Purpose: To develop and evaluate a large language model (LLM)-based learning tool, featuring virtual patients (VPs) and virtual assessors (VAs), and to assess its impact on medical students’ perceptions of history-taking education compared to conventional learning methods. Methods: A tool using the GPT-4 API was developed to provide seven clinical VP scenarios and a VA that delivered both immediate, reflective dialogue and comprehensive written feedback. First- and second-year medical students participated in a 6-day study. Pre- and post-participation surveys using a 5-point Likert scale assessed perceptions of the LLM tool versus conventional methods across usability, self-efficacy, and feedback quality domains. Results: Twenty-one students completed the study. The LLM-based tool demonstrated statistically significant improvements over conventional methods in all assessed domains. Students reported greater comfort during practice (mean 4.57 vs. 2.95, p=0.0002). Significant gains were seen in six of eight self-efficacy measures, including confidence in handling unfamiliar cases (4.00 vs. 2.90, p=0.0002). All nine feedback quality dimensions improved significantly, with feedback perceived as more specific (4.43 vs. 3.24, p=0.0005) and personalized (4.19 vs. 3.19, p=0.0001). Conclusion An LLM-based learning tool featuring VPs and VAs can significantly enhance medical students’ perceived learning experience in history-taking education. It offers a scalable, accessible, and cost-effective complementary training method. Future research should validate these subjective improvements with objective performance metrics.

Background and Objectives: Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy. Methods: We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription. Results: A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort. Conclusion Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.