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Home > diy > Building & Construction > What Is Construction Logistics

• Building & Construction

What Is Construction Logistics

Modified: December 7, 2023

Written by: Chloe Davis

Learn the importance of construction logistics in building construction projects. Explore the effective planning and coordination process for seamless project delivery.

• Construction & Tools
• Architecture

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• Introduction

Construction logistics is a crucial aspect of every building project. It involves the management and coordination of resources, materials, equipment, and personnel to ensure the smooth and efficient execution of construction activities. From the initial planning stages to the final delivery of a completed structure, construction logistics plays a vital role in optimizing productivity, minimizing costs, and ensuring timely project completion.

Construction logistics encompasses a wide range of activities, including procurement, transportation, inventory management, site layout, and waste disposal. By effectively managing these functions, construction companies can avoid delays, reduce construction waste, and maintain a safe working environment.

In recent years, the construction industry has witnessed significant advancements in technology and methodologies that have revolutionized construction logistics. From the use of Building Information Modeling (BIM) to automate project planning and visualization, to the adoption of GPS tracking systems for efficient vehicle routing, construction logistics has become more streamlined and data-driven than ever before.

This article explores the importance of construction logistics and the key components that contribute to its success. We will also delve into the challenges faced in construction logistics and discuss strategies for effective management. Additionally, we will examine real-life case studies that highlight successful implementation of construction logistics, as well as explore future trends in the field.

Whether you are a construction professional, a project manager, or simply curious about the complexities of building projects, this article will provide valuable insights into the world of construction logistics.

Key Takeaways:

• Construction logistics is the systematic planning and management of resources, materials, and personnel, crucial for optimizing productivity, minimizing costs, and ensuring timely project completion in the construction industry.
• Embracing advanced technology, collaborative approaches, and sustainable practices are essential for overcoming challenges and shaping the future of construction logistics, leading to greater efficiency and improved project outcomes.

Read more : What Is Pre-Construction In Construction

• Definition of Construction Logistics

Construction logistics can be defined as the systematic planning, coordination, and management of resources, materials, equipment, and personnel involved in construction projects.

It encompasses a wide range of activities that are essential for the successful execution of construction projects, including but not limited to:

• Procurement and sourcing of materials and equipment
• Transportation and delivery of materials to the construction site
• Inventory management and control
• Site layout and organization
• Waste disposal and environmental management
• Coordination of subcontractors and labor
• Scheduling and sequencing of construction activities
• Monitoring and tracking of project progress

The main goal of construction logistics is to optimize the flow of resources and ensure their timely availability at the construction site. This involves managing the entire supply chain, from the sourcing of raw materials to the delivery of finished components to the construction site.

The construction logistics process starts with the identification of project requirements and the development of a comprehensive logistics plan. This plan outlines the strategies, procedures, and systems to be employed in the execution of the construction project. It also considers factors such as budget, timeline, safety, and sustainability.

Effective construction logistics requires close collaboration between all stakeholders, including the project manager, contractors, suppliers, and logistics providers. Clear communication and a well-coordinated approach are vital to ensure that materials are available when needed, equipment is properly maintained, and personnel are deployed efficiently.

With the advancements in technology, construction logistics has become increasingly digitized and data-driven. Building Information Modeling (BIM) software allows for 3D visualization of construction projects, enabling better planning and coordination. Furthermore, the use of GPS tracking systems and real-time monitoring tools helps streamline transportation and improve overall project efficiency.

Overall, construction logistics is a critical function that ensures the smooth operation of construction projects. Its efficient implementation leads to cost savings, improved productivity, and timely project delivery, making it a key factor in the success of any construction endeavor.

• Importance of Construction Logistics

Construction logistics plays a vital role in the successful completion of construction projects. It is a crucial function that impacts various aspects of the project, from cost and time management to overall project efficiency. Here are some key reasons why construction logistics is of utmost importance:

• Optimized Resource Allocation: Construction projects require a plethora of resources, including materials, equipment, and manpower. Effective construction logistics ensures that these resources are allocated efficiently, avoiding wastage and reducing costs. By optimizing the procurement and transport of materials, construction companies can minimize project expenses and maximize productivity.
• Timely Project Completion: Construction deadlines are often tight, and any delay can have significant financial consequences. Construction logistics ensures that materials and equipment arrive at the construction site on time, allowing for seamless execution of construction activities. This timely delivery helps prevent delays and enables the project to stay on track for completion within the designated timeframe.
• Improved Productivity: By streamlining construction processes and eliminating bottlenecks, construction logistics enhances productivity. Efficient coordination of resources and scheduling of construction activities ensures that work proceeds smoothly, minimizing downtime and maximizing output. This leads to increased efficiency and allows for the completion of construction projects in a more cost-effective manner.
• Enhanced Safety: Construction sites can be hazardous environments, and safety is of utmost importance. Effective construction logistics ensures that materials, equipment, and personnel are managed in a way that promotes safety. This includes proper handling and transportation of heavy equipment, ensuring the availability of safety gear, and implementing safety protocols. By prioritizing safety through construction logistics, the risk of accidents and injuries can be minimized.
• Sustainable Construction: With growing environmental concerns, sustainable construction practices have become essential. Construction logistics can contribute to sustainability by optimizing transportation routes to reduce fuel consumption and emissions. It also involves efficient waste management, recycling, and proper disposal of construction materials. By incorporating sustainability into construction logistics, projects can meet environmental standards and minimize their ecological impact.

Overall, construction logistics is crucial for the successful execution of construction projects. It enables efficient resource allocation, timely project completion, improved productivity, enhanced safety, and sustainable construction practices. By recognizing the importance of construction logistics, construction companies can optimize their processes, reduce costs, and deliver high-quality projects in a more efficient and effective manner.

• Key Components of Construction Logistics

Construction logistics involves the management of various components that are essential for the smooth execution of construction projects. These components work together to ensure the timely availability, efficient transportation, and proper utilization of resources. Here are the key components of construction logistics:

• Procurement and Sourcing: This component involves the identification and acquisition of materials, equipment, and services required for the construction project. It includes activities such as selecting suppliers, negotiating contracts, and managing the supply chain to ensure timely delivery of materials to the construction site.
• Transportation and Delivery: The transportation and delivery component focuses on moving materials and equipment from suppliers to the construction site. It includes planning and scheduling transportation routes, selecting appropriate modes of transportation, and managing logistics providers to ensure on-time and efficient delivery.
• Inventory Management: Inventory management involves the control and tracking of materials and equipment throughout the construction process. It includes activities such as receiving, storing, and distributing materials, as well as monitoring inventory levels, managing stockouts, and optimizing inventory turnover.
• Site Layout and Organization: This component focuses on optimizing the layout and organization of the construction site for efficient workflow. It includes activities such as site planning, determining the location of storage areas, establishing access routes, and organizing the site to minimize congestion and maximize productivity.
• Waste Disposal and Environmental Management: Construction projects generate a significant amount of waste, and proper disposal is crucial to minimize environmental impact. This component involves implementing waste management strategies to recycle, reuse, or appropriately dispose of construction waste. It also includes adhering to environmental regulations and promoting sustainable practices.
• Coordination of Subcontractors and Labor: Construction projects often involve multiple subcontractors and labor teams. This component focuses on coordinating their activities to ensure seamless workflow and efficient utilization of resources. It includes scheduling subcontractors, managing labor availability, and coordinating their tasks to avoid conflicts and delays.
• Scheduling and Sequencing: The scheduling and sequencing component involves determining the order and timeline of construction activities. It includes creating construction schedules, allocating resources to specific tasks, and optimizing the sequence of activities to minimize delays and maximize efficiency.
• Monitoring and Tracking: Monitoring and tracking involve constantly assessing the progress of the construction project. This component uses tools such as project management software, GPS tracking systems, and real-time monitoring to track the movement of materials, monitor project milestones, and ensure that the project stays on schedule.

Successful construction logistics relies on effective management and coordination of these key components. By optimizing each component and ensuring their seamless integration, construction companies can achieve improved project outcomes, cost savings, and enhanced efficiency.

• Challenges in Construction Logistics

Construction logistics can be a complex and challenging process due to various factors inherent in the construction industry. Understanding these challenges is crucial for effective management and mitigation. Here are some common challenges faced in construction logistics:

• Supply Chain Disruptions: Construction projects rely on a network of suppliers and vendors to provide materials and equipment. Any disruption in the supply chain, such as delays, shortages, or quality issues, can significantly impact construction logistics. Unforeseen events like natural disasters, labor strikes, or global crises can further disrupt the supply chain, leading to project delays and increased costs.
• Constrained Timeframes: Construction projects often operate on tight schedules, with deadlines that must be met. The time-sensitive nature of construction logistics can pose challenges in coordinating and delivering materials, equipment, and labor within the allocated timeframes. Delays in any aspect of construction logistics can have a ripple effect on the project timeline.
• Complex Project Requirements: Each construction project is unique, with its own set of requirements and specifications. Managing the diverse range of materials, equipment, and skilled labor required can be a challenge. Different projects may have different technical specifications, safety considerations, and quality standards that must be adhered to, adding complexity to construction logistics.
• Transportation and Traffic: Transporting materials and equipment to and from the construction site can be challenging, especially in urban areas with heavy traffic. Congestion, road closures, and limited access can hinder the timely delivery of resources, leading to delays and increased costs. Efficient route planning and coordination with local authorities are necessary to overcome these challenges.
• Unpredictable Weather Conditions: Construction projects are susceptible to weather conditions that can impact logistics operations. Extreme weather events, such as hurricanes, heavy rainfall, or snowstorms, can halt transportation, disrupt supply chains, and pose safety risks. Construction logistics must be adaptable and contingency plans should be in place to mitigate the effects of unpredictable weather.
• Communication and Coordination: Effective communication and coordination among stakeholders are critical in construction logistics. Construction projects involve multiple parties, including contractors, suppliers, logistics providers, and subcontractors. Miscommunication or inadequate coordination can lead to delays, errors, and disruptions in the supply chain. Clear lines of communication and efficient collaboration platforms are essential for successful construction logistics.
• Quality Control and Inspections: Ensuring the quality of materials and equipment is crucial in construction projects. Construction logistics must incorporate quality control processes and inspections to verify that materials meet the required standards. Comprehensive quality checks at various stages of the logistics process can help prevent issues such as substandard materials or faulty equipment from affecting the project.
• Health and Safety Considerations: The construction industry is inherently risky, and safety is a top priority. Construction logistics must prioritize the health and safety of workers and comply with regulations and best practices. This includes managing the movement of heavy equipment, ensuring proper handling and storage of materials, and implementing safety protocols throughout the logistics process.

