This research investigates the potential of two advanced AI language models, ChatGPT-4 and Co-Pilot, to transform medical education through clinical scenario generation. Focusing on scenarios for Diabetic Neuropathy, Acute Myocardial Infarction, and Pediatric Asthma, the study compares the accuracy, depth, and practical teaching utility of content generated by each platform. A panel of medical experts assessed the AI-generated scenarios, and healthcare professionals provided feedback on their perceived usefulness in educational settings. Results suggest that ChatGPT-4 excels in providing structured foundational knowledge, while Co-Pilot offers greater depth through realistic patient narratives and a focus on holistic care. This indicates that both platforms have value, with their suitability depending on specific educational objectives – ChatGPT-4 aligns better with introductory learning, and Co-Pilot better serves advanced applications emphasizing practical clinical reasoning.

1. Comparative Analysis of ChatGPT-4 and
Co-Pilot in Clinical Education
Insights for Medical Teaching and Learning
Vaikunthan Rajaratnam
Senior Consultant Hand Surgeon, KTPH,
Singapore,
Adjunct Professor & UNESCO Chair Partner,
Asia Pacific University of Technology and
Innovation, Malaysia.
Dr S. Tan
Lecturer, NUMed Malaysia
Dr Usama F Omar
Hand Surgery Fellow
Khoo Teck Puat Hospital
INTED2024 - Valencia, Spain

2. Introduction
Generative
AI platforms
Revolutionising
medical
education
Novel
approaches to
pedagogy
Effectiveness in
clinical
teaching

3. Problem and Scenario Based Learning
in Medical Education
Critical thinking
Communication
abilities
Clinical
competence
Cornerstone of
medical
education
DAVIS, M. H., & HARDEN, R. M. (1999). AMEE Medical Education Guide No. 15: Problem-based learning: a practical guide.
Medical Teacher, 21(2), 130–140

4. Challenges of Scenario Development
Resources
Time
Money
Manpower
Faculty
Competency
Buy in
Time
Data set
Inclusivity
Bias
Regular
review
Instructionally
sound
Accuracy
Appropriate
Graded

5. Generative AI
Large Dataset and LLM
Patient profiles
Medical histories
Social details
Lab results or imaging
studies
Mapping plausible decision
trees and outcomes
Providing variety and
complexity
Crafting feedback and
debriefing materials.

6. Objectives
ChatGPT4 vs CoPilot
Developing complex clinical scenarios
•Accuracy
•Depth of explanation
•Practical applicability
•User satisfaction

7. Methods
Generation of
standardised prompt
ChatGPT4 and
Copilot
Drafting of Scenarios
Evaluation of
scenarios
Expert review panel
Comparative
Qualitative Analysis
ChatGPT4
Synthesis of findings
Write me a prompt to get a clinical
scenario to be used as the trigger
to get ChatGPT to produce content
to teach a medical student on the
subject of [ Diabetic neuropathy,
acute myocardial infarction,
paediatric asthma ]

8. Standardised Prompt Clinical Problem 1
( Diabetic Neuropathy)
• Develop a detailed clinical scenario for a medical student focusing on diabetic neuropathy. The patient, a
58-year-old individual with a 10-year history of type 2 diabetes mellitus, presents to the clinic with
complaints of numbness and a tingling sensation in both feet, progressively worsening over the past six
months. The patient has been managing diabetes with oral hypoglycemics and reports inconsistent
adherence to the prescribed medication regimen. Additionally, the patient has a history of hypertension
and hyperlipidemia.
• Include in the scenario an exploration of the patient's full medical history, lifestyle factors, and a
description of the physical examination findings typical of diabetic neuropathy. Highlight the need for a
comprehensive neurological examination, focusing on sensory and motor function, as well as reflexes in the
lower extremities.
• The scenario should also cover the differential diagnosis to consider in this case, emphasizing the
importance of distinguishing diabetic neuropathy from other potential causes of peripheral neuropathy.
Discuss the relevant diagnostic tests that should be considered, including blood glucose levels, HbA1c,
nerve conduction studies, and electromyography.
• Conclude the scenario with a discussion on the management strategies for diabetic neuropathy, including
both pharmacological and non-pharmacological approaches. Address the importance of strict glycemic
control, lifestyle modifications, pain management, and potential complications such as foot ulcers and
infections. Finally, include patient education components about self-care practices to prevent further
complications.
• This clinical scenario should serve as a comprehensive educational tool for medical students to understand
the complexities of diabetic neuropathy, its diagnosis, management, and the holistic care of patients with
this condition."

