Better than real-life clinical rotations? How one university is using ChatGPT to fill the missing pieces in pharmacist training

Can’t make the trek to attend a clinical course? For students enrolled in the management of oral anticoagulation therapy (MOAT) certificate program at the University of Waterloo in Waterloo, Ont., taking the course online may be just as good as in-person clinical rotations.That’s because the program has a particularly knowledge-rich teaching assistant: the artificial intelligence chatbot application known as ChatGPT.“The first four years we did this course using IBM’s Watson (data analytics processor), which was good but not quite where I wanted it to be,” explained Jeff Nagge, clinical associate professor at the University of Waterloo’s school of pharmacy and co-designer of the program, which is offered as a continuing professional development course and as an elective for third-year pharmacy students. “Now we’ve been using ChatGPT for the past year and that’s where I’m really excited.”The program uses AI to create clinic simulations that mimic real-life interactions with patients, and that ensure students are exposed to an extensive range of potential scenarios in warfarin therapy management. By comparison, trainees in real-life clinical settings are typically limited to what's presented by the patients who come to the clinic.The same technology and approach are applied to quizzes to make them feel less like tests and more like clonical debriefs. Because of ChatGPT’s ability to process and deliver information using natural language, it doesn’t take long for students to forget they’re having a conversation with a computer and not actual humans, said Nagge, who delivered a presentation on the program during the Ontario Pharmacists Association's RxTalks conference, held earlier this year in Toronto.Read: Artificial intelligence in retail pharmacy: the impact and potential of AIOne particular advantage of the program is its accessibility to students who can’t come to the university’s campuses. Many pharmacists in Nova Scotia, for example, have taken the program.“They have the highest-quality warfarin management in a primary care setting ever reported in Canada,” said Nagge. “A big factor for that is that they’re doing point-of-care INR (international normalized ratio) testing—it’s an accessible place in the pharmacy. But I would also say that a portion of their success is due to the fact they got experiential training to do this and it’s almost like they had a mini clinical rotation in anticoagulation.”When Nagge first started offering anticoagulation clinic courses in 2006, he designed a two-part program that was self-guided learning in the first part and onsite training in the second part. At the time Nagge was convinced that face-to-face, experiential learning was the best model for this type of training.Read: ChatGPT is mostly wrong in answering drug questions, study showsThe strategic integration of generative AI into clinical simulation has been a game-changer. As of the end of January, about 60 pharmacists had completed the ChatGPT-powered course.Nagge said he’s looking at creating similar courses for other topics, for pharmacists and other healthcare providers such as nurses. Hypertension is one area that looks particularly promising.“Hypertension management is almost pretty much ubiquitous in pharmacy practice, and the opportunities to manage people with hypertension are increasing,” he said. “The big thing with pharmacists, though, is they often don’t have enough trust in their skills and knowledge. I think the missing piece is clinical training and with generative AI we're providing a way to deliver that training virtually and in a way that is really experiential.”Read: 'It happens frequently': What you need to know about the abuse of pharmacists by patients

Better than real-life clinical rotations? How one university is using ChatGPT to fill the missing pieces in pharmacist training

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