Addressing these challenges requires a proactive and adaptive approach. Careful planning, effective risk management, and continuous monitoring and communication can help mitigate potential issues and ensure the smooth flow of construction logistics.

Read more : What Is Construction

• Strategies for Effective Construction Logistics

Effective construction logistics requires careful planning, coordination, and execution of various processes. Implementing the following strategies can help optimize construction logistics and improve project outcomes:

• Comprehensive Planning: Begin with a detailed logistics plan that accounts for all the components and stages of the construction project. This includes identifying project requirements, creating a timeline, determining material and equipment needs, and establishing clear communication channels.
• Collaborative Approach: Encourage collaboration and open communication among all stakeholders involved in the construction project. Foster strong relationships with suppliers, logistics providers, subcontractors, and workers to ensure smooth coordination and timely delivery of resources.
• Advanced Technology: Embrace technology to streamline construction logistics. Utilize building information modeling (BIM) software for visualizing and planning the project, GPS tracking systems to monitor transportation routes, and project management software to track progress and communicate updates.
• Efficient Inventory Management: Implement an effective inventory management system that tracks the availability, movement, and usage of materials and equipment. Regularly monitor inventory levels, optimize stock levels based on project needs, and streamline the ordering and delivery process to avoid shortages or excessive inventory.
• Optimized Transportation: Optimize transportation routes and modes of transportation to reduce costs and improve efficiency. Consider factors such as distance, traffic conditions, fuel consumption, and emissions. Explore options for consolidating shipments and utilizing eco-friendly transport methods when possible.
• Continuous Monitoring and Adaptation: Regularly monitor and track progress throughout the construction project. Identify potential bottlenecks or issues and make necessary adjustments to overcome them. Continuously assess the logistics plan and adapt it as needed to accommodate any unforeseen circumstances or new project requirements.
• Risk Management: Anticipate and mitigate risks associated with construction logistics. Identify potential risks such as supply chain disruptions, weather conditions, or labor shortages, and develop contingency plans to minimize their impact. Regularly review and update risk management strategies as the project progresses.
• Emphasis on Safety: Prioritize safety throughout the logistics process. Ensure workers are trained in proper handling and storage of materials and equipment. Implement safety protocols and provide appropriate personal protective equipment. Regularly conduct safety audits and inspections to identify and address potential hazards.
• Continuous Improvement: Seek feedback and conduct post-project evaluations to identify areas for improvement in construction logistics. Learn from past experiences and implement lessons learned in future projects. Encourage a culture of continuous improvement to enhance the efficiency and effectiveness of construction logistics.

By adopting these strategies, construction companies can optimize their logistics operations, improve project outcomes, and achieve cost savings. Effective construction logistics not only ensures the timely availability of resources but also enhances productivity, safety, and overall project success.

Tip: Utilize a centralized logistics plan to coordinate material deliveries, equipment transportation, and workforce scheduling to optimize efficiency and reduce project delays in construction logistics.

• Case Studies in Construction Logistics

Examining real-life case studies can provide valuable insights into successful implementation of construction logistics. Let’s explore two examples:

Case Study 1: The Shard, London

The Shard, located in London, is one of the tallest buildings in Europe. Its construction presented unique logistical challenges due to its sheer height and central location. To overcome these challenges, the project team implemented innovative strategies:

• Advanced Planning: The logistics team conducted detailed planning and sequencing of construction activities. They used BIM technology to visualize the project and identify potential obstacles or clashes before construction began.
• Vertical Transportation: Given the height of the building, efficient vertical transportation was crucial. The project used a dedicated hoist system with multiple levels of elevators and cranes to ensure smooth movement of materials and workers throughout the building.
• Just-in-Time Delivery: Due to limited space on the construction site, the logistics team coordinated just-in-time deliveries of materials. This minimized on-site storage and reduced the risk of damage or theft.
• Off-Site Assembly: To expedite construction, certain components of the building were prefabricated off-site and transported to the construction site. This approach allowed for better quality control and faster installation.

The successful implementation of construction logistics enabled the completion of The Shard within the scheduled timeframe and budget, showcasing the importance of meticulous planning and innovative solutions.

Case Study 2: Panama Canal Expansion

The expansion of the Panama Canal involved the construction of new locks and the widening of existing channels. This complex project required sophisticated construction logistics due to its scale and geographical challenges:

• Supply Chain Management: The logistics team established strong relationships with suppliers worldwide to ensure a steady and timely supply of construction materials. They implemented advanced tracking systems to monitor the movement of materials and mitigate logistical risks.
• Optimized Transportation: The logistics team utilized a combination of land, water, and air transportation for the efficient delivery of materials. They developed detailed transportation plans, considering factors such as distance, weight, and road conditions to optimize routes and reduce costs.
• Coordination with Stakeholders: Due to the involvement of multiple contractors and subcontractors, effective coordination and communication among stakeholders were key. Regular meetings, collaborative platforms, and clear communication channels were established to ensure seamless coordination of construction activities.
• Risk Mitigation: The project team developed robust risk management strategies to mitigate potential challenges such as adverse weather conditions and labor fluctuations. Contingency plans were in place to address unforeseen events and maintain project progress.
• Environmental Considerations: The logistics team implemented sustainable practices, such as recycling construction waste and utilizing eco-friendly transportation. They also adhered to strict environmental regulations to minimize the project’s impact on the surrounding ecosystem.

The successful completion of the Panama Canal expansion demonstrates the importance of effective supply chain management, stakeholder coordination, risk mitigation, and sustainability in construction logistics.

These case studies highlight the significance of meticulous planning, innovative solutions, and effective coordination in construction logistics. By learning from these examples, construction companies can apply best practices and strategies to overcome logistical challenges and achieve successful project outcomes.

Read more : What Is LEED In Construction

• Future Trends in Construction Logistics

The field of construction logistics is continuously evolving, driven by advancements in technology and changing industry trends. Here are some future trends that will shape the construction logistics landscape:

• Automation and Robotics: The integration of automation and robotics in construction logistics will revolutionize processes and improve efficiency. Autonomous vehicles for material transportation, robotic arms for loading and unloading, and unmanned aerial vehicles (drones) for site inspections and inventory management are already being explored to enhance productivity and reduce labor costs.
• Internet of Things (IoT) and Real-time Monitoring: IoT devices will play a crucial role in construction logistics by connecting various elements of the supply chain. Sensors and trackers embedded in materials, equipment, and vehicles can provide real-time data on location, condition, and performance. This data can be used to optimize routing, prevent theft or damage, and improve overall project management.
• Artificial Intelligence (AI) and Predictive Analytics: AI algorithms and predictive analytics will enable construction logistics to anticipate and address potential issues before they arise. Through analyzing historical data, AI can predict material requirements, optimize schedules, and identify potential risks. AI-powered optimization algorithms can optimize logistics plans by considering various factors such as cost, time, and environmental impact.
• Green and Sustainable Practices: The demand for sustainable construction practices will continue to influence construction logistics. Green transportation methods, such as electric vehicles and alternative fuels, will become more prevalent. Logistics plans will incorporate eco-friendly practices, including waste reduction, recycling, and carbon emission reduction strategies. Sustainable supply chain management will be a key focus for construction companies.
• 3D Printing and Modular Construction: 3D printing and modular construction techniques will transform the construction industry, including logistics. With the ability to create building components on-site or off-site, supply chain logistics will be simplified, transportation costs will be reduced, and construction timelines will be significantly shortened. The logistics focus will shift towards efficient delivery and assembly of prefabricated modules.
• Digitalization and Integrated Platforms: Comprehensive digital platforms that integrate various aspects of construction logistics, such as procurement, tracking, scheduling, and communication, will become more common. These platforms will enable seamless collaboration and data sharing between project teams, suppliers, and logistics providers, improving transparency and efficiency throughout the construction process.
• Augmented Reality (AR) and Virtual Reality (VR): AR and VR technologies will play a significant role in construction logistics. These immersive technologies can assist in site planning, equipment operation, and training. Virtual simulations can be used for training and troubleshooting, reducing the risk of errors and improving safety.
• Drone Technology: Drones will continue to revolutionize construction logistics. Besides inventory management and site inspections, drones can be used for aerial surveys, mapping, monitoring construction progress, and even aerial transportation of lightweight materials. They offer fast and cost-effective solutions for various logistics tasks.

The future of construction logistics is exciting, with technology-driven advancements and a growing emphasis on sustainability and efficiency. By embracing these trends, construction companies can stay ahead of the curve and optimize their logistics processes to deliver projects more effectively and sustainably.

Construction logistics plays a critical role in the success of building projects. It involves the systematic planning, coordination, and management of resources, materials, equipment, and personnel to ensure the smooth execution of construction activities. By optimizing construction logistics, companies can achieve cost savings, improve productivity, enhance safety, and deliver projects on time and within budget.

Throughout this article, we have explored the key components of construction logistics, the challenges encountered, and the strategies employed to overcome them. We have also examined real-life case studies that exemplify effective construction logistics in action.

The future of construction logistics holds exciting opportunities, driven by advancements in technology and changing industry trends. Automation, artificial intelligence, IoT, and sustainable practices will shape the evolution of construction logistics, leading to greater efficiency, improved decision-making, and enhanced environmental stewardship.

In conclusion, construction logistics is a complex and crucial aspect of building projects. It requires careful planning, effective coordination, and a proactive approach to overcome challenges and optimize operations. By embracing the latest trends and technologies, construction companies can streamline logistics processes, improve project outcomes, and stay ahead in an increasingly competitive industry.

