HKUMed Surgeon’s AI Chatbot Trains Students to Clerk Patients
A brush with airline chatbot in 2020 inspired a HKUMed teacher to adapt the technology to teach medical students with the help of virtual patients.
At the height of the COVID-19 pandemic, Dr Michael Co, a Clinical Assistant Professor in the Department of Surgery, found himself talking to a chatbot to rebook his flights.
Despite the shortfalls of the airline’s virtual assistant, Dr Co quickly realised the tool could replace the hands-on training students were missing owing to pandemic restrictions
“It came to mind that if we can use chatbots for customer services, how can we expand the chatbots into medical education,” Dr Co said. “Immediately, [what came] into my mind was to create a chatbot for history taking to act as a virtual patient.”
HKUMed’s Bachelor of Medicine and Bachelor of Surgery (MBBS) students learn how to take a patient’s history, known as clerking, in their fourth year. They are taught to ask about the patient’s basic personal information, symptoms, medications and other details to report the information to the doctor on the ward.
However, COVID-19 health restrictions meant students could not access hospitals or clinics for their usual training, limiting their exposure to patients.
These challenges inspired the breast surgeon to collaborate with Dr John Yuen from the University of Hong Kong’s Department of Computer Science to produce the “Bennie and the Chats” app in 2021. The app’s name was inspired by the Elton John song Bennie and the Jets.
The app currently consists of more than 10 patients, each of which have a full medical history written by Dr Co, along with personality traits like shyness or impatience.
Dr Co and his collaborators published a study on the use of “Bennie and the Chats” comparing the effectiveness of learning with the app against conventional bedside teaching.
It found the students from both groups were able to obtain an accurate history, suggesting using a chatbot to train students to take histories is a feasible alternative to traditional methods.
An early prototype of the app relied on pre-loaded patient responses written by the surgeon.
Following an update, the tool incorporates ChatGPT’s generative AI technology to give human-like responses based on a patient profile written by Dr Co.
“Every time this virtual patient gives you slightly different responses, just like a real patient,” he said. “Because even when you’re talking to a genuine patient asking the history from the same patient, they might give you a slightly different response.”
“Bennie and the Chats” is one of many ways HKUMed is embracing technology to ensure graduates are prepared for dynamic healthcare settings. HKUMed’s MBBS students can now access virtual reality to reinforce their knowledge of anatomy and are trained to use point-of care ultrasounds, along with other additions to the cirriculum.
Dr Co graduated from the MBBS programme at HKUMed in 2006, joining the Faculty as an academic in 2015. He became increasingly interested in innovative teaching methods in face of the challenges brought by the pandemic.
Post-pandemic, “Bennie and the Chats” offers value by allowing teachers to customise cases with a level of complexity suited to the students’ ability. Teachers are also able to give the virtual patients post-operative complications or even layer complications on top of complications.
Additionally, the chatbot can help ensure students all have the same exposure to rare cases, unlike how chance used to dictate learning experiences on the ward.
“For us in the past, seeing complex or rare diseases was purely by luck,” he said. “Nowadays, we can always design our own complex patients [and] we will then show them the clinical photos or images of those complex patients afterwards.”
Dr Co hopes that by using a familiar format for students, the chatbot experience will remind the aspiring physicians of the importance of traditional clinical tools.
“History taking is a vital part of reaching a diagnosis because nowadays, what we can see is that students focus a lot more on investigations,” Dr Co said. “They tend to forget the fundamentals of clinical medicine, which is the history taking, and a proper physical examination.”
Dr Co now plans to open “Bennie and the Chats” to teachers from other HKUMed departments to upload their own cases.
And beyond HKUMed, he has international ambitions for the chatbot.
In October, Dr Co will host a virtual bedside teaching session and discussion with colleagues and students at the National University of Singapore.
Students from NUS and HKUMed will take histories of a patient from Hong Kong and a patient from Singapore, giving them exposure to rare cases they may not see in their own cities.
If successful, he plans to collaborate with universities further afield.
Dr Co views these workshops as an opportunity for HKUMed students access to cases they would not see locally as well as a chance to discuss cases with their overseas peers.
