Journal of Educational Evaluation for Health Professions

Editorial

Presidential address 2025: expansion of computer-based testing from 12 to 27 health professions by 2027 and adoption of a large language model for item generation: Hyunjoo Pai; J Educ Eval Health Prof. 2025;22:7. Published online January 20, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.7 [Epub ahead of print]

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Research articles

Empirical effect of the Dr Lee Jong-wook Fellowship Program to empower sustainable change for the health workforce in Tanzania: a mixed-methods study: Masoud Dauda, Swabaha Aidarus Yusuph, Harouni Yasini, Issa Mmbaga, Perpetua Mwambinngu, Hansol Park, Gyeongbae Seo, Kyoung Kyun Oh; J Educ Eval Health Prof. 2025;22:6. Published online January 20, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.6 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
This study evaluated the Dr Lee Jong-wook Fellowship Program’s impact on Tanzania’s health workforce, focusing on relevance, effectiveness, efficiency, impact, and sustainability in addressing healthcare gaps.
Methods
A mixed-methods research design was employed. Data were collected from 97 out of 140 alumni through an online survey, 35 in-depth interviews, and one focus group discussion. The study was conducted from November to December 2023 and included alumni from 2009 to 2022. Measurement instruments included structured questionnaires for quantitative data and semi-structured guides for qualitative data. Quantitative analysis involved descriptive and inferential statistics (Spearman’s rank correlation, non-parametric tests) using Python ver. 3.11.0 and Stata ver. 14.0. Thematic analysis was employed to analyze qualitative data using NVivo ver. 12.0.
Results
Findings indicated high relevance (mean=91.6, standard deviation [SD]=8.6), effectiveness (mean=86.1, SD=11.2), efficiency (mean=82.7, SD=10.2), and impact (mean=87.7, SD=9.9), with improved skills, confidence, and institutional service quality. However, sustainability had a lower score (mean=58.0, SD=11.1), reflecting challenges in follow-up support and resource allocation. Effectiveness strongly correlated with impact (ρ=0.746, P<0.001). The qualitative findings revealed that participants valued tailored training but highlighted barriers, such as language challenges and insufficient practical components. Alumni-led initiatives contributed to knowledge sharing, but limited resources constrained sustainability.
Conclusion
The Fellowship Program enhanced Tanzania’s health workforce capacity, but it requires localized curricula and strengthened alumni networks for sustainability. These findings provide actionable insights for improving similar programs globally, confirming the hypothesis that tailored training positively influences workforce and institutional outcomes.

Reliability and construct validation of the Blended Learning Usability Evaluation–Questionnaire with interprofessional clinicians in Canada : a methodological study: Anish Kumar Arora, Jeff Myers, Tavis Apramian, Kulamakan Kulasegaram, Daryl Bainbridge, Hsien Seow; J Educ Eval Health Prof. 2025;22:5. Published online January 16, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.5 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
To generate Cronbach’s alpha and further mixed methods construct validity evidence for the Blended Learning Usability Evaluation–Questionnaire (BLUE-Q).
Methods
Forty interprofessional clinicians completed the BLUE-Q after finishing a 3-month long blended learning professional development program in Ontario, Canada. Reliability was assessed with Cronbach’s α for each of the 3 sections of the BLUE-Q and for all quantitative items together. Construct validity was evaluated through the Grand-Guillaume-Perrenoud et al. framework, which consists of 3 elements: congruence, convergence, and credibility. To compare quantitative and qualitative results, descriptive statistics, including means and standard deviations for each Likert scale item of the BLUE-Q were calculated.
Results
Cronbach’s α was 0.95 for the pedagogical usability section, 0.85 for the synchronous modality section, 0.93 for the asynchronous modality section, and 0.96 for all quantitative items together. Mean ratings (with standard deviations) were 4.77 (0.506) for pedagogy, 4.64 (0.654) for synchronous learning, and 4.75 (0.536) for asynchronous learning. Of the 239 qualitative comments received, 178 were identified as substantive, of which 88% were considered congruent and 79% were considered convergent with the high means. Among all congruent responses, 69% were considered confirming statements and 31% were considered clarifying statements, suggesting appropriate credibility. Analysis of the clarifying statements assisted in identifying 5 categories of suggestions for program improvement.
Conclusion
The BLUE-Q demonstrates high reliability and appropriate construct validity in the context of a blended learning program with interprofessional clinicians, making it a valuable tool for comprehensive program evaluation, quality improvement, and evaluative research in health professions education.

