. Interviews were audio recorded and transcribed. The \"Sort and Sift, Think and Shift\" method was applied. Emergent themes were identified by systematically generating summaries, memoranda, and quotation diagrams independently by two coders.</p><p><strong>Results: </strong>Key themes included the need to prioritize individual decision-making autonomy and to provide prenatal patient education about infant feeding and postpartum contraception. Participants also discussed the types of social support needed for successful breastfeeding efforts and the impact of infant feeding on mental health. Contextual factors related to infant feeding and postpartum contraceptive decision-making encompassed cultural influences (eg, the historical context of reproductive rights and breastfeeding in public), the inherent challenges of rurality (eg, lack of transportation and the closure of labor and delivery units), and family leave and workplace policies.</p><p><strong>Conclusions: </strong>Infant feeding method and postpartum contraception are highly individualized decisions, which are supported through patient education and shared decision making, particularly during the prenatal period. Findings suggest the importance of incorporating infant feeding within the sexual and reproductive health literature.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"189-195"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"α-Galactose Syndrome Cases within the Prisma Health System, South Carolina.","authors":"Hanna Waltz, Lilianne Kaminski, Kyndall Dye-Braumuller, Matthew Haldeman, Emily Owens Pickle, Melissa S Nolan","doi":"10.14423/SMJ.0000000000001799","DOIUrl":"10.14423/SMJ.0000000000001799","url":null,"abstract":"<p><strong>Objectives: </strong>Humans can develop a vector-associated allergy to galactose-α-1,3-galactose (α-gal) a polysaccharide found in mammalian meats and by-products, resulting in α-gal syndrome (AGS). <i>Amblyomma americanum</i> tick bites have been implicated in AGS development in the United States, but the AGS clinical burden in South Carolina is not well understood. Because <i>A. americanum</i> is the predominant tick species in the state and large AGS cohorts exist in neighboring states, the potential for AGS clinical cases in South Carolina exists. Increased understanding of high-incidence geographical clusters is critical for clinical and public education given the potential for severe anaphylaxis.</p><p><strong>Methods: </strong>We conducted a 5-year retrospective chart abstraction of AGS patient cases serologically confirmed within the state's largest healthcare system to characterize this condition in South Carolina's Upstate and Midlands regions.</p><p><strong>Results: </strong>From October 2017 to February 2023, 50 patients were serologically diagnosed as having AGS within the Prisma Health system. Cohort demographics were mostly older, White males, and Black patients were significantly underrepresented in the AGS caseload (<i>P</i> = 0.0004). Immunosuppressing comorbidities and cooccurring allergies were common.</p><p><strong>Conclusions: </strong>This article presents the first clinical AGS case series in South Carolina, warranting further clinical and public education and a need for continued clinical research on this emerging tick-associated condition.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"161-166"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Chat Generative Pre-Trained Transformer on Personal Review of Learning in Obstetrics and Gynecology.","authors":"Adam Cohen, Jersey Burns, Martina Gabra, Alex Gordon, Nicholas Deebel, Ryan Terlecki, Katherine L Woodburn","doi":"10.14423/SMJ.0000000000001783","DOIUrl":"10.14423/SMJ.0000000000001783","url":null,"abstract":"<p><strong>Objectives: </strong>Chat Generative Pre-Trained Transformer (ChatGPT) is a popular natural-language processor that is able to analyze and respond to a variety of prompts, providing eloquent answers based on a collection of Internet data. ChatGPT has been considered an avenue for the education of resident physicians in the form of board preparation in the contemporary literature, where it has been applied against board study material across multiple medical specialties. The purpose of our study was to evaluate the performance of ChatGPT on the Personal Review of Learning in Obstetrics and Gynecology (PROLOG) assessments and gauge its specialty specific knowledge for educational applications.</p><p><strong>Methods: </strong>PROLOG assessments were administered to ChatGPT version 3.5, and the percentage of correct responses was recorded. Questions were categorized by question stem order and used to measure ChatGPT performance. Performance was compared using descriptive statistics.</p><p><strong>Results: </strong>There were 848 questions without visual components; ChatGPT answered 57.8% correct (N = 490). ChatGPT performed worse on higher-order questions compared with first-order questions, 56.8% vs 60.5%, respectively. There were 65 questions containing visual data, and ChatGPT answered 16.9% correctly.</p><p><strong>Conclusions: </strong>The passing score for the PROLOG assessments is 80%; therefore ChatGPT 3.5 did not perform satisfactorily. Given this, it is unlikely that the tested version of ChatGPT has sufficient specialty-specific knowledge or logical capability to serve as a reliable tool for trainee education.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"102-105"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}