9. Response
• Clinical Problem 1 ChatGPT
• Diabetic Neuropathy in a 58-Year-Old Patient with Type 2 Diabetes Mellitus
• Patient Presentation: A 58-year-old individual with a 10-year history of type 2 diabetes mellitus presents to the clinic with complaints of numbness
and a tingling sensation in both feet, progressively worsening over the past six months. The patient has been on oral hypoglycemic agents, but admits
to inconsistent adherence to the medication regimen. The patient also has a history of hypertension and hyperlipidemia.
• Medical History and Lifestyle Factors: The patient's medical history reveals long-standing type 2 diabetes, with recent suboptimal glycemic control
(latest HbA1c was 8.2%). The patient has a sedentary lifestyle, with a diet high in carbohydrates and fats. There is no history of smoking or alcohol
use. Family history includes a parent with type 2 diabetes and neuropathy.
• Physical Examination: Examination shows decreased sensation to light touch and vibration in both feet, with diminished ankle reflexes. There are no
visible foot ulcers or deformities. The remainder of the neurological examination, including motor strength and coordination, is normal.
• Differential Diagnosis: The differential diagnosis includes diabetic neuropathy, vitamin B12 deficiency, chronic inflammatory demyelinating
polyneuropathy, and alcoholic neuropathy. Given the patient's long history of diabetes and symptomatology, diabetic neuropathy is the most likely
diagnosis.
• Diagnostic Tests: Recommended tests include blood glucose levels, HbA1c to assess long-term glycemic control, serum B12 levels, and a
comprehensive metabolic panel. Nerve conduction studies and electromyography should be performed to confirm the diagnosis and assess the
severity of neuropathy.
• Management Strategies:
1. Pharmacological Approaches: Include the use of medications such as pregabalin or gabapentin for neuropathic pain management. Antidepressants
like duloxetine may also be considered.
2. Non-Pharmacological Approaches: Emphasize the importance of strict glycemic control through medication adherence, dietary modifications, and
regular physical activity.
3. Pain Management: Address pain control through medications, and consider referral to a pain specialist if needed.
4. Prevention of Complications: Regular foot care and monitoring for ulcers or infections are crucial. Educate the patient about proper foot hygiene and
the need for immediate medical attention if foot injuries occur.
• Patient Education: Focus on educating the patient about the importance of medication adherence, lifestyle changes (diet, exercise), regular foot care,
and monitoring for signs of complications. Discuss the chronic nature of diabetic neuropathy and the importance of regular follow-up visits.
• Conclusion: This scenario encapsulates the critical aspects of managing a patient with diabetic neuropathy, emphasizing a holistic approach that
includes both medical and lifestyle interventions. It serves as a comprehensive tool for medical students to understand the multifaceted aspects of
diabetic neuropathy care.

10. Scenario 1
Diabetic
Neuropathy
• ChatGPT (Blue)
• Copilot (Green)

11. Patient Presentation: A 58-year-
old individual with a 10-year
history of type 2 diabetes
mellitus presents to the clinic
with complaints of numbness
and a tingling sensation in both
feet, progressively worsening
over the past six months.
The patient has been on oral
hypoglycemic agents but admits
to inconsistent adherence to the
medication regimen. The patient
also has a history of
hypertension and
hyperlipidemia.
Patient Presentation: Mr. Tan, a
58-year-old individual, presents to
the clinic with complaints of
numbness and a tingling
sensation in both feet,
progressively worsening over the
past six months. He has a 10-year
history of type 2 diabetes
mellitus, which he has been
managing with oral
hypoglycemics. However, he
reports inconsistent adherence to
the prescribed medication
regimen. Additionally, Mr. Tan has
a history of hypertension and
hyperlipidemia.