Educational/Faculty development material

The role of large language models in the peer-review process: opportunities and challenges for medical journal reviewers and editors: Jisoo Lee, Jieun Lee, Jeong-Ju Yoo; J Educ Eval Health Prof. 2025;22:4. Published online January 16, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.4 [Epub ahead of print]

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Abstract PDF Supplementary Material: The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.

Research articles

Empathy and tolerance of ambiguity in medical students and doctors participating in art-based observational training at the Rijksmuseum in Amsterdam, Netherlands: a before-and-after study: Stella Anna Bult, Thomas van Gulik; J Educ Eval Health Prof. 2025;22:3. Published online January 14, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.3 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
This research presents an experimental study using validated questionnaires to quantitatively assess the outcomes of art-based observational training in medical students, residents, and specialists. The study tested the hypothesis that art-based observational training would lead to measurable effects on judgement skills (tolerance of ambiguity) and empathy in medical students and doctors.
Methods
An experimental cohort study with pre- and post-intervention assessments was conducted using validated questionnaires and qualitative evaluation forms to examine the outcomes of art-based observational training in medical students and doctors. Between December 2023 and June 2024, 15 art courses were conducted in the Rijksmuseum in Amsterdam. Participants were assessed on empathy using the Jefferson Scale of Empathy (JSE) and tolerance of ambiguity using the Tolerance of Ambiguity in Medical Students and Doctors scale (TAMSAD).
Results
In total, 91 participants were included; 29 participants completed the JSE and 62 completed the TAMSAD scales. The results showed statistically significant post-test increases for mean JSE and TAMSAD scores (3.71 points for the JSE, ranging from 20 to 140, and 1.86 points for the TAMSAD, ranging from 0 to 100). The qualitative findings were predominantly positive.
Conclusion
The results suggest that incorporating art-based observational training in medical education improves empathy and tolerance of ambiguity. This study highlights the importance of art-based observational training in medical education in the professional development of medical students and doctors.

Pharmacy students’ perspective on remote flipped classrooms in Malaysia: a qualitative study: Wei Jin Wong, Shaun Wen Huey Lee, Ronald Fook Seng Lee; J Educ Eval Health Prof. 2025;22:2. Published online January 14, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.2 [Epub ahead of print]

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Abstract PDF: Purpose
This study aimed to explore pharmacy students’ perceptions of remote flipped classrooms in Malaysia, focusing on their learning experiences and identifying areas for potential improvement to inform future educational strategies.
Methods
A qualitative approach was employed, utilizing inductive thematic analysis. Twenty Bachelor of Pharmacy students (18 women, 2 men; age range, 19–24 years) from Monash University participated in 8 focus group discussions over 2 rounds during the coronavirus disease 2019 pandemic (2020–2021). Participants were recruited via convenience sampling. The focus group discussions, led by experienced academics, were conducted in English via Zoom, recorded, and transcribed for analysis using NVivo. Themes were identified through emergent coding and iterative discussions to ensure thematic saturation.
Results
Five major themes emerged: flexibility, communication, technological challenges, skill-based learning challenges, and time-based effects. Students appreciated the flexibility of accessing and reviewing pre-class materials at their convenience. Increased engagement through anonymous question submission was noted, yet communication difficulties and lack of non-verbal cues in remote workshops were significant drawbacks. Technological issues, such as internet connectivity problems, hindered learning, especially during assessments. Skill-based learning faced challenges in remote settings, including lab activities and clinical examinations. Additionally, prolonged remote learning led to feelings of isolation, fatigue, and a desire to return to in-person interactions.
Conclusion
Remote flipped classrooms offer flexibility and engagement benefits but present notable challenges related to communication, technology, and skill-based learning. To improve remote education, institutions should integrate robust technological support, enhance communication strategies, and incorporate virtual simulations for practical skills. Balancing asynchronous and synchronous methods while addressing academic success and socioemotional wellness is essential for effective remote learning environments.