As the construction industry continues to evolve, the importance of construction logistics will only increase. By recognizing its significance and investing in its optimization, companies can ensure successful project delivery, client satisfaction, and long-term success in the dynamic world of construction.

• Frequently Asked Questions about What Is Construction Logistics

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Improving Construction Logistics a Case Study of Residential and Commercial Building Project

2020, International Journal for Research in Applied Science and Engineering Technology IJRASET

This study concerns logistics at the construction projects. Most construction projects suffer from unnecessary activities on site which indicates the need for improving construction logistics. Hence the purpose of this paper was to investigate, through site observations and interviews, the current logistics situation on the construction site and to suggest possible solution for improving construction logistics. The main focus of this study was on material deliveries and time that craftsmen spend on handling materials. The thesis concludes that skilled craftsmen are transporting the third part of all incoming interior materials by their selves. Due to poor logistics planning workers are also doing lots of rework and extra work. The study showed that, by implementing other logistics solutions, it is possible to reduce the production costs by 65 SEK/m2 of living area and also to shorten the production time by 3.3%. The study actualizes the importance of construction logistics which is often underestimated. The study also showed what consequences ineffective logistics solution could have on the construction project. While, on the opposite, proper logistics planning gives benefits to the project. I. INTRODUCTION A. General The construction industry is one of the most complex industries. The construction process consists of several phases where many different participants are involved during each phase. The uniqueness of this industry is that it is a project based industry, where each construction project could be considered as a temporary organization. However there is a similarity with other industries as well. The similarity is that all industries are interested in high production efficiency while keeping the overall costs as low as possible (Agerberg et al., 2010). Most construction projects are affected by several factors that have a high impact on the efficiency of the workforce by reducing their overall productivity. This affects quality, time and costs of the project. The reason for that is often poor management of materials, equipment and tools. Proper management of these three important components could increase productivity significantly. These components should be accurately managed on site, in order for the projects to be successful. (Almohsen, Ruwanpura, 2011) Due to its nature, the construction industry is one of the most challenging to work in. The information flow in construction is complex and the process is affected by various factors. One of these factors is logistics which is defined as the management of the flow of materials, tools and equipment from the point of release to the point of use. (European Construction Institute, 1994). As the construction industry is constantly developing, production costs are rising steadily as well, but the production efficiency and the way of working have not developed that much. Improving logistics by reducing activities that do not add value to the final product could be one possible solution to lower the production costs. Activities that do not add value to the final product are defined as "waste" which is directly related to the logistics issue. Waste has been studied earlier by among others Josephson and Saukkoriipi (2007) who concluded that it is possible to reduce the production costs with 30-35% by minimizing the total amount of waste.

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Nuruddeen Usman , Muhammad Ahmad Ibrahim

Management of construction logistics at construction sites becomes increasingly complex with rising construction volume, which made it relatively inefficient in the developing nations even with the technological advancement. The objective of this research is to conceptually synthesise the approaches and challenges befall in the course of construction logistic management, with the aim to proffer possible solution to it. Therefore, this study appraised the glitches associated with both conventional and technological methods of construction logistic management that result in its inefficiency. Thus, this investigation found that, both conventional and the technological issues were due to certain obstacles that affect the construction logistic managementwhich resulted into delays, accidents, fraudulent activities, time and cost overrun. Therefore, this study has developed a framework that might bring alasting solution to the challenges of construction logistic management.

Improving logistics management in construction project is becoming more challenging as the construction industry is getting more complex than what we have had then. However, the construction industry is left behind as compared to other industry such as manufacturing and retail industry. The logistics issues in construction project have hindered its performance thus the construction project goals (time, cost, and quality) cannot be achieved. The purpose of this paper is to highlight the logistics issues that occur in a construction project. An overview of construction logistics is being presented in the paper followed by defining of construction logistics. After that, the factors contributing to efficient of construction logistics are presented in this paper. Four academic databases namely Google Scholar, Science Direct, Emerald Insight and Elsevier were used to collect literatures. The literatures were explored in-depth to come up with write-up. Twenty (20) numbers of research paper...

ehsan asnaashari

Logistics has been recognized as a major factor in industrial organizations for many years. However, it has not been applied appropriately in construction yet. The reason is that the nature of construction is different to other industries like manufacturing or food. Some characteristics of construction industry like matchless projects, fragmented supply chain, unique design, temporary organization, and working in different geographical locations, necessitates undertaking a new approach for managing logistics in construction projects. Construction logistics is a system with six agents (sub-systems): (1) site preparation, (2) purchasing, (3) delivery, (4) handling methods, (5) warehousing and (6) monitoring. This paper only covers issues regarding storage and the warehousing process. Owning to the space, staff and equipment that are required, warehousing is a costly element of a logistics system and therefore it should be manage efficiently. This paper aims to describe and evaluate th...

System-Based Vision for Strategic and Creative Design: Proceedings of the Second International Conference on Structural and Construction Engineering, 23-26 September 2003, Rome, Italy. ISBN:9058095991.

Sheyla M B Serra

The main objective is to present a tool for the development and implementation of logistics plans in building construction. Firstly it shows a review of related concepts. These are followed by a study of the relationship of the logistic plan with the elements that conditions its success. These are considered as main requirements for correct plan formulation, such as: simultaneity among external logistics (control of suppliers) and internal logistics (construction site management). In conclusion, this paper present the guidelines for formulation and implantation of logistics plans that will aid in the operational planning of the work, programming of the deliveries of materials and improvement in the conditions of the work. Application of the logistics guidelines cited is directly dependent on a change in the culture and structure of construction companies, which must perforce begin to use lean thinking to guide decisions and to execute activities in every organizational level, with special emphasis on top management.

26th Annual Conference of the International Group for Lean Construction

Farook Hamzeh

vol 5 issue 15

Road construction all over the world especially in the developing countries is considered to be one of the most important projects for a country. As important as they might be it becomes more important to execute them with utmost care as to optimize the logistics and minimizing the waste to optimize the cost and ultimately planning in such a way to maximize the productivity of the construction team which depends mainly upon different aspects relating to materials access to the workers on site, cost of them, choice of materials etc. Logistics optimization is one of the major factors for successful delivery of road construction projects. Logistics comprises the flow of information and material, optimization can be achieved through effective planning in terms of material planning, material delivery, material management and material handling. This research paper is aimed at studying the importance of material in logistic process of road construction projects in Pakistan. The study may b...

There are poor management of logistics in the construction industry. The poor management of logistics has a negative effect on quality, cause delays to project and cost overruns. Accordingly the purpose of this study is to identify the scope of current methods and techniques of construction logistics being used, both traditional and alternative, and show the role they can play in reducing waste, and to develop an efficient construction logistics management within and outside a construction site. And to show other important points about the use of consolidation centers in the construction logistics. In the literature has been found four methods of construction logistics being used, both traditional and alternative. An alternative arrangement no commonly used in construction site. In alternative method 4 there are seven main logistics techniques. In this study authors are focus on Construction Consolidation Centre and some techniques which support the primary activity CC to take place. Through theory, interview and observation the authors define the reasons of waste in construction industry. Therefore, the intention of the authors is a construction industry without waste, where resources used sustainably; by using construction consolidation centers and Lean tools to eliminate construction waste, saving resource and reduce carbon emissions.

Quint van Honk

Editor IJRET

Mundia Muya

of cost, quality and time. Customer service is the key element that holds together all supply logistics activities, thus, the effectiveness in selecting suppliers should begin with evaluating characteristics that are deemed necessary for a supplier to provide a pre-requisite level of customer service. Such factors, or enablers, provide indications as to whether a given supplier will be able to meet key materials delivery objectives. This paper provides a review of problems besetting the supply of construction materials as identified in current literature. Opportunities presented by the introduction of information and communication technologies for improving the materials management process have been examined. A logistics perspective of construction materials management has been adopted. The analytic hierarchy process has been presented as an appropriate methodology for assessing factors that enable achievement of efficient and cost-effective materials supply logistics to support con...

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Exploring Logistics Strategy in Construction

• Conference paper
• First Online: 24 August 2019
• Cite this conference paper

• Martin Rudberg   ORCID: orcid.org/0000-0003-1066-2094 19 &
• Duncan Maxwell   ORCID: orcid.org/0000-0002-9039-1441 20  

Part of the book series: IFIP Advances in Information and Communication Technology ((IFIPAICT,volume 566))

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• IFIP International Conference on Advances in Production Management Systems

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The purpose of this research is to explore logistics strategies in construction. There are very few studies on logistics and SCM practices in construction, especially when it comes to the long-term strategic work of construction companies. Therefore, this research takes a contractor’s perspective and addresses logistics strategy based on the empirical examination of two case companies in the construction industry. The main focus is the contents of the strategy and possible components of the logistics strategy are identified through a literature review. Also the process of the strategy is treated through exploring logistics strategy in two case companies exemplifying two strategic approaches to construction logistics. However, the approaches differ, implying a spectrum that at one end responds in a standardized manner to a pre-determined design solution and at the other reveals a re-configurable modular approach. The main contributions of this study lie in exploring logistics strategy in construction and providing examples of how construction companies work with logistics strategies, adding empirical knowledge to the field of construction logistics.

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1 Introduction

Construction is essentially a complex industry due to the large number of participants and interactions (Winch 2010 ). Where traditional manufacturing industries can work long-term and strategically in a stable and process-oriented environment, the construction industry is typically characterized by one-off projects, tendering and procuring sub-contractors and suppliers on a short term-basis each time a project is launched (Dubois and Gadde 2000 ; Kristiansen et al. 2005 ). This leads to a situation where projects are managed locally, in a tactical manner, becoming disconnected from the strategic company level (cf. Dubois and Gadde 2002 ; Kristiansen et al. 2005 ). This in turn affects how logistics and supply chains are managed within construction companies, where it is uncommon to find logistics strategies defined at the company level that are implemented as logistics plans at the project level. Recent research has demonstrated that the principles of supply chain management, particularly when focused on logistics, offer a potential means of overcoming this complexity and improving productivity (Vrijhoef and Koskela 2000 ), yet achieving this in practice is far from straightforward. While some progress has been made, the nature of the industry and the scale of relationships involved cause barriers to progress (Meng 2013 ). This indicates the need for a ‘big picture’ view of construction logistics and supply chain management, one that is more strategic than operational in nature.