12. CRITERIA CHATGPT COPILOT
Accuracy of Information
- Clinically accurate presentation and
management strategies.
- Comprehensive differential diagnosis and
appropriate diagnostic tests.
- Detailed and realistic lifestyle information.
- Accurate depiction of symptoms and
diagnostic process.
Depth of Explanation
- Concise overview of management.
- Solid foundation in the diagnostic process.
- Detailed examination findings and
management plan.
- Highlights the impact of lifestyle on
condition.
Usefulness in Teaching
- Good for teaching clinical reasoning from
presentation to management.
- Balanced view of pharmacological and non-
pharmacological management.
- Useful for illustrating complex care and
comprehensive approach.
- Emphasizes holistic management and
interdisciplinary care.
Key Features
- Simplified, yet comprehensive approach
suitable for foundational learning.
- Emphasizes medical and lifestyle
interventions.
- Detailed patient history and lifestyle factors.
- Focus on patient education and the
importance of lifestyle modifications.
Targeted Learning Outcome
- Understanding of clinical reasoning and
basic management strategies.
- Deep dive into patient management
complexities and holistic care approach.
COMPARISION Scenario 1
Qualitative Analysis – Human Loop

13. CRITERIA CHATGPT COPILOT
Depth
- Comprehensive overview of AMI management.<br>- Clear
distinction between STEMI and NSTEMI management
strategies.
- Detailed long-term management and secondary prevention
outlined.
- Similar comprehensive coverage with additional personal
details (Mr. Lee).
- Specific medications and cardiac rehabilitation program
mentioned, providing concrete examples.
Accuracy
- Accurately reflects clinical guidelines for AMI management.
- Includes evidence-based practices for immediate and long-
term care.
- Maintains accuracy with clinical guidelines.
- Enhances realism with specific treatment names and
detailed patient education, adhering to evidence-based
practices.
Usefulness for Teaching
- Structured format suitable for clear, concise learning.
- Ideal for teaching critical steps in AMI management.<br>-
Good for understanding broad treatment strategies.
- Narrative style may improve engagement and information
retention.
- Detailed patient history and management strategies offer a
holistic view of patient care.<br>- Particularly useful for
teaching comprehensive care.
Engagement Level
- High level of clinical detail suitable for foundational learning.
- May be more appealing to learners preferring direct, to-the-
point information.
- Narrative approach adds a personal touch, potentially
increasing engagement.
- More suitable for learners who appreciate a story-like
format to understand clinical complexities.
Educational Approach
- Emphasizes critical thinking and clinical decision-making
within a structured framework.
- Suitable for introducing AMI management concepts.
- Encourages a holistic approach to patient care.
- Effective for teaching about the importance of patient
education, lifestyle modifications, and interdisciplinary care.
COMPARISION Scenario 2
Qualitative Analysis – Human Loop

14. Criteria ChatGPT CoPilot
Depth
- Comprehensive management outline including
stepwise medication approach, acute exacerbation
criteria, and regular monitoring.
- Detailed diagnostic evaluation methods.
- Provides practical management details and a
narrative on trial treatment and home monitoring.
- Specific advice on patient and parent education
regarding acute exacerbations and asthma action
plans.
Accuracy
- Accurately reflects current paediatric asthma
management guidelines.
- Appropriate emphasis on diagnostic evaluation
and identifying triggers.
- Maintains accuracy with guidelines, with added
detail on environmental control and trigger
avoidance.
- Accurate depiction of management strategies,
including medication and education on exacerbation
signs.
Usefulness for Teaching
- Structured and foundational, suitable for
understanding critical asthma care components
- Ideal for teaching the theoretical framework of
asthma management.
- Enhanced by practical insights and narrative
elements, beneficial for applying guidelines in
clinical settings.
- Detailed information on environmental control and
patient education makes it highly useful for
comprehensive learning.
Educational Approach
- Emphasizes a theoretical understanding of asthma
management.
- Suitable for introducing concepts and stepwise
management strategies.
- Focuses on applying management guidelines in
practice.
- Useful for teaching the importance of patient
involvement and real-world application of care
strategies.
Engagement Level
- High due to comprehensive coverage of
management strategies.
- May appeal more to learners who prefer
structured, guideline-focused information.
- Potentially higher engagement through narrative
details and practical advice.
- Appeals to learners interested in the holistic and
practical aspects of patient care.
Target Audience
- Medical students and healthcare professionals
seeking a foundational understanding of pediatric
asthma management.
- Medical students and healthcare professionals
looking for an in-depth understanding of practical
asthma care and patient education.
COMPARISION Scenario 1 Qualitative Analysis – Human Loop