Editorial

Halted medical education and medical residents’ training in Korea, journal metrics, and appreciation to reviewers and volunteers: Sun Huh; J Educ Eval Health Prof. 2025;22:1. Published online January 13, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.1 [Epub ahead of print]

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Corrigendum

Notice of Retraction and Replacement: Insights into undergraduate medical student selection tools: a systematic review and meta-analysis: Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf; J Educ Eval Health Prof. 2024;21:41. Published online December 31, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.41; Corrects: J Educ Eval Health Prof 2024;21(0):22

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PDF Supplementary Material

Correspondence

Item difficulty index, discrimination index, and reliability of the 26 health professions licensing examinations in 2023, Korea: a psychometric study: Yoon Hee Kim, Bo Hyun Kim, Joonki Kim, Bokyoung Jung, Sangyoung Bae; J Educ Eval Health Prof. 2024;21:40. Published online December 11, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.40

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Research article

Inter-rater reliability and content validity of the measurement tool for portfolio assessments used in the Introduction to Clinical Medicine course at Ewha Womans University College of Medicine: a methodological study: Dong-Mi Yoo, Jae Jin Han; J Educ Eval Health Prof. 2024;21:39. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.39

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Abstract PDF Supplementary Material: Purpose
This study aimed to examine the reliability and validity of a measurement tool for portfolio assessments in medical education. Specifically, it investigated scoring consistency among raters and assessment criteria appropriateness according to an expert panel.
Methods
A cross-sectional observational study was conducted from September to December 2018 for the Introduction to Clinical Medicine course at the Ewha Womans University College of Medicine. Data were collected for 5 randomly selected portfolios scored by a gold-standard rater and 6 trained raters. An expert panel assessed the validity of 12 assessment items using the content validity index (CVI). Statistical analysis included Pearson correlation coefficients for rater alignment, the intraclass correlation coefficient (ICC) for inter-rater reliability, and the CVI for item-level validity.
Results
Rater 1 had the highest Pearson correlation (0.8916) with the gold-standard rater, while Rater 5 had the lowest (0.4203). The ICC for all raters was 0.3821, improving to 0.4415 after excluding Raters 1 and 5, indicating a 15.6% reliability increase. All assessment items met the CVI threshold of ≥0.75, with some achieving a perfect score (CVI=1.0). However, items like “sources” and “level and degree of performance” showed lower validity (CVI=0.72).
Conclusion
The present measurement tool for portfolio assessments demonstrated moderate reliability and strong validity, supporting its use as a credible tool. For a more reliable portfolio assessment, more faculty training is needed.

Case Study

Feasibility of utilizing functional near-infrared spectroscopy to measure the cognitive load of paramedicine students undertaking high-acuity clinical simulations in Australia: a case study: Jason Betson, Erich Christian Fein, David Long, Peter Horrocks; J Educ Eval Health Prof. 2024;21:38. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.38

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Abstract PDF Supplementary Material: Purpose
Paramedicine education often uses high-fidelity simulations that mimic real-life emergencies. These experiences can trigger stress responses characterized by physiological changes, including alterations in cerebral blood flow and oxygenation. Functional near-infrared spectroscopy (fNIRS) is emerging as a promising tool for assessing cognitive stress in educational settings.
Methods
Eight final-year undergraduate paramedicine students completed 2 high-acuity scenarios 7 days apart. Real-time continuous recording of cerebral blood flow and oxygenation levels in the prefrontal cortex was undertaken via fNIRS as a means of assessing neural activity during stressful scenarios.
Results
fNIRS accurately determined periods of increased cerebral oxygenation when participants were undertaking highly technical skills or making significant clinical decisions.
Conclusion
fNIRS holds potential for objectively measuring the cognitive load in undergraduate paramedicine students. By providing real-time insights into neurophysiological responses, fNIRS may enhance training outcomes in paramedicine programs and improve student well-being (Australian New Zealand Clinical Trials Registry: ACTRN12623001214628).

Research article

Validation of the 21st Century Skills Assessment Scale for public health students in Thailand: a methodological study: Suphawadee Panthumas, Kaung Zaw, Wirin Kittipichai; J Educ Eval Health Prof. 2024;21:37. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.37

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Abstract PDF Supplementary Material: Purpose
This study aimed to develop and validate the 21st Century Skills Assessment Scale (21CSAS) for Thai public health (PH) undergraduate students using the Partnership for 21st Century Skills framework.
Methods
A cross-sectional survey was conducted among 727 first- to fourth-year PH undergraduate students from 4 autonomous universities in Thailand. Data were collected using self-administered questionnaires between January and March 2023. Exploratory factor analysis (EFA) was used to explore the underlying dimensions of 21CSAS, while confirmatory factor analysis (CFA) was conducted to test the hypothesized factor structure using Mplus software (Muthén & Muthén). Reliability and item discrimination were assessed using Cronbach’s α and the corrected item-total correlation, respectively.
Results
EFA performed on a dataset of 300 students revealed a 20-item scale with a 6-factor structure: (1) creativity and innovation; (2) critical thinking and problem-solving; (3) information, media, and technology; (4) communication and collaboration; (5) initiative and self-direction; and (6) social and cross-cultural skills. The rotated eigenvalues ranged from 2.12 to 1.73. CFA performed on another dataset of 427 students confirmed a good model fit (χ2/degrees of freedom=2.67, comparative fit index=0.93, Tucker-Lewis index=0.91, root mean square error of approximation=0.06, standardized root mean square residual=0.06), explaining 34%–71% of variance in the items. Item loadings ranged from 0.58 to 0.84. The 21CSAS had a Cronbach’s α of 0.92.
Conclusion
The 21CSAS proved be a valid and reliable tool for assessing 21st century skills among Thai PH undergraduate students. These findings provide insights for educational system to inform policy, practice, and research regarding 21st-century skills among undergraduate students.

