Evolution of large language models and their applications in clinical medical education_West China Medical Journal

Authors：

WANG Yanan ^1,2,3 , JIANG Zhixuan ⁴ , HE Haoyang ^1,2,3 , LIU Ming ^1,2 ,  WU Simiao ^1,2,3

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Centre of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Institute of Brain Science and Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China;

Corresponding?author：

WU Simiao, Email: simiao.wu@hotmail.com

Keywords：

Large language model; clinical medical education; artificial intelligence

DOI：

10.7507/1002-0179.202504061

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Large language models (LLMs), a key component of artificial intelligence (AI), represent a significant breakthrough in natural language processing. As the capabilities of LLMs continue to evolve, their potential applications and future implications in clinical medical education warrant considerable attention. This study systematically reviews the development of LLMs, explores their innovative applications within the context of current challenges in clinical medical education, and critically assesses both the advantages and limitations of their implementation. The objective is to provide a comprehensive reference for the continued integration of AI-driven LLMs into clinical medical education.

Citation： WANG Yanan, JIANG Zhixuan, HE Haoyang, LIU Ming, WU Simiao. Evolution of large language models and their applications in clinical medical education. West China Medical Journal, 2025, 40(5): 777-782. doi: 10.7507/1002-0179.202504061 Copy

1.	王隴德. “健康中國 2030”的機遇與挑戰. 科技導報, 2018, 36(22): 8-11.
2.	袁力, 張敬軍, 劉林祥, 等. 改革傳統醫學教育模式提高醫學生核心競爭力. 中華醫學教育雜志, 2015, 35(1): 15-17, 107.
3.	Raiaan MAK, Mukta MSH, Fatema K, et al. A review on large language models: architectures, applications, taxonomies, open issues and challenges. IEEE Access, 2024, 82(2): 26839-26874.
4.	Omiye JA, Gui H, Rezaei SJ, et al. Large language models in medicine: the potentials and pitfalls : a narrative review. Ann Intern Med, 2024, 177(2): 210-220.
5.	Abd-Alrazaq A, AlSaad R, Alhuwail D, et al. Large language models in medical education: opportunities, challenges, and future directions. JMIR Med Educ, 2023, 9: e48291.
6.	邢永康, 馬少平. 統計語言模型綜述. 計算機科學, 2003(9): 22-26.
7.	林奕歐, 雷航, 李曉瑜, 等. 自然語言處理中的深度學習: 方法及應用. 電子科技大學學報, 2017, 46(6): 913-919.
8.	Gao C, Yan J, Zhou S, et al. Long short-term memory-based deep recurrent neural networks for target tracking. Inform Sci, 2019, 502(1): 279-296.
9.	Xu P, Zhu X, Clifton DA. Multimodal learning with transformers: a survey. IEEE Trans Pattern Anal Mach Intell, 2023, 45(10): 12113-12132.
10.	Elnaggar A, Heinzinger M, Dallago C, et al. ProtTrans: toward understanding the language of life through self-supervised learning. IEEE Trans Pattern Anal Mach Intell, 2022, 44(10): 7112-7127.
11.	Jowsey T, Stokes-Parish J, Singleton R, et al. Medical education empowered by generative artificial intelligence large language models. Trends Mol Med, 2023, 29(12): 971-973.
12.	任福繼, 張彥如. 通用大模型演進路線. 科技導報, 2024, 42(12): 44-50.