The purpose of this research is therefore to explore how logistics strategies can be developed in construction companies, and how they can be a platform for developing effective logistics plans for individual projects. There are very few studies on logistics and SCM practices in construction (Bankvall et al. 2010 ), especially when it comes to the long-term strategic work of construction companies. This research takes the perspective of the contractor and focuses on the empirical examination of the contents of logistics strategy in the construction industry. In so doing, the following research questions are addressed:

What are the typical components of a logistics strategy?

What constitutes logistics strategy in construction?

Building on these research questions the following section describes the research design. Thereafter the literature review is introduced, with a focus on investigating research question 1. Research question 2 is then addressed through case studies followed by case analysis and discussion. The paper is then concluded, and possible further research is identified.

2 Research Design

There is a lack of studies on logistics strategies in construction, therefore this study is explorative, using a case-based research method. The research design is divided into two phases. The first phase is a literature review taking a stance in the traditional logistics and operations management literature, searching for suitable factors for describing and defining the contents of a logistics strategy.

The second phase of the research is based on an empirical study focusing on two case studies representing construction companies that have developed logistics strategies for their operations. One of the case companies has a logistics strategy that is standardized and deployed for all of the company’s construction projects, whereas the other case represents a construction company employing a modularized logistics strategy that forms the basis of configurable specific logistics plans for individual projects. As such, we use two contrasting cases to identify and describe critical variables (Stuart et al. 2002 ). Contextual variables and project specific characteristics are identified and coded to facilitate the use of pattern matching and logical models (Yin 2014 ) for a cross-case analysis, and for contrasting the case studies with the results from the literature review. The main sources of data are: archival records (logistics strategy statements, internal reports, project documents, master’s thesis reports) and semi-structured interviews (strategists, logistics managers, project managers).

3 Literature Review

3.1 the construction industry setting.

The productivity in the construction industry is considered relatively low (Abdel-Wahab and Vogl 2011 ; Fulford and Standing 2014 ; Josephson and Chao 2014 ), but the construction industry also faces unique settings that to some extent can explain the low level of productivity and the high costs. This uniqueness is characterized by the construction site that creates a temporary factory around the product (Bygballe and Ingemansson 2014 ), since these products are typically large and immobile, meaning they must be built on the site of use. Therefore, construction work is carried out in temporary organizations with temporary supply chains (Behera et al. 2015 ). Typically, a construction project is dependent on many, often small, firms acting as subcontractors (Dubois and Gadde 2002 ; Miller et al. 2002 ). As a result of the construction industry setting, many studies report on poor performance that originates from poor logistics management (Meng 2012 ), e.g. high costs (Hwang et al. 2009 ), waste (Josephson and Saukkoriipi 2005 ), and waiting time (Thunberg and Persson 2013 ). This is one of the reasons why some authors (e.g. Bankvall et al. 2010 ; Department for Business Innovation and Skills 2013 ; Thunberg and Persson 2013 ; Vrijhoef and Koskela 2000 ) argue that many of the problems in construction could be mitigated through better managed supply chains and better logistics management.

3.2 Logistics Strategy

There are surprisingly few clear definitions of what a logistics ‘strategy’ is, even outside of construction in its more traditional domain of manufacturing. According to the Financial Times Lexicon, a logistics strategy is “the set of guiding principles, driving forces and ingrained attitudes that help to coordinate goals, plans and policies between partners across a given supply chain.” (Financial Times Lexicon, n.d.). Seeking their categorization, Autry et al. ( 2008 ) defined logistics strategies as “…directives formulated at the corporate level … used to guide more efficient and effective logistics activities at the operational level of the organization”. This establishes the important separation of logistics as a strategic activity at the company-level, compared to its implementation at an operational, or in construction’s case, project-level (see Fig.  1 ). Figure  1 also shows that logistics strategy is divided between the strategy contents and the strategy process. The main focus of this study is the strategy content, including how the contents are transferred into detailed descriptions of logistics components in logistic plans for each individual project. However, the empirical part of the study also includes the strategy process, including parts of the formulation and implementation of the strategy when the strategy is realized into logistics plans at the project level. As such, the unit of analysis is the logistics strategy content and process, taking a contractor’s perspective.

Logistics strategy and plans divided into content and process aspects of strategy.

3.3 Components of Logistics Strategy

Bowersox and Daugherty ( 1987 ) established the first logistics strategy classification, identifying three distinct bases for logistics development: process-based/functional, focusing on cost-reduction; market-based, focusing on customer service; and information/external-based, focusing on coordination and collaboration. McGinnis and Kohn ( 1990 ) similarly investigated forms of logistics strategies. Throughout this strand of research into logistics strategy has been a continual questioning of the detail of what such a proposition contains (Clinton and Closs 1997 ). Relying on the division between the contents and the process of a strategy, it is possible to identify a set of logistics components that make up the strategy content and some examples of this from the literature review is presented in Table  1 .

The identified components reveal a list of areas where strategic logistics decisions must be made and executed as logistics plans and decisions, these components help companies to work actively to define logistics strategies. McGinnis et al. ( 2010 ) identify that companies working intensively with their logistics strategy show significantly better performance than more passive companies, especially when it comes to logistics coordination effectiveness and customer service commitment. These performance indicators, in turn, are argued to positively affect overall company competitiveness (McGinnis et al. 2010 ).

4 Case Studies

The two case companies, referred to as company A and B, operate mainly in the Swedish market. Company A, a commercial construction company, shows a construction logistics ‘strategy’ that is focused upon a narrow ‘product-type’—commercial office buildings in dense, urban areas of Sweden. Their projects are mostly new-builds, with some renovations, and typically have budgets up to 500m SEK (US$53.8m at March 2019). Utilizing traditional construction methods, the company only undertakes a handful of projects at one time. Company A’s logistics strategy is highly standardized in order to meet the pre-defined demands of these projects.

Company B, a larger construction company than A, undertakes projects all over Sweden in urban and sub-urban locations. The projects that they have developed a logistics strategy for are residential in nature and almost exclusively new-builds. The structures are built using a mix of traditional and prefabricated methods, with a typical cost between 50m–300m SEK (US$5.4m–$32.3m at March 2019). Being a large company, they have many projects running concurrently around the country.

As for the contents of the logistics strategies, both company A and B have clearly defined the components of their strategies. Company A demonstrates that a clearly defined logistics strategy can be put in place that responds to a fixed ‘product’ through a pre-defined, standardized logistics approach at the project-level. Company B’s logistics strategy has created a reconfigurable ‘modular’ approach, meaning that components of the strategy are defined and then a range of solutions within these components are defined for selection based upon the nature of the specific project’s context when logistic plans are developed. A summary of the logistics strategy components for the case companies is provided in Table  2 .

Overlaps between company A and B appear in the content of these strategies. However, rather than focusing on the content (that is specific to each company’s business model), instead the two approaches reveal distinct ways of approaching a logistics strategy and its implementation at the project-level. Company A has a standardized logistics strategy, where the logistic plans are strictly based on what is defined in the components of the strategy contents. Basically, all logistics plans look the same, since the strategy is adjusted to the narrow focus of the projects that company A is bidding for, with the only variable being the site conditions. Company B uses the components of the strategy contents as decision-making areas that must be dealt with when developing their logistics plans for their different projects. Since the projects vary so much in location, design, structure, size, etc., company B’s strategy must be more flexible and can be seen as a modularized strategy, where the modules (components) are adjusted to the contextual factors as logistics plans are developed.

5 Discussion

Case studies A and B demonstrate that construction logistics strategies emerge in response to specific contextual factors. This context extends beyond the physical construction site and includes factors that are related to the specific business models of the companies themselves, responding to their technical platform (construction method), product offering (type of building), and target market (customer profile or budget), in line with Brege et al’s. ( 2014 ) definition of construction business models. Case Studies A and B reveal the possibilities of a strategic approach to construction logistics. These approaches establish a spectrum that at one end responds in a standardized manner to a pre-determined design solution (as in A) and at the other uses a reconfigurable modular approach (as B shows).

The main contribution of this study lies in establishing an exploration of logistics strategy in construction, drawing attention to logistics as a strategic activity for contracting companies. Furthermore, this study provides examples of how construction companies work with logistics strategies, identifies that a spectrum of approaches exists, adding empirical knowledge to the field of construction logistics. Relating to the two research questions, a possible set of components of the logistics strategy contents have been listed in Table  1 (RQ1) and examples of what constitutes logistics strategies in construction (RQ2) have been provided through the case studies, especially through Table  2 .

The research presented here is exploratory and a starting point to research logistics strategy in construction. There are a number of ways to continue this research, of which some are: to extend the literature review to further define the logistics strategy components; to increase the number of cases and also the number of projects within each case organization where logistics plans, anchored in logistics strategies at corporate level, have been implemented; and to extend the cases to countries outside of Sweden.

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Rudberg, M., Maxwell, D. (2019). Exploring Logistics Strategy in Construction. In: Ameri, F., Stecke, K., von Cieminski, G., Kiritsis, D. (eds) Advances in Production Management Systems. Production Management for the Factory of the Future. APMS 2019. IFIP Advances in Information and Communication Technology, vol 566. Springer, Cham. https://doi.org/10.1007/978-3-030-30000-5_65

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Sponsored by Environmental Defense Fund (EDF), Dr. Edgar E Blanco Research Director of the Carbon-Efficient Supply Chains Research Project at the MIT Center for Transportation & Logistics, worked alongside three US companies to help them quantify the carbon footprint of some of their logistics initiatives. The goal was to document the projects, and illustrate to other companies that it is possible to reduce cost and become more environmentally friendly.  

In this case study we present two Ocean Spray initiatives – distribution network redesign and intermodal shift from road to rail – that in combination led to a 20% reduction in transportation CO2 emissions, while achieving comparable cost savings across the transportation network.

