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Record W4417534853 · doi:10.1371/journal.pdig.0001156

Evaluating ChatGPT-4 in the development of family medicine residency examinations

2025· article· en· W4417534853 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenuePLOS Digital Health · 2025
Typearticle
Languageen
FieldMedicine
TopicArtificial Intelligence in Healthcare and Education
Canadian institutionsSt. Michael's HospitalUniversity of TorontoUniversity Health Network
Fundersnot available
KeywordsQuality (philosophy)Educational measurementMEDLINEMedical schoolResidency training

Abstract

fetched live from OpenAlex

Creating high-quality medical examinations is challenging due to time, cost, and training requirements. This study evaluates the use of ChatGPT 4.0 (ChatGPT-4) in generating medical exam questions for postgraduate family medicine (FM) trainees. Develop a standardized method for postgraduate multiple-choice medical exam question creation using ChatGPT-4 and compare the effectiveness of large language model (LLM) generated questions to those created by human experts. Eight academic FM physicians rated multiple-choice questions (MCQs) generated by humans and ChatGPT-4 across four categories: 1) human-generated, 2) ChatGPT-4 cloned, 3) ChatGPT-4 novel, and 4) ChatGPT-4 generated questions edited by a human expert. Raters scored each question on 17 quality domains. Quality scores were compared using linear mixed effect models. ChatGPT-4 and human-generated questions were rated as high quality, addressing higher-order thinking. Human-generated questions were less likely to be perceived as artificial intelligence (AI) generated, compared to ChatGPT-4 generated questions. For several quality domains ChatGPT-4 was non-inferior (at a 10% margin), but not superior, to human-generated questions. ChatGPT-4 can create medical exam questions that are high quality, and with respect to certain quality domains, non-inferior to those developed by human experts. LLMs can assist in generating and appraising educational content, leading to potential cost and time savings.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.874
Threshold uncertainty score0.412

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.485
GPT teacher head0.547
Teacher spread0.062 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it