Acceso usuarios
Ricardo Xopan Suárez García, Quetzal Chavez Castañeda, Rodrigo Orrico Pérez, Sebastián Valencia Marin, Ari Evelyn Castañeda Ramírez, Efrén Quiñones Lara, Claudio Adrián Ramos Cortés, Areli Marlene Gaytán Gómez, Jonathan Cortés Rodríguez, Jazel Jarquín Ramírez, Nallely Guadalupe Aguilar Marchand, Graciela Valdés Hernández, Tomás Eduardo Campos Martínez, Alonso Vilches Flores, Sonia Leon Cabrera, Adolfo René Méndez Cruz, Brenda Ofelia Jay Jímenez, Héctor Iván Saldívar Cerón
DIALOGUE (DIagnostic AI Learning through Objective Guided User Experience) is a generative artificial intelligence (GenAI)-based training program designed to enhance diagnostic communication skills in medical students. In this single-arm pre–post study, we evaluated whether DIALOGUE could improve students’ ability to disclose a type 2 diabetes mellitus (T2DM) diagnosis with clarity, structure, and empathy. Thirty clinical-phase students completed two pre-test virtual encounters with an AI-simulated patient (ChatGPT, GPT-4o), scored by blinded raters using an eight-domain rubric. Participants then engaged in ten asynchronous GenAI scenarios with automated natural-language feedback. Seven days later, they completed two post-test consultations with human standardized patients, again evaluated with the same rubric. Mean total performance increased by 36.7 points (95% CI: 31.4–42.1; p < 0.001), and the proportion of high-performing students rose from 0% to 70%. Gains were significant across all domains, most notably in opening the encounter, closure, and diabetes specific explanation. Multiple regression showed that lower baseline empathy (β = −0.41, p = 0.005) and higher digital self-efficacy (β = 0.35, p = 0.016) independently predicted greater improvement; gender had only a marginal effect. Cluster analysis revealed three learner profiles, with the highest-gain group characterized by low empathy and high digital self-efficacy. Inter-rater reliability was excellent (ICC ≈ 0.90). These findings provide empirical evidence that GenAI-mediated training can meaningfully enhance diagnostic communication and may serve as a scalable, individualized adjunct to conventional medical education.