13.	Lucas HC, Upperman JS, Robinson JR. A systematic review of large language models and their implications in medical education. Med Educ, 2024, 58(11): 1276-1285.
14.	羅姚, 談在祥. ChatGPT 對循證醫學發展的影響、挑戰及其應對. 醫學與哲學, 2024, 45(12): 16-21.
15.	商魯翔, 薛茗月, 孫華鑫, 等. ChatGPT 作為醫學教育工具的思考——以心血管內科主治醫師資格考試為例. 醫學與哲學, 2024, 45(14): 10-13.
16.	馬應卓, 王俊, 劉彤, 等. 大語言模型在護理學領域應用的范圍綜述. 護理學雜志, 2024, 39(19): 124-129.
17.	馬慧群. “ChatGPT+”時代皮膚專業規培教育面臨的危機. 中國皮膚性病學雜志, 2023, 37(8): 973-975.
18.	羅妍, 劉宇煬, 李曉瑛, 等. 面向醫學大模型的體系化人工智能框架構建與應用. 北京郵電大學學報, 2024, 47(4): 98-104.
19.	蔡睿, 葛軍, 孫哲, 等. AI 預訓練大模型發展綜述. 小型微型計算機系統, 2024, 45(10): 2327-2337.
20.	馬武仁, 弓孟春, 戴輝, 等. 以 ChatGPT 為代表的大語言模型在臨床醫學中的應用綜述. 醫學信息學雜志, 2023, 44(7): 9-17.
21.	Gan W, Ouyang J, Li H, et al. Integrating ChatGPT in orthopedic education for medical undergraduates: randomized controlled trial. J Med Internet Res, 2024, 26: e57037.
22.	Rao VM, Hla M, Moor M, et al. Multimodal generative AI for medical image interpretation. Nature, 2025, 639(8056): 888-896.
23.	Kung TH, Cheatham M, Medenilla A, et al. Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models. PLOS Digit Health, 2023, 2(2): e0000198.
24.	張麗, 張雪, 周海燕, 等. ChatGPT 在中國臨床執業醫師資格模擬考試中的表現研究. 中國繼續醫學教育, 2024, 16(15): 157-162.
25.	Wang H, Wu W, Dou Z, et al. Performance and exploration of ChatGPT in medical examination, records and education in Chinese: pave the way for medical AI. Int J Med Inform, 2023, 177: 105173.
26.	Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. Nature, 2023, 620(7972): 172-180.
27.	Toku? B, Varol G. Medical education in the era of advancing technology. Balkan Med J, 2023, 40(6): 395-399.
28.	Dunn C, Hunter J, Steffes W, et al. Artificial intelligence-derived dermatology case reports are indistinguishable from those written by humans: a single-blinded observer study. J Am Acad Dermatol, 2023, 89(2): 388-390.
29.	Lu MY, Chen B, Williamson DFK, et al. A multimodal generative AI copilot for human pathology. Nature, 2024, 634(8033): 466-473.
30.	Brügge E, Ricchizzi S, Arenbeck M, et al. Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial. BMC Med Educ, 2024, 24(1): 1391.
31.	劉大明, 李雅琦. 基于生成式大語言模型的教學設計研究. 中國科技論文在線精品論文, 2024, 17(4): 592-599.
32.	劉暉, 任曼, 寇麗圓, 等. ChatGPT 對醫學臨床實踐教學的影響與思考. 中國醫學教育技術, 2024, 38(4): 389-393, 400.
33.	劉江峰, 張冉, 王東波, 等. 追溯科學融合的歷史軌跡: AIGC 賦能交叉科學測度研究. 圖書情報工作, 2024, 68(7): 137-150.
34.	Hswen Y, Abbasi J. AI will-and should-change medical school, says Harvard’s dean for medical education. JAMA, 2023, 330(19): 1820-1823.
35.	Xu X, Chen Y, Miao J. Opportunities, challenges, and future directions of large language models, including ChatGPT in medical education: a systematic scoping review. J Educ Eval Health Prof, 2024, 21: 6.
36.	Zhou Z, Qin P, Cheng X, et al. ChatGPT in oncology diagnosis and treatment: applications, legal and ethical challenges. Curr Oncol Rep, 2025, 27(4): 336-354.
37.	Huo B, Boyle A, Marfo N, et al. Large language models for chatbot health advice studies: a systematic review. JAMA Network Open, 2025, 8(2): e2457879.
38.	Li H, Moon JT, Purkayastha S, et al. Ethics of large language models in medicine and medical research. Lancet Digit Health, 2023, 5(6): e333-e335.
39.	全筱筱, 熊文舉, 潘軍杰, 等. 基于大語言模型的數據查詢機器人在醫學領域的應用. 醫學新知, 2024, 34(9): 1057-1063.

