Transforming education: tackling the two sigma problem with AI in journal clubs - a proof of concept

Journal clubs are integral to continuing medical education, promoting critical thinking and evidence-based learning. However, inconsistent engagement, reliance on faculty expertise, and the complexity of research articles can limit their effectiveness. Generative Artificial Intelligence (Gen AI), particularly Large Language Models (LLMs) offers a potential solution, but general-purpose LLMs may generate inaccurate responses ("hallucinations"). Retrieval-Augmented Generation (RAG) mitigates this by integrating AI-generated content with curated knowledge sources, ensuring more accurate and contextually relevant responses. This study explores the development and preliminary evaluation of a RAG-enhanced LLM to support journal club discussions.

A specialized LLM was deployed using Microsoft Azure's GPT-4o. A vector database was created by embedding journal club articles using text-embedding-ada-002 (Version 2) for efficient information retrieval. A dedicated website provided user-friendly access. The study followed a design-based research (DBR) approach, engaging residents and faculty who interacted with the LLM before and during journal club sessions. Data collection included focus group discussions (FGDs) and questionnaires assessing engagement, usability, and impact.

The study involved a total of 13 residents and three faculty members as participants. 50% of residents reported a positive experience, while the rest had a neutral response, citing both advantages and limitations. The LLM improved article summarization, query responses, and engagement as reported by residents. Moreover, the faculty observed enhanced discussion quality and preparation whereas overall challenges included the need for precise prompts and occasional misleading responses.

The study highlights the potential of a RAG-enhanced LLM to improve journal club engagement and learning. Future advancements in AI and open-source models may enhance accessibility, warranting further research.