History article

History of the medical licensure system in Korea from the late 1800s to 1992: Sang-Ik Hwang; J Educ Eval Health Prof. 2024;21:36. Published online December 9, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.36

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Abstract PDF Supplementary Material: The introduction of modern Western medicine in the late 19th century, notably through vaccination initiatives, marked the beginning of governmental involvement in medical licensure, with the licensing of doctors who performed vaccinations. The establishment of the national medical school “Euihakkyo” in 1899 further formalized medical education and licensure, granting graduates the privilege to practice medicine without additional examinations. The enactment of the Regulations on Doctors in 1900 by the Joseon government aimed to define doctor qualifications, including modern and traditional practitioners, comprehensively. However, resistance from the traditional medical community hindered its full implementation. During the Japanese colonial occupation of the Korean Peninsula from 1910 to 1945, the medical licensure system was controlled by colonial authorities, leading to the marginalization of traditional Korean medicine and the imposition of imperial hierarchical structures. Following liberation in 1945 from Japanese colonial rule, the Korean government undertook significant reforms, culminating in the National Medical Law, which was enacted in 1951. This law redefined doctor qualifications and reinstated the status of traditional Korean medicine. The introduction of national examinations for physicians increased state involvement in ensuring medical competence. The privatization of the Korean Medical Licensing Examination led to the establishment of the Korea Health Personnel Licensing Examination Institute in 1992, which assumed responsibility for administering licensing examinations for all healthcare workers. This shift reflected a move towards specialized management of professional standards. The evolution of the medical licensure system in Korea illustrates a dynamic process shaped by the historical context, balancing the protection of public health with the rights of medical practitioners.

Erratum

Erratum: Impact of a change from A–F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis: J Educ Eval Health Prof. 2024;21:35. Published online November 26, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.35; Corrects: J Educ Eval Health Prof 2024;21(0):20

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Research article

Effectiveness of ChatGPT-4o in developing continuing professional development plans for graduate radiographers: a descriptive study: Minh Chau, Elio Stefan Arruzza, Kelly Spuur; J Educ Eval Health Prof. 2024;21:34. Published online November 18, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.34

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Abstract PDF Supplementary Material: Purpose
This study evaluates the use of ChatGPT-4o in creating tailored continuing professional development (CPD) plans for radiography students, addressing the challenge of aligning CPD with Medical Radiation Practice Board of Australia (MRPBA) requirements. We hypothesized that ChatGPT-4o could support students in CPD planning while meeting regulatory standards.
Methods
A descriptive, experimental design was used to generate 3 unique CPD plans using ChatGPT-4o, each tailored to hypothetical graduate radiographers in varied clinical settings. Each plan followed MRPBA guidelines, focusing on computed tomography specialization by the second year. Three MRPBA-registered academics assessed the plans using criteria of appropriateness, timeliness, relevance, reflection, and completeness from October 2024 to November 2024. Ratings underwent analysis using the Friedman test and intraclass correlation coefficient (ICC) to measure consistency among evaluators.
Results
ChatGPT-4o generated CPD plans generally adhered to regulatory standards across scenarios. The Friedman test indicated no significant differences among raters (P=0.420, 0.761, and 0.807 for each scenario), suggesting consistent scores within scenarios. However, ICC values were low (–0.96, 0.41, and 0.058 for scenarios 1, 2, and 3), revealing variability among raters, particularly in timeliness and completeness criteria, suggesting limitations in the ChatGPT-4o’s ability to address individualized and context-specific needs.
Conclusion
ChatGPT-4o demonstrates the potential to ease the cognitive demands of CPD planning, offering structured support in CPD development. However, human oversight remains essential to ensure plans are contextually relevant and deeply reflective. Future research should focus on enhancing artificial intelligence’s personalization for CPD evaluation, highlighting ChatGPT-4o’s potential and limitations as a tool in professional education.

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