Shifting to Rail – A Collaborative Approach

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Ocean Spray added new manufacturing and distribution capabilities in Florida to support the company’s growing customer base. To fully and effectively utilize these additions, Ocean Spray conducted a national network re-design project to determine which customers will receive product from the new location. Ocean Spray projected that over 17% of the total shipments will be served from the new facility.

Read the full Ocean Spray case study here .  

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Switching Shipment Packaging from Steel to Light-Weight Plastic

At present, Caterpillar uses steel containers to transport parts. Caterpillar has been working for the past four years to phase out these steel containers and replace them with plastic containers, which weigh considerably less.

Analyzing Inbound Shipments to Identify Potential Consolidation

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Read the full Caterpillar case study here .  

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Reducing CO2 Emissions Through Carload Direct

Traditionally, manufacturers use trucks, or a mix of trucks and rail, to transport their products to customers. As trucks produce greater emissions than trains, a logical way to reduce emissions is to minimize the use of trucks and maximize the use of rail. Boise coordinated with its customers to promote rail transport so that product could be sent directly from the manufacturing plant to the customer’s warehouse. The transition from using a mix of truck and rail to exclusively rail eliminated more than 2,600 tons of C02; the equivalent of saving over 264,000 gallons of fuel consumed by road vehicles.

Optimizing Railcar Utilization with Three-Tier Pallets

Prior to this project, railcars were loaded two pallets high, leaving a space from the top of the second pallet to the roof of the railcar, thus under-utilizing the full capacity of the railcar. Boise redesigned its pallets and loading structure by creating a half-pallet, which allowed the company to rethink pallet stacking and maximize shipping capacities for its loads. These redesigns maximized carloads by reducing the number of shipments required to deliver product. Using just 930 railcars in 2011 reduced the company’s C02 emissions by 190 tons, which is equal to the C02 emissions from 21,637 gallons of fuel consumed by road vehicles.

Read the full Boise case study here .

Hear directly from Dr. Edgar Blanco, from MIT CTL, joined by EDF’s Jason Mathers, Ross Corthell from Boise, Kristine Young from Ocean Spray, and Zena Onstott from Caterpillar as they share their insights from these case studies on this webinar . 

To find out more about the case studies, contact Dr. Edgar E. Blanco , Research Director, Carbon Efficient Supply Chains Research Project, MIT CTL, and co-founder of the LEAP consortium.

The Carbon Efficient Supply Chains Research Project is addressing three challenges: how to measure the carbon footprint of a supply chain, developing strategies for reducing supply chain carbon emissions, and communicating carbon footprints to consumers and stakeholders. Further information is available here .

The Leaders in Environmental Assessment and Performance (LEAP) consortium is a vehicle for organizations to leverage MIT’s knowledge and resources as well as the lessons learned from corporate environmental efforts. LEAP is a joint initiative between MIT CTL and the MIT Material Systems Laboratory. Further information is available here .

• Open access
• Published: 22 April 2024

Artificial intelligence and medical education: application in classroom instruction and student assessment using a pharmacology & therapeutics case study

• Kannan Sridharan 1 &
• Reginald P. Sequeira 1  

BMC Medical Education volume  24 , Article number:  431 ( 2024 ) Cite this article

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Artificial intelligence (AI) tools are designed to create or generate content from their trained parameters using an online conversational interface. AI has opened new avenues in redefining the role boundaries of teachers and learners and has the potential to impact the teaching-learning process.

In this descriptive proof-of- concept cross-sectional study we have explored the application of three generative AI tools on drug treatment of hypertension theme to generate: (1) specific learning outcomes (SLOs); (2) test items (MCQs- A type and case cluster; SAQs; OSPE); (3) test standard-setting parameters for medical students.

Analysis of AI-generated output showed profound homology but divergence in quality and responsiveness to refining search queries. The SLOs identified key domains of antihypertensive pharmacology and therapeutics relevant to stages of the medical program, stated with appropriate action verbs as per Bloom’s taxonomy. Test items often had clinical vignettes aligned with the key domain stated in search queries. Some test items related to A-type MCQs had construction defects, multiple correct answers, and dubious appropriateness to the learner’s stage. ChatGPT generated explanations for test items, this enhancing usefulness to support self-study by learners. Integrated case-cluster items had focused clinical case description vignettes, integration across disciplines, and targeted higher levels of competencies. The response of AI tools on standard-setting varied. Individual questions for each SAQ clinical scenario were mostly open-ended. The AI-generated OSPE test items were appropriate for the learner’s stage and identified relevant pharmacotherapeutic issues. The model answers supplied for both SAQs and OSPEs can aid course instructors in planning classroom lessons, identifying suitable instructional methods, establishing rubrics for grading, and for learners as a study guide. Key lessons learnt for improving AI-generated test item quality are outlined.

Conclusions

AI tools are useful adjuncts to plan instructional methods, identify themes for test blueprinting, generate test items, and guide test standard-setting appropriate to learners’ stage in the medical program. However, experts need to review the content validity of AI-generated output. We expect AIs to influence the medical education landscape to empower learners, and to align competencies with curriculum implementation. AI literacy is an essential competency for health professionals.

Peer Review reports

Artificial intelligence (AI) has great potential to revolutionize the field of medical education from curricular conception to assessment [ 1 ]. AIs used in medical education are mostly generative AI large language models that were developed and validated based on billions to trillions of parameters [ 2 ]. AIs hold promise in the incorporation of history-taking, assessment, diagnosis, and management of various disorders [ 3 ]. While applications of AIs in undergraduate medical training are being explored, huge ethical challenges remain in terms of data collection, maintaining anonymity, consent, and ownership of the provided data [ 4 ]. AIs hold a promising role amongst learners because they can deliver a personalized learning experience by tracking their progress and providing real-time feedback, thereby enhancing their understanding in the areas they are finding difficult [ 5 ]. Consequently, a recent survey has shown that medical students have expressed their interest in acquiring competencies related to the use of AIs in healthcare during their undergraduate medical training [ 6 ].

Pharmacology and Therapeutics (P & T) is a core discipline embedded in the undergraduate medical curriculum, mostly in the pre-clerkship phase. However, the application of therapeutic principles forms one of the key learning objectives during the clerkship phase of the undergraduate medical career. Student assessment in pharmacology & therapeutics (P&T) is with test items such as multiple-choice questions (MCQs), integrated case cluster questions, short answer questions (SAQs), and objective structured practical examination (OSPE) in the undergraduate medical curriculum. It has been argued that AIs possess the ability to communicate an idea more creatively than humans [ 7 ]. It is imperative that with access to billions of trillions of datasets the AI platforms hold promise in playing a crucial role in the conception of various test items related to any of the disciplines in the undergraduate medical curriculum. Additionally, AIs provide an optimized curriculum for a program/course/topic addressing multidimensional problems [ 8 ], although robust evidence for this claim is lacking.

The existing literature has evaluated the knowledge, attitude, and perceptions of adopting AI in medical education. Integration of AIs in medical education is the need of the hour in all health professional education. However, the academic medical fraternity facing challenges in the incorporation of AIs in the medical curriculum due to factors such as inadequate grounding in data analytics, lack of high-quality firm evidence favoring the utility of AIs in medical education, and lack of funding [ 9 ]. Open-access AI platforms are available free to users without any restrictions. Hence, as a proof-of-concept, we chose to explore the utility of three AI platforms to identify specific learning objectives (SLOs) related to pharmacology discipline in the management of hypertension for medical students at different stages of their medical training.

Study design and ethics

The present study is observational, cross-sectional in design, conducted in the Department of Pharmacology & Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain, between April and August 2023. Ethical Committee approval was not sought given the nature of this study that neither had any interaction with humans, nor collection of any personal data was involved.

Study procedure

We conducted the present study in May-June 2023 with the Poe© chatbot interface created by Quora© that provides access to the following three AI platforms:

Sage Poe [ 10 ]: A generative AI search engine developed by Anthropic © that conceives a response based on the written input provided. Quora has renamed Sage Poe as Assistant © from July 2023 onwards.

Claude-Instant [ 11 ]: A retrieval-based AI search engine developed by Anthropic © that collates a response based on pre-written responses amongst the existing databases.

ChatGPT version 3.5 [ 12 ]: A generative architecture-based AI search engine developed by OpenAI © trained on large and diverse datasets.

We queried the chatbots to generate SLOs, A-type MCQs, integrated case cluster MCQs, integrated SAQs, and OSPE test items in the domain of systemic hypertension related to the P&T discipline. Separate prompts were used to generate outputs for pre-clerkship (preclinical) phase students, and at the time of graduation (before starting residency programs). Additionally, we have also evaluated the ability of these AI platforms to estimate the proportion of students correctly answering these test items. We used the following queries for each of these objectives:

Specific learning objectives

Can you generate specific learning objectives in the pharmacology discipline relevant to undergraduate medical students during their pre-clerkship phase related to anti-hypertensive drugs?

Can you generate specific learning objectives in the pharmacology discipline relevant to undergraduate medical students at the time of graduation related to anti-hypertensive drugs?

A-type MCQs

In the initial query used for A-type of item, we specified the domains (such as the mechanism of action, pharmacokinetics, adverse reactions, and indications) so that a sample of test items generated without any theme-related clutter, shown below:

Write 20 single best answer MCQs with 5 choices related to anti-hypertensive drugs for undergraduate medical students during the pre-clerkship phase of which 5 MCQs should be related to mechanism of action, 5 MCQs related to pharmacokinetics, 5 MCQs related to adverse reactions, and 5 MCQs should be related to indications.

The MCQs generated with the above search query were not based on clinical vignettes. We queried again to generate MCQs using clinical vignettes specifically because most medical schools have adopted problem-based learning (PBL) in their medical curriculum.

Write 20 single best answer MCQs with 5 choices related to anti-hypertensive drugs for undergraduate medical students during the pre-clerkship phase using a clinical vignette for each MCQ of which 5 MCQs should be related to the mechanism of action, 5 MCQs related to pharmacokinetics, 5 MCQs related to adverse reactions, and 5 MCQs should be related to indications.

