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Using artificial intelligence to create diverse and inclusive medical case vignettes for education

Abstract Aims: Medical case vignettes play a crucial role in medical education, yet they often fail to authentically represent diverse patients. Moreover, these vignettes tend to oversimplify the complex relationship between patient characteristics and medical conditions, leading to biased and potentially harmful perspectives among students. Displaying aspects of patient diversity, such as ethnicity, in written cases proves challenging. Additionally, creating these cases places a significant burden on teachers in terms of labour and time. Our objective is to explore the potential of artificial intelligence (AI)-assisted computer-generated clinical cases to expedite case creation and enhance diversity, along with AI-generated patient photographs for more lifelike portrayal. Methods: In this study, we employed ChatGPT (OpenAI, GPT 3.5) to develop diverse and inclusive medical case vignettes. We evaluated various approaches and identified a set of eight consecutive prompts that can be readily customized to accommodate local contexts and specific assignments. To enhance visual representation, we utilized Adobe Firefly beta for image generation. Results: Using the described prompts, we consistently generated cases for various assignments, producing sets of 30 cases at a time. We ensured the inclusion of mandatory checks and formatting, completing the process within approximately 60 min per set. Conclusions: Our approach significantly accelerated case creation and improved diversity, although prioritizing maximum diversity compromised representativeness to some extent. While the optimized prompts are easily reusable, the process itself demands computer skills not all educators possess. To address this, we aim to share all created patients as open educational resources, empowering educators to create cases independently.

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Stakeholder Engagement for a Local Energy Community in Energy Transition– Case of De Heuvel/Amstelwijk

The goal of a local energy community (LEC) is to create a more sustainable, resilient, and efficient energy system by reducing dependence on centralized power sources and enabling greater participation and control by local communities and individuals. LEC requires transformations in local energy systems, and strongly depends on the preferences and actions of the local actors involved. The necessity for extensive stakeholder involvement adds complexity to the energy transition, posing a significant challenge for all involved parties. The municipality of Leidschendam-Voorburg has committed to the national decision for energy transition. It has taken a strategic approach by proceeding De Heuvel/Amstelwijk as the pioneer in this initiative, leading the way for other neighborhoods to follow. It is crucial to devise strategies that effectively facilitate stakeholder engagement. To this end, a thorough stakeholder analysis is needed. Such an analysis can focus on the identification of key stakeholders, their interests, their influence, and their behavioral characteristics in relation to the energy transition. Additionally, it's crucial to uncover the challenges encountered by these stakeholders and finally develop appropriate strategies to address them hence enhance their engagement. This thesis begins with an introduction to the research background, including a presentation of the case study and a statement of the problem identified in the field, followed by the research questions underpinning the study. A thorough literature review ensues, providing a robust synthesis of existing research relating to stakeholder engagement in LECs, with a view to expediting energy transitions. The literature review not only forms the foundation for the research methods adopted in this study but also promotes in the construction of the conceptual model. Subsequent to the literature review, the research method is detailed. The filed research is conducted in five steps: Step 1 - identification of stakeholders, Step 2 - prioritization of stakeholders, Step 3 - interviewing, Step 4 - data analysis, including stakeholder profiling with mapping and addressing challenges, and finally, Step 5 - proposal of strategies for stakeholder engagement enhancement based on the expected and current levels of stakeholders engagement. This research collects necessary information to understand the profiles of stakeholders in De Heuvel/Amstelwijk, tackle challenges faced by different stakeholders, propose strategies to increase stakeholders engagement. It not only aims to enrich the depth of theoretical knowledge on the subject matter but also strives to aid in the development of a localized energy strategy that is optimally suited for the De Heuvel/Amstelwijk neighborhood as good example for other neighborhoods.

Principals and Suggestions for Sustainable Materials Management within Facility Management

Background and aim ʹ Many countries signed the Paris Agreement to mitigate global average temperature rise. In this context, Dutch government decided to realize a reduction of 50% using resources and raw materials in 2030. This paper explores how practice-based research into facility operations can contribute to this aim. Methods / Methodology ʹ Practice-based research which includes direct observations, desk research, and participatory action research. Results ʹ This explorative research presents principles and suggestions for facility managers and procurement managers on how they can embed sustainable materials management in the organisation and how to take control of waste. The proposed suggestions are derived from practice-based research and presented as topics of attention for facility professionals. Originality ʹ Within education of Dutch universities of applied sciences and daily professional facility practices, the phenomenon of materials management is underexposed. To contribute to the national and international climate objectives, (future) facility professionals need better support to reduce waste. Bachelor students were involved throughout this research. This approach gave refreshing insights into waste at the end of the supply chain (control separation units) that can improve informed decisionmaking at the beginning of the supply chain. Practical or social implications ʹ Facility management professionals have an important role to play in the mitigation of global average temperature rise, because of their leading role in procurement, service operations, and materials management. However, they struggle to find sustainable solutions. This paper seeks to inspire professionals with interventions that have proven effectiveness on the reduction of waste. Type of paper ʹ Short research paper.

The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.

Concerns of Owner‐Occupants in Realising the Aims of Energy Transition

Although there is an array of technical solutions available for retrofitting the building stock, the uptake of these by owner‐occupants in home improvement activities is lagging. Energy performance improvement is not included in maintenance, redecoration, and/or upgrading activities on a scale necessary to achieve the CO2 reduction aimed for in the built environment. Owner‐occupants usually adapt their homes in response to everyday concerns, such as having enough space available, increasing comfort levels, or adjusting arrangements to future‐proof their living conditions. Home energy improvements should be offered accordingly. Retrofit providers typically offer energy efficiency strategies and/or options for renewable energy generation only and tend to gloss over home comfort and homemaking as key considerations in decision‐making for home energy improvement. In fact, retrofit providers struggle with the tension between customisation requirements from private homeowners and demand aggregation to streamline their supply chains and upscale their retrofit projects. Customer satisfaction is studied in three different Dutch approaches to retrofit owner‐occupied dwellings to increase energy efficiency. For the analysis, a customer satisfaction framework is used that makes a distinction between satisfiers, dissatisfiers, criticals, and neutrals. This framework makes it possible to identify and structure different relevant factors from the perspective of owner‐occupants, allows visualising gaps with the professional perspective, and can assist to improve current propositions.