Advantages and pitfalls in utilizing artificial intelligence for crafting medical examinations: a medical education pilot study with GPT-4

Background: The task of writing multiple choice question examinations for medical students is complex, timely and requires significant efforts from clinical staff and faculty. Applying artificial intelligence algorithms in this field of medical education may be advisable.

Methods: During March to April 2023, we utilized GPT-4, an OpenAI application, to write a 210 multi choice questions-MCQs examination based on an existing exam template and thoroughly investigated the output by specialist physicians who were blinded to the source of the questions. Algorithm mistakes and inaccuracies, as identified by specialists were classified as stemming from age, gender or geographical insensitivities.

Results: After inputting a detailed prompt, GPT-4 produced the test rapidly and effectively. Only 1 question (0.5%) was defined as false; 15% of questions necessitated revisions. Errors in the AI-generated questions included: the use of outdated or inaccurate terminology, age-sensitive inaccuracies, gender-sensitive inaccuracies, and geographically sensitive inaccuracies. Questions that were disqualified due to flawed methodology basis included elimination-based questions and questions that did not include elements of integrating knowledge with clinical reasoning.

Conclusion: GPT-4 can be used as an adjunctive tool in creating multi-choice question medical examinations yet rigorous inspection by specialist physicians remains pivotal.