We attempted to explore whether AI platforms can provide useful guidance on standard-setting. Hence, we used the following search query.

Can you do a simulation with 100 undergraduate medical students to take the above questions and let me know what percentage of students got each MCQ correct?

Integrated case cluster MCQs

Write 20 integrated case cluster MCQs with 2 questions in each cluster with 5 choices for undergraduate medical students during the pre-clerkship phase integrating pharmacology and physiology related to systemic hypertension with a case vignette.

Write 20 integrated case cluster MCQs with 2 questions in each cluster with 5 choices for undergraduate medical students during the pre-clerkship phase integrating pharmacology and physiology related to systemic hypertension with a case vignette. Please do not include ‘none of the above’ as the choice. (This modified search query was used because test items with ‘None of the above’ option were generated with the previous search query).

Write 20 integrated case cluster MCQs with 2 questions in each cluster with 5 choices for undergraduate medical students at the time of graduation integrating pharmacology and physiology related to systemic hypertension with a case vignette.

Integrated short answer questions

Write a short answer question scenario with difficult questions based on the theme of a newly diagnosed hypertensive patient for undergraduate medical students with the main objectives related to the physiology of blood pressure regulation, risk factors for systemic hypertension, pathophysiology of systemic hypertension, pathological changes in the systemic blood vessels in hypertension, pharmacological management, and non-pharmacological treatment of systemic hypertension.

Write a short answer question scenario with moderately difficult questions based on the theme of a newly diagnosed hypertensive patient for undergraduate medical students with the main objectives related to the physiology of blood pressure regulation, risk factors for systemic hypertension, pathophysiology of systemic hypertension, pathological changes in the systemic blood vessels in hypertension, pharmacological management, and non-pharmacological treatment of systemic hypertension.

Write a short answer question scenario with questions based on the theme of a newly diagnosed hypertensive patient for undergraduate medical students at the time of graduation with the main objectives related to the physiology of blood pressure regulation, risk factors for systemic hypertension, pathophysiology of systemic hypertension, pathological changes in the systemic blood vessels in hypertension, pharmacological management, and non-pharmacological treatment of systemic hypertension.

Can you generate 5 OSPE pharmacology and therapeutics prescription writing exercises for the assessment of undergraduate medical students at the time of graduation related to anti-hypertensive drugs?

Can you generate 5 OSPE pharmacology and therapeutics prescription writing exercises containing appropriate instructions for the patients for the assessment of undergraduate medical students during their pre-clerkship phase related to anti-hypertensive drugs?

Can you generate 5 OSPE pharmacology and therapeutics prescription writing exercises containing appropriate instructions for the patients for the assessment of undergraduate medical students at the time of graduation related to anti-hypertensive drugs?

Both authors independently evaluated the AI-generated outputs, and a consensus was reached. We cross-checked the veracity of answers suggested by AIs as per the Joint National Commission Guidelines (JNC-8) and Goodman and Gilman’s The Pharmacological Basis of Therapeutics (2023), a reference textbook [ 13 , 14 ]. Errors in the A-type MCQs were categorized as item construction defects, multiple correct answers, and uncertain appropriateness to the learner’s level. Test items in the integrated case cluster MCQs, SAQs and OSPEs were evaluated with the Preliminary Conceptual Framework for Establishing Content Validity of AI-Generated Test Items based on the following domains: technical accuracy, comprehensiveness, education level, and lack of construction defects (Table  1 ). The responses were categorized as complete and deficient for each domain.

The pre-clerkship phase SLOs identified by Sage Poe, Claude-Instant, and ChatGPT are listed in the electronic supplementary materials 1 – 3 , respectively. In general, a broad homology in SLOs generated by the three AI platforms was observed. All AI platforms identified appropriate action verbs as per Bloom’s taxonomy to state the SLO; action verbs such as describe, explain, recognize, discuss, identify, recommend, and interpret are used to state the learning outcome. The specific, measurable, achievable, relevant, time-bound (SMART) SLOs generated by each AI platform slightly varied. All key domains of antihypertensive pharmacology to be achieved during the pre-clerkship (pre-clinical) years were relevant for graduating doctors. The SLOs addressed current JNC Treatment Guidelines recommended classes of antihypertensive drugs, the mechanism of action, pharmacokinetics, adverse effects, indications/contraindications, dosage adjustments, monitoring therapy, and principles of monotherapy and combination therapy.

The SLOs to be achieved by undergraduate medical students at the time of graduation identified by Sage Poe, Claude-Instant, and ChatGPT listed in electronic supplementary materials 4 – 6 , respectively. The identified SLOs emphasize the application of pharmacology knowledge within a clinical context, focusing on competencies needed to function independently in early residency stages. These SLOs go beyond knowledge recall and mechanisms of action to encompass competencies related to clinical problem-solving, rational prescribing, and holistic patient management. The SLOs generated require higher cognitive ability of the learner: action verbs such as demonstrate, apply, evaluate, analyze, develop, justify, recommend, interpret, manage, adjust, educate, refer, design, initiate & titrate were frequently used.

The MCQs for the pre-clerkship phase identified by Sage Poe, Claude-Instant, and ChatGPT listed in the electronic supplementary materials 7 – 9 , respectively, and those identified with the search query based on the clinical vignette in electronic supplementary materials ( 10 – 12 ).

All MCQs generated by the AIs in each of the four domains specified [mechanism of action (MOA); pharmacokinetics; adverse drug reactions (ADRs), and indications for antihypertensive drugs] are quality test items with potential content validity. The test items on MOA generated by Sage Poe included themes such as renin-angiotensin-aldosterone (RAAS) system, beta-adrenergic blockers (BB), calcium channel blockers (CCB), potassium channel openers, and centrally acting antihypertensives; on pharmacokinetics included high oral bioavailability/metabolism in liver [angiotensin receptor blocker (ARB)-losartan], long half-life and renal elimination [angiotensin converting enzyme inhibitors (ACEI)-lisinopril], metabolism by both liver and kidney (beta-blocker (BB)-metoprolol], rapid onset- short duration of action (direct vasodilator-hydralazine), and long-acting transdermal drug delivery (centrally acting-clonidine). Regarding the ADR theme, dry cough, angioedema, and hyperkalemia by ACEIs in susceptible patients, reflex tachycardia by CCB/amlodipine, and orthostatic hypotension by CCB/verapamil addressed. Clinical indications included the drug of choice for hypertensive patients with concomitant comorbidity such as diabetics (ACEI-lisinopril), heart failure and low ejection fraction (BB-carvedilol), hypertensive urgency/emergency (alpha cum beta receptor blocker-labetalol), stroke in patients with history recurrent stroke or transient ischemic attack (ARB-losartan), and preeclampsia (methyldopa).

Almost similar themes under each domain were identified by the Claude-Instant AI platform with few notable exceptions: hydrochlorothiazide (instead of clonidine) in MOA and pharmacokinetics domains, respectively; under the ADR domain ankle edema/ amlodipine, sexual dysfunction and fatigue in male due to alpha-1 receptor blocker; under clinical indications the best initial monotherapy for clinical scenarios such as a 55-year old male with Stage-2 hypertension; a 75-year-old man Stage 1 hypertension; a 35-year-old man with Stage I hypertension working on night shifts; and a 40-year-old man with stage 1 hypertension and hyperlipidemia.

As with Claude-Instant AI, ChatGPT-generated test items on MOA were mostly similar. However, under the pharmacokinetic domain, immediate- and extended-release metoprolol, the effect of food to enhance the oral bioavailability of ramipril, and the highest oral bioavailability of amlodipine compared to other commonly used antihypertensives were the themes identified. Whereas the other ADR themes remained similar, constipation due to verapamil was a new theme addressed. Notably, in this test item, amlodipine was an option that increased the difficulty of this test item because amlodipine therapy is also associated with constipation, albeit to a lesser extent, compared to verapamil. In the clinical indication domain, the case description asking “most commonly used in the treatment of hypertension and heart failure” is controversial because the options listed included losartan, ramipril, and hydrochlorothiazide but the suggested correct answer was ramipril. This is a good example to stress the importance of vetting the AI-generated MCQ by experts for content validity and to assure robust psychometrics. The MCQ on the most used drug in the treatment of “hypertension and diabetic nephropathy” is more explicit as opposed to “hypertension and diabetes” by Claude-Instant because the therapeutic concept of reducing or delaying nephropathy must be distinguished from prevention of nephropathy, although either an ACEI or ARB is the drug of choice for both indications.

It is important to align student assessment to the curriculum; in the PBL curriculum, MCQs with a clinical vignette are preferred. The modification of the query specifying the search to generate MCQs with a clinical vignette on domains specified previously gave appropriate output by all three AI platforms evaluated (Sage Poe; Claude- Instant; Chat GPT). The scenarios generated had a good clinical fidelity and educational fit for the pre-clerkship student perspective.

The errors observed with AI outputs on the A-type MCQs are summarized in Table  2 . No significant pattern was observed except that Claude-Instant© generated test items in a stereotyped format such as the same choices for all test items related to pharmacokinetics and indications, and all the test items in the ADR domain are linked to the mechanisms of action of drugs. This illustrates the importance of reviewing AI-generated test items by content experts for content validity to ensure alignment with evidence-based medicine and up-to-date treatment guidelines.