15. Qualitative Analysis ChatGPT
Criteria ChatGPT CoPilot
Depth
Comprehensive management and diagnostic
details for asthma and AMI, with clear
guidelines and distinctions between
conditions.
Practical insights with narrative elements for
asthma; detailed examples and personal
touches for AMI, enhancing depth with
concrete examples.
Accuracy
Reflects current guidelines accurately for
paediatric asthma and AMI, with appropriate
emphasis on diagnostics and triggers.
Maintains guideline accuracy; adds detail on
environmental control for asthma and presents
realistic lifestyle information for AMI.
Usefulness for Teaching
Structured for foundational understanding;
theoretical framework of asthma and AMI
management.
Practical and holistic insights; comprehensive
learning through detailed patient education
and environmental control for asthma, complex
care for AMI.
Educational Approach
Theoretical understanding of management
strategies; introduces concepts and stepwise
strategies for asthma and AMI.
Application of guidelines in practice; holistic
patient care, interdisciplinary care, and real-
world application for asthma and AMI.
Engagement Level
High, with a structured, guideline-focused
approach for learners who prefer
comprehensive coverage.
Potentially higher through practical advice and
narrative details, appealing to learners
interested in holistic care.
Target Audience
Medical students and professionals seeking
foundational knowledge of pediatric asthma
and AMI management.
Medical students and professionals looking for
in-depth, practical care understanding and
patient education for asthma and AMI.
Key Features
Simplified yet comprehensive approach;
emphasizes medical and lifestyle interventions
for AMI.
Detailed patient history and lifestyle factors;
patient education and lifestyle modifications
for AMI.
Targeted Learning Outcome
Clinical reasoning and basic management
strategies understanding for AMI.
Holistic care approach and patient

16. Category Mean
Standard
Deviation Minimum
25th
Percentile
50th
Percentile
75th
Percentile Maximum
Platform Preference N/A N/A N/A N/A A A A
Scenario Evaluation (Accuracy) 3.1 0.9 1 3 3 4 4
Scenario Evaluation (Up-to-date) 3.6 0.7 3 3 3.5 4 5
Scenario Evaluation (Inclusion) 4.1 0.32 4 4 4 4 5
Educational Effectiveness (Level) 4.1 0.32 4 4 4 4 5
Educational Effectiveness (Objectives) 3.9 0.32 3 4 4 4 4
Educational Effectiveness (Thinking) 2.7 0.48 2 2.3 3 3 3
Realism and Engagement (Setting) 4.1 0.32 4 4 4 4 5
Realism and Engagement (Interest) 3.9 0.57 3 4 4 4 5
Realism and Engagement (Ethics) 3.1 0.32 3 3 3 3 4
Utility as a Teaching Tool (Value) 3.8 0.42 3 4 4 4 4
Utility as a Teaching Tool (Basis) 4 0 4 4 4 4 4
Utility as a Teaching Tool (Improvement) 3.9 0.47 3 4 4 4 5
Overall Assessment 3.9 0.32 3 4 4 4 5
Recommendation 3.8 0.63 3 3.25 4 4 5