1. 王隴德. “健康中國 2030”的機遇與挑戰. 科技導報, 2018, 36(22): 8-11.
2. 袁力, 張敬軍, 劉林祥, 等. 改革傳統醫學教育模式提高醫學生核心競爭力. 中華醫學教育雜志, 2015, 35(1): 15-17, 107.
3. Raiaan MAK, Mukta MSH, Fatema K, et al. A review on large language models: architectures, applications, taxonomies, open issues and challenges. IEEE Access, 2024, 82(2): 26839-26874.
4. Omiye JA, Gui H, Rezaei SJ, et al. Large language models in medicine: the potentials and pitfalls : a narrative review. Ann Intern Med, 2024, 177(2): 210-220.
5. Abd-Alrazaq A, AlSaad R, Alhuwail D, et al. Large language models in medical education: opportunities, challenges, and future directions. JMIR Med Educ, 2023, 9: e48291.
6. 邢永康, 馬少平. 統計語言模型綜述. 計算機科學, 2003(9): 22-26.
7. 林奕歐, 雷航, 李曉瑜, 等. 自然語言處理中的深度學習: 方法及應用. 電子科技大學學報, 2017, 46(6): 913-919.
8. Gao C, Yan J, Zhou S, et al. Long short-term memory-based deep recurrent neural networks for target tracking. Inform Sci, 2019, 502(1): 279-296.
9. Xu P, Zhu X, Clifton DA. Multimodal learning with transformers: a survey. IEEE Trans Pattern Anal Mach Intell, 2023, 45(10): 12113-12132.
10. Elnaggar A, Heinzinger M, Dallago C, et al. ProtTrans: toward understanding the language of life through self-supervised learning. IEEE Trans Pattern Anal Mach Intell, 2022, 44(10): 7112-7127.
11. Jowsey T, Stokes-Parish J, Singleton R, et al. Medical education empowered by generative artificial intelligence large language models. Trends Mol Med, 2023, 29(12): 971-973.
12. 任福繼, 張彥如. 通用大模型演進路線. 科技導報, 2024, 42(12): 44-50.
13. Lucas HC, Upperman JS, Robinson JR. A systematic review of large language models and their implications in medical education. Med Educ, 2024, 58(11): 1276-1285.
14. 羅姚, 談在祥. ChatGPT 對循證醫學發展的影響、挑戰及其應對. 醫學與哲學, 2024, 45(12): 16-21.
15. 商魯翔, 薛茗月, 孫華鑫, 等. ChatGPT 作為醫學教育工具的思考——以心血管內科主治醫師資格考試為例. 醫學與哲學, 2024, 45(14): 10-13.
16. 馬應卓, 王俊, 劉彤, 等. 大語言模型在護理學領域應用的范圍綜述. 護理學雜志, 2024, 39(19): 124-129.
17. 馬慧群. “ChatGPT+”時代皮膚專業規培教育面臨的危機. 中國皮膚性病學雜志, 2023, 37(8): 973-975.
18. 羅妍, 劉宇煬, 李曉瑛, 等. 面向醫學大模型的體系化人工智能框架構建與應用. 北京郵電大學學報, 2024, 47(4): 98-104.
19. 蔡睿, 葛軍, 孫哲, 等. AI 預訓練大模型發展綜述. 小型微型計算機系統, 2024, 45(10): 2327-2337.
20. 馬武仁, 弓孟春, 戴輝, 等. 以 ChatGPT 為代表的大語言模型在臨床醫學中的應用綜述. 醫學信息學雜志, 2023, 44(7): 9-17.
21. Gan W, Ouyang J, Li H, et al. Integrating ChatGPT in orthopedic education for medical undergraduates: randomized controlled trial. J Med Internet Res, 2024, 26: e57037.
22. Rao VM, Hla M, Moor M, et al. Multimodal generative AI for medical image interpretation. Nature, 2025, 639(8056): 888-896.
23. Kung TH, Cheatham M, Medenilla A, et al. Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models. PLOS Digit Health, 2023, 2(2): e0000198.
24. 張麗, 張雪, 周海燕, 等. ChatGPT 在中國臨床執業醫師資格模擬考試中的表現研究. 中國繼續醫學教育, 2024, 16(15): 157-162.
25. Wang H, Wu W, Dou Z, et al. Performance and exploration of ChatGPT in medical examination, records and education in Chinese: pave the way for medical AI. Int J Med Inform, 2023, 177: 105173.
26. Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. Nature, 2023, 620(7972): 172-180.
27. Toku? B, Varol G. Medical education in the era of advancing technology. Balkan Med J, 2023, 40(6): 395-399.
28. Dunn C, Hunter J, Steffes W, et al. Artificial intelligence-derived dermatology case reports are indistinguishable from those written by humans: a single-blinded observer study. J Am Acad Dermatol, 2023, 89(2): 388-390.
29. Lu MY, Chen B, Williamson DFK, et al. A multimodal generative AI copilot for human pathology. Nature, 2024, 634(8033): 466-473.
30. Brügge E, Ricchizzi S, Arenbeck M, et al. Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial. BMC Med Educ, 2024, 24(1): 1391.
31. 劉大明, 李雅琦. 基于生成式大語言模型的教學設計研究. 中國科技論文在線精品論文, 2024, 17(4): 592-599.
32. 劉暉, 任曼, 寇麗圓, 等. ChatGPT 對醫學臨床實踐教學的影響與思考. 中國醫學教育技術, 2024, 38(4): 389-393, 400.
33. 劉江峰, 張冉, 王東波, 等. 追溯科學融合的歷史軌跡: AIGC 賦能交叉科學測度研究. 圖書情報工作, 2024, 68(7): 137-150.
34. Hswen Y, Abbasi J. AI will-and should-change medical school, says Harvard’s dean for medical education. JAMA, 2023, 330(19): 1820-1823.
35. Xu X, Chen Y, Miao J. Opportunities, challenges, and future directions of large language models, including ChatGPT in medical education: a systematic scoping review. J Educ Eval Health Prof, 2024, 21: 6.
36. Zhou Z, Qin P, Cheng X, et al. ChatGPT in oncology diagnosis and treatment: applications, legal and ethical challenges. Curr Oncol Rep, 2025, 27(4): 336-354.
37. Huo B, Boyle A, Marfo N, et al. Large language models for chatbot health advice studies: a systematic review. JAMA Network Open, 2025, 8(2): e2457879.
38. Li H, Moon JT, Purkayastha S, et al. Ethics of large language models in medicine and medical research. Lancet Digit Health, 2023, 5(6): e333-e335.
39. 全筱筱, 熊文舉, 潘軍杰, 等. 基于大語言模型的數據查詢機器人在醫學領域的應用. 醫學新知, 2024, 34(9): 1057-1063.

West China Medical Journal

Evolution of large language models and their applications in clinical medical education

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content