The test items generated by ChatGPT had the advantage of explanations supplied rendering these more useful for learners to support self-study. The following examples illustrate this assertion: “ A patient with hypertension is started on a medication that works by blocking beta-1 receptors in the heart (metoprolol)”. Metoprolol is a beta blocker that works by blocking beta-1 receptors in the heart, which reduces heart rate and cardiac output, resulting in a decrease in blood pressure. However, this explanation is incomplete because there is no mention of other less important mechanisms, of beta receptor blockers on renin release. Also, these MCQs were mostly recall type: Which of the following medications is known to have a significant first-pass effect? The explanation reads: propranolol is known to have a significant first pass-effect, meaning that a large portion of the drug is metabolized by the liver before it reaches systemic circulation. Losartan, amlodipine, ramipril, and hydrochlorothiazide do not have significant first-pass effect. However, it is also important to extend the explanation further by stating that the first-pass effect of propranolol does not lead to total loss of pharmacological activity because the metabolite hydroxy propranolol also has potent beta-blocking activity. Another MCQ test item had a construction defect: “A patient with hypertension is started on a medication that can cause photosensitivity. Which of the following medications is most likely responsible?” Options included: losartan, amlodipine, ramipril, hydrochlorothiazide, hydrochlorothiazide/triamterene. The explanation states that hydrochlorothiazide (HCTZ) can cause photosensitivity, which is increased sensitivity to sunlight that can cause skin rashes and sunburns. Losartan, amlodipine, ramipril, and HCTZ/triamterene are less likely to cause photosensitivity. However, it is irrational to claim that HCTZ/triamterene, one of the wrong options, is less likely to cause photosensitivity. The difficulty index of such test items is likely unacceptable in high-stake tests to make equitable psychometric decisions.

The responses from Sage Poe, Claude-Instant, and ChatGPT on guidance for standard-setting methods are listed in the electronic supplementary materials 13 – 15 . Sage Poe offered this information with the caveat that “the results of this simulation were purely hypothetical and do not reflect the actual performance of any real students”. The simulation estimates of examinees correctly answering test items ranged from 60 to 90% for the mechanism of action, 65–85% for pharmacokinetics, 60–80% for adverse reactions, and 75–90% for clinical indications of antihypertensives.

In contrast, Claude-Instant admitted that “Performing a full simulation with 100 medical students is beyond the scope of what I can do as an AI assistant. I can generate sample MCQ questions and answers, but I do not have access to a population of medical students to administer the questions. A true simulation that administers questions to real students and analyzes the results would require access to a database of medical students, a platform to deliver the questions, and code to analyze the responses. As an AI assistant, I lack these capabilities. While I cannot perform a full simulation, here are some considerations for administering MCQ questions to medical students: provide details on the purpose and instructions for the test to ensure students understand what is expected out of them; consider including some easier questions in addition to more challenging ones to boost students’ confidence and motivation; avoid ambiguous wording and ensure each question has only one unambiguously correct answer option; when analyzing results, look for questions factors that may have impacted performance, like unclear wording or answer options that are too similar. Focusing on weak questions can help improve future tests; compare performance across different student groups to identify areas where more teaching may be needed; provide detailed answer explanations and review sessions after the test to help students learn from any errors and reinforce correct concepts”. However, ChatGPT offered the simulation result estimates for the 20 MCQ on antihypertensive drugs: mechanism of action ranged from 67 to 92%, pharmacokinetics 63–86%, adverse effects 65–82%, and clinical indications 64–89%. Furthermore, it also stated that “Overall, the performance of the students was quite good, with most questions having a response rate of over 70%. However, there were some questions where the projected correct response rate was rather low, such as Question #5 (Mechanism of Action of Hydrochlorothiazide; see Electronic Supplementary Material 12 ) and Question 18 (Indications for Verapamil; see Electronic Supplementary Material 10 ). This may suggest areas where students need more focused education or review.”

We asked AI assistants to generate 20 integrated case cluster MCQs with 2 test items in each cluster with five options for undergraduate medical students in the pre-clerkship phase integrating pharmacology and physiology related to systemic hypertension with a case vignette and the responses by Sage Poe, Claude-Instant, and ChatGPT are listed in the electronic supplementary materials ( 16 – 18 ). In all instances, the test items generated had focused case descriptions in the form of a clinical vignette, and horizontal integration across the pathophysiology of hypertension and pharmacology of antihypertensive drugs. These test items mostly targeted the ‘knows (knowledge)’ or ‘knows how (competence)’ level on Miller’s pyramid and are suitable for assessing the clinical competence of pre-clerkship medical students, especially in an integrated PBL curriculum. Both the AI assistants generated excellent clinical vignettes and themes; however, most of the cluster MCQs by ChatGPT had “None of the above” as an option, which is often considered a test item construction flaw. Notwithstanding these limitations, case cluster integrated test items are valuable for learners to integrate their knowledge of different basic medical sciences and their application to clinical sciences. This integrated approach can be used for both instructional and student assessment purposes to make the course more meaningful. Indeed, one of the basic tenets of PBL is curriculum integration.

In the next query, we asked AI assistants to write integrated case cluster MCQs with 2 test items in each cluster with 5 options for undergraduate medical students at the time of graduation integrating pharmacology and physiology of hypertension with a case vignette. The responses are listed in the electronic supplementary materials 19 – 21 . Claude-Instant has provided only partial responses to both the queries. Overall, the information provided in case vignettes requires the learner to interpret the clinical information and make therapeutic decisions. Such test items are appropriate for assessing the minimum competency of medical school graduates to start internship or residency programs; these MCQs are generally comparable to test items used in USMLE Part 2. The evaluation of the integrated case cluster test items provided by all the AI platforms is summarized in Table  3 . In general, the AI outputs had at least one construction defect, and did not include all the core sub-topics to a sufficient degree.

When asked to simulate the above-generated test items to 100 undergraduate medical students at the time of graduation and provide a percentage of students who are likely to correctly answer each item, the AI assistant responded:

“ As an AI language model, I cannot simulate the responses of 100 undergraduate medical students likely to obtain the correct answer for each question. However, I can provide some general information about the difficulty level of each question based on the complexity of the concepts being tested and the level of integration between pharmacology and physiology ”.

AI assistant went on to clarify that questions that require knowledge of basic pharmacology principles, such as the mechanism of action of specific drugs, are likely to be easier for students to answer correctly. Test items that require an understanding of the physiological mechanisms underlying hypertension and correlating with symptoms are likely to be more challenging for students. The AI assistant sorted these test items into two categories accordingly. Overall, the difficulty level of the test item is based on the level of integration between pharmacology and pathophysiology. Test items that require an understanding of both pharmacological and physiological mechanisms are likely to be more challenging for students requiring a strong foundation in both pharmacology and physiology concepts to be able to correctly answer integrated case-cluster MCQs.

Short answer questions

The responses to a search query on generating SAQs appropriate to the pre-clerkship phase Sage Poe, Claude-Instant, and ChatGPT generated items are listed in the electronic supplementary materials 22 – 24 for difficult questions and 25–27 for moderately difficult questions.

It is apparent from these case vignette descriptions that the short answer question format varied. Accordingly, the scope for asking individual questions for each scenario is open-ended. In all instances, model answers are supplied which are helpful for the course instructor to plan classroom lessons, identify appropriate instructional methods, and establish rubrics for grading the answer scripts, and as a study guide for students.

We then wanted to see to what extent AI can differentiate the difficulty of the SAQ by replacing the search term “difficult” with “moderately difficult” in the above search prompt: the changes in the revised case scenarios are substantial. Perhaps the context of learning and practice (and the level of the student in the MD/medical program) may determine the difficulty level of SAQ generated. It is worth noting that on changing the search from cardiology to internal medicine rotation in Sage Poe the case description also changed. Thus, it is essential to select an appropriate AI assistant, perhaps by trial and error, to generate quality SAQs. Most of the individual questions tested stand-alone knowledge and did not require students to demonstrate integration.

The responses of Sage Poe, Claude-Instant, and ChatGPT for the search query to generate SAQs at the time of graduation are listed in the electronic supplementary materials 28 – 30 . It is interesting to note how AI assistants considered the stage of the learner while generating the SAQ. The response by Sage Poe is illustrative for comparison. “You are a newly graduated medical student who is working in a hospital” versus “You are a medical student in your pre-clerkship.”

Some questions were retained, deleted, or modified to align with competency appropriate to the context (Electronic Supplementary Materials 28 – 30 ). Overall, the test items at both levels from all AI platforms were technically accurate and thorough addressing the topics related to different disciplines (Table  3 ). The differences in learning objective transition are summarized in Table  4 . A comparison of learning objectives revealed that almost all objectives remained the same except for a few (Table  5 ).

A similar trend was apparent with test items generated by other AI assistants, such as ChatGPT. The contrasting differences in questions are illustrated by the vertical integration of basic sciences and clinical sciences (Table  6 ).

Taken together, these in-depth qualitative comparisons suggest that AI assistants such as Sage Poe and ChatGPT consider the learner’s stage of training in designing test items, learning outcomes, and answers expected from the examinee. It is critical to state the search query explicitly to generate quality output by AI assistants.

The OSPE test items generated by Claude-Instant and ChatGPT appropriate to the pre-clerkship phase (without mentioning “appropriate instructions for the patients”) are listed in the electronic supplementary materials 31 and 32 and with patient instructions on the electronic supplementary materials 33 and 34 . For reasons unknown, Sage Poe did not provide any response to this search query.

The five OSPE items generated were suitable to assess the prescription writing competency of pre-clerkship medical students. The clinical scenarios identified by the three AI platforms were comparable; these scenarios include patients with hypertension and impaired glucose tolerance in a 65-year-old male, hypertension with chronic kidney disease (CKD) in a 55-year-old woman, resistant hypertension with obstructive sleep apnea in a 45-year-old man, and gestational hypertension at 32 weeks in a 35-year-old (Claude-Instant AI). Incorporating appropriate instructions facilitates the learner’s ability to educate patients and maximize safe and effective therapy. The OSPE item required students to write a prescription with guidance to start conservatively, choose an appropriate antihypertensive drug class (drug) based on the patients’ profile, specifying drug name, dose, dosing frequency, drug quantity to be dispensed, patient name, date, refill, and caution as appropriate, in addition to prescribers’ name, signature, and license number. In contrast, ChatGPT identified clinical scenarios to include patients with hypertension and CKD, hypertension and bronchial asthma, gestational diabetes, hypertension and heart failure, and hypertension and gout (ChatGPT). Guidance for dosage titration, warnings to be aware, safety monitoring, and frequency of follow-up and dose adjustment. These test items are designed to assess learners’ knowledge of P & T of antihypertensives, as well as their ability to provide appropriate instructions to patients. These clinical scenarios for writing prescriptions assess students’ ability to choose an appropriate drug class, write prescriptions with proper labeling and dosing, reflect drug safety profiles, and risk factors, and make modifications to meet the requirements of special populations. The prescription is required to state the drug name, dose, dosing frequency, patient name, date, refills, and cautions or instructions as needed. A conservative starting dose, once or twice daily dosing frequency based on the drug, and instructions to titrate the dose slowly if required.

