title: A natural language intelligent tutoring system for training pathologists: implementation and evaluation.
abstract: BACKGROUND
  We developed and evaluated a Natural Language Interface (NLI) for an Intelligent Tutoring System (ITS) in Diagnostic Pathology. The system teaches residents to examine pathologic slides and write accurate pathology reports while providing immediate feedback on errors they make in their slide review and diagnostic reports. Residents can ask for help at any point in the case, and will receive context-specific feedback.
  
  
  OBJECTIVE
  We evaluated (1) the performance of our natural language system, (2) the effect of the system on learning (3) the effect of feedback timing on learning gains and (4) the effect of ReportTutor on performance to self-assessment correlations.
  
  
  METHODS
  The study uses a crossover 2 x 2 factorial design. We recruited 20 subjects from 4 academic programs. Subjects were randomly assigned to one of the four conditions--two conditions for the immediate interface, and two for the delayed interface. An expert dermatopathologist created a reference standard and 2 board certified AP/CP pathology fellows manually coded the residents' assessment reports. Subjects were given the opportunity to self grade their performance and we used a survey to determine student response to both interfaces.
  
  
  RESULTS
  Our results show a highly significant improvement in report writing after one tutoring session with 4-fold increase in the learning gains with both interfaces but no effect of feedback timing on performance gains. Residents who used the immediate feedback interface first experienced a feature learning gain that is correlated with the number of cases they viewed. There was no correlation between performance and self-assessment in either condition.
authors.affiliation: Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, USA.
authors.forename: Gilan M
authors.initials: GM
authors.lastname: El Saadawi
authors.forename: Eugene
authors.initials: E
authors.lastname: Tseytlin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Legowski
authors.forename: Drazen
authors.initials: D
authors.lastname: Jukic
authors.forename: Melissa
authors.initials: M
authors.lastname: Castine
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fine
authors.forename: Robert
authors.initials: R
authors.lastname: Gormley
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Crowley
mesh_terms: D003194:Computer-Assisted Instruction / Q000379:methods* / Q000592:standards; D030141:Feedback, Psychological; D006801:Humans; D007396:Internship and Residency; D017145:Models, Educational; D009323:Natural Language Processing; D010336:Pathology / Q000193:education*; D018794:Problem-Based Learning / Q000379:methods; D015397:Program Evaluation; D012647:Self-Assessment; D014584:User-Computer Interface; D014956:Writing / Q000592:standards