18. Results - User Satisfaction
Platform
Preference
Inconclusive: An
even split between
ChatGPT and
Copilot.
Scenario
Evaluation
Strong
Foundations
Room for
Refinement on
Evidence
Educational
Effectiveness
Appropriate Level:
Objective-
Centered
Critical Thinking
Potential
Realism and
Engagement
Authenticity
Interest Factor
Ethical Dimension
Utility as a
Teaching Tool
Valuable Asset:
Facilitators of
Learning:

19. Qualitative Feedback
Expert Review Panel
Evidence-Based
Medicine
• Clearly cite specific
guidelines and
research studies
alongside diagnoses,
investigations, and
treatments.
Depth and Complexity
• Provide more detailed
patient history and
exam findings.
• Increase complexity to
challenge critical
thinking (e.g.,
introduce broader
differentials, risk
factors).
• Include more nuanced
treatment plans,
discussing dosage,
alternatives, and
rationale.
Realism and Patient-
Centeredness
• Use authentic patient
language to mirror
clinical encounters.
• Incorporate
biopsychosocial factors
influencing diagnosis
and management.
• Emphasize patient
education, self-
management, and
safety.

20. Implications for Medical Education
Iincorporating Generative AI
tools
• Medical education teaching practice
• Competencies for faculty development
Medical educators collaboration
with AI developers
Productivity & Efficiency for
Medical Educators

21. Future Research
Impact of Gen AI
among medical
educators
Quality of
Generative AI
outputs
Impact of
outputs on
learners
Acceptance of AI
tools

22. Conclusion
ChatGPT
provides a structured,
comprehensive
management outline
adhering to clinical
guidelines, ideal for
foundational learning.
suited to learners needing
clear, systematic clinical
reasoning and foundational
knowledge
CoPilot
practical insights with
narrative details,
emphasising holistic patient
care and real-world
application.
learners favouring an
application-oriented, story-
like format for engagement
and retention.
Both AI
tools
are valuable in medical
education, each enhancing
different aspects of learning
and teaching.
alignment with learning
goals and continual
assessment to stay relevant

23. References
• Bate, E., Hommes, J., Duvivier, R., & Taylor, D. C. M. (2013). Problem-based learning (PBL): Getting the most out of
your students - Their roles and responsibilities: AMEE Guide No. 84. Medical Teacher.
https://doi.org/10.3109/0142159X.2014.848269
• Cannon-Bowers, J. A. (2008). Recent advances in scenario-based training for medical education. Current Opinion in
Anaesthesiology, 21(6), 784–789. Crossref. https://doi.org/10.1097/aco.0b013e3283184435
• DAVIS, M. H., & HARDEN, R. M. (1999). AMEE Medical Education Guide No. 15: Problem-based learning: a practical
guide. Medical Teacher, 21(2), 130–140. https://doi.org/10.1080/01421599979743
• Kneebone, R., Kidd, J., Nestel, D., Asvall, S., Paraskeva, P., & Darzi, A. (2002). An innovative model for teaching and
learning clinical procedures. Medical Education, 36(7), 628–634. https://doi.org/10.1046/j.1365-
2923.2002.01261.x
• Preiksaitis, C., & Rose, C. (2023). Opportunities, Challenges, and Future Directions of Generative Artificial
Intelligence in Medical Education: Scoping Review. JMIR Medical Education, 9, e48785.
• Topaz, M., Peltonen, L.-M., Michalowski, M., Stiglic, G., Ronquillo, C., Pruinelli, L., Song, J., O, ’Connor Siobhan,
Miyagawa, S., & Fukahori, H. (2024). The ChatGPT Effect: Nursing Education and Generative Artificial Intelligence.
Journal of Nursing Education, 0(0), 1–4. https://doi.org/10.3928/01484834-20240126-01
• Zhao, W., He, L., Deng, W., Zhu, J., Su, A., & Zhang, Y. (2020). The effectiveness of the combined problem-based
learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease.
BMC Medical Education, 20(1), 381. https://doi.org/10.1186/s12909-020-02306-y

24. Contact Information
vaikunthan@gmail.com