The responses from Claude-Instant and ChatGPT for the search query related to generating OSPE test items at the time of graduation are listed in electronic supplementary materials 35 and 36 . In contrast to the pre-clerkship phase, OSPEs generated for graduating doctors’ competence assessed more advanced drug therapy comprehension. For example, writing a prescription for:

(1) A 65-year- old male with resistant hypertension and CKD stage 3 to optimize antihypertensive regimen required the answer to include starting ACEI and diuretic, titrating the dosage over two weeks, considering adding spironolactone or substituting ACEI with an ARB, and need to closely monitor serum electrolytes and kidney function closely.

(2) A 55-year-old woman with hypertension and paroxysmal arrhythmia required the answer to include switching ACEI to ARB due to cough, adding a CCB or beta blocker for rate control needs, and adjusting the dosage slowly and monitoring for side effects.

(3) A 45-year-old man with masked hypertension and obstructive sleep apnea require adding a centrally acting antihypertensive at bedtime and increasing dosage as needed based on home blood pressure monitoring and refer to CPAP if not already using one.

(4) A 75-year-old woman with isolated systolic hypertension and autonomic dysfunction to require stopping diuretic and switching to an alpha blocker, upward dosage adjustment and combining with other antihypertensives as needed based on postural blood pressure changes and symptoms.

(5) A 35-year-old pregnant woman with preeclampsia at 29 weeks require doubling methyldopa dose and consider adding labetalol or nifedipine based on severity and educate on signs of worsening and to follow-up immediately for any concerning symptoms.

These case scenarios are designed to assess the ability of the learner to comprehend the complexity of antihypertensive regimens, make evidence-based regimen adjustments, prescribe multidrug combinations based on therapeutic response and tolerability, monitor complex patients for complications, and educate patients about warning signs and follow-up.

A similar output was provided by ChatGPT, with clinical scenarios such as prescribing for patients with hypertension and myocardial infarction; hypertension and chronic obstructive pulmonary airway disease (COPD); hypertension and a history of angina; hypertension and a history of stroke, and hypertension and advanced renal failure. In these cases, wherever appropriate, pharmacotherapeutic issues like taking ramipril after food to reduce side effects such as giddiness; selection of the most appropriate beta-blocker such as nebivolol in patients with COPD comorbidity; the importance of taking amlodipine at the same time every day with or without food; preference for telmisartan among other ARBs in stroke; choosing furosemide in patients with hypertension and edema and taking the medication with food to reduce the risk of gastrointestinal adverse effect are stressed.

The AI outputs on OSPE test times were observed to be technically accurate, thorough in addressing core sub-topics suitable for the learner’s level and did not have any construction defects (Table  3 ). Both AIs provided the model answers with explanatory notes. This facilitates the use of such OSPEs for self-assessment by learners for formative assessment purposes. The detailed instructions are helpful in creating optimized therapy regimens, and designing evidence-based regimens, to provide appropriate instructions to patients with complex medical histories. One can rely on multiple AI sources to identify, shortlist required case scenarios, and OSPE items, and seek guidance on expected model answers with explanations. The model answer guidance for antihypertensive drug classes is more appropriate (rather than a specific drug of a given class) from a teaching/learning perspective. We believe that these scenarios can be refined further by providing a focused case history along with relevant clinical and laboratory data to enhance clinical fidelity and bring a closer fit to the competency framework.

In the present study, AI tools have generated SLOs that comply with the current principles of medical education [ 15 ]. AI tools are valuable in constructing SLOs and so are especially useful for medical fraternities where training in medical education is perceived as inadequate, more so in the early stages of their academic career. Data suggests that only a third of academics in medical schools have formal training in medical education [ 16 ] which is a limitation. Thus, the credibility of alternatives, such as the AIs, is evaluated to generate appropriate course learning outcomes.

We observed that the AI platforms in the present study generated quality test items suitable for different types of assessment purposes. The AI-generated outputs were similar with minor variation. We have used generative AIs in the present study that could generate new content from their training dataset [ 17 ]. Problem-based and interactive learning approaches are referred to as “bottom-up” where learners obtain first-hand experience in solving the cases first and then indulge in discussion with the educators to refine their understanding and critical thinking skills [ 18 ]. We suggest that AI tools can be useful for this approach for imparting the core knowledge and skills related to Pharmacology and Therapeutics to undergraduate medical students. A recent scoping review evaluating the barriers to writing quality test items based on 13 studies has concluded that motivation, time constraints, and scheduling were the most common [ 19 ]. AI tools can be valuable considering the quick generation of quality test items and time management. However, as observed in the present study, the AI-generated test items nevertheless require scrutiny by faculty members for content validity. Moreover, it is important to train faculty in AI technology-assisted teaching and learning. The General Medical Council recommends taking every opportunity to raise the profile of teaching in medical schools [ 20 ]. Hence, both the academic faculty and the institution must consider investing resources in AI training to ensure appropriate use of the technology [ 21 ].

The AI outputs assessed in the present study had errors, particularly with A-type MCQs. One notable observation was that often the AI tools were unable to differentiate the differences between ACEIs and ARBs. AI platforms access several structured and unstructured data, in addition to images, audio, and videos. Hence, the AI platforms can commit errors due to extracting details from unauthenticated sources [ 22 ] created a framework identifying 28 factors for reconstructing the path of AI failures and for determining corrective actions. This is an area of interest for AI technical experts to explore. Also, this further iterates the need for human examination of test items before using them for assessment purposes.

There are concerns that AIs can memorize and provide answers from their training dataset, which they are not supposed to do [ 23 ]. Hence, the use of AIs-generated test items for summative examinations is debatable. It is essential to ensure and enhance the security features of AI tools to reduce or eliminate cross-contamination of test items. Researchers have emphasized that AI tools will only reach their potential if developers and users can access full-text non-PDF formats that help machines comprehend research papers and generate the output [ 24 ].

AI platforms may not always have access to all standard treatment guidelines. However, in the present study, it was observed that all three AI platforms generally provided appropriate test items regarding the choice of medications, aligning with recommendations from contemporary guidelines and standard textbooks in pharmacology and therapeutics. The prompts used in the study were specifically focused on the pre-clerkship phase of the undergraduate medical curriculum (and at the time of their graduation) and assessed fundamental core concepts, which were also reflected in the AI outputs. Additionally, the recommended first-line antihypertensive drug classes have been established for several decades, and information regarding their pharmacokinetics, ADRs, and indications is well-documented in the literature.

Different paradigms and learning theories have been proposed to support AI in education. These paradigms include AI- directed (learner as recipient), AI-supported (learner as collaborator), and AI-empowered (learner as leader) that are based on Behaviorism, Cognitive-Social constructivism, and Connectivism-Complex adaptive systems, respectively [ 25 ]. AI techniques have potential to stimulate and advance instructional and learning sciences. More recently a three- level model that synthesizes and unifies existing learning theories to model the roles of AIs in promoting learning process has been proposed [ 26 ]. The different components of our study rely upon these paradigms and learning theories as the theoretical underpinning.

Strengths and limitations

To the best of our knowledge, this is the first study evaluating the utility of AI platforms in generating test items related to a discipline in the undergraduate medical curriculum. We have evaluated the AI’s ability to generate outputs related to most types of assessment in the undergraduate medical curriculum. The key lessons learnt for improving the AI-generated test item quality from the present study are outlined in Table  7 . We used a structured framework for assessing the content validity of the test items. However, we have demonstrated using a single case study (hypertension) as a pilot experiment. We chose to evaluate anti-hypertensive drugs as it is a core learning objective and one of the most common disorders relevant to undergraduate medical curricula worldwide. It would be interesting to explore the output from AI platforms for other common (and uncommon/region-specific) disorders, non-/semi-core objectives, and disciplines other than Pharmacology and Therapeutics. An area of interest would be to look at the content validity of the test items generated for different curricula (such as problem-based, integrated, case-based, and competency-based) during different stages of the learning process. Also, we did not attempt to evaluate the generation of flowcharts, algorithms, or figures for generating test items. Another potential area for exploring the utility of AIs in medical education would be repeated procedural practices such as the administration of drugs through different routes by trainee residents [ 27 ]. Several AI tools have been identified for potential application in enhancing classroom instructions and assessment purposes pending validation in prospective studies [ 28 ]. Lastly, we did not administer the AI-generated test items to students and assessed their performance and so could not comment on the validity of test item discrimination and difficulty indices. Additionally, there is a need to confirm the generalizability of the findings to other complex areas in the same discipline as well as in other disciplines that pave way for future studies. The conceptual framework used in the present study for evaluating the AI-generated test items needs to be validated in a larger population. Future studies may also try to evaluate the variations in the AI outputs with repetition of the same queries.

Notwithstanding ongoing discussions and controversies, AI tools are potentially useful adjuncts to optimize instructional methods, test blueprinting, test item generation, and guidance for test standard-setting appropriate to learners’ stage in the medical program. However, experts need to critically review the content validity of AI-generated output. These challenges and caveats are to be addressed before the use of widespread use of AIs in medical education can be advocated.

Data availability

All the data included in this study are provided as Electronic Supplementary Materials.

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RPS– Conceived the idea; KS– Data collection and curation; RPS and KS– Data analysis; RPS and KS– wrote the first draft and were involved in all the revisions.

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Sridharan, K., Sequeira, R.P. Artificial intelligence and medical education: application in classroom instruction and student assessment using a pharmacology & therapeutics case study. BMC Med Educ 24 , 431 (2024). https://doi.org/10.1186/s12909-024-05365-7

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Received : 26 September 2023

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Published : 22 April 2024

DOI : https://doi.org/10.1186/s12909-024-05365-7

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