Introduction: This research investigated the capabilities of ChatGPT-4 compared to medical students in answering MCQs using the revised Bloom’s Taxonomy as a benchmark. Methods: A cross-sectional study was conducted at The University of the West Indies, Barbados. ChatGPT-4 and medical students were assessed on MCQs from various medical courses using computer-based testing. Results: The study included 304 MCQs. Students demonstrated good knowledge, with 78% correctly answering at least 90% of the questions. However, ChatGPT-4 achieved a higher overall score (73.7%) compared to students (66.7%). Course type significantly affected ChatGPT-4’s performance, but revised Bloom’s Taxonomy levels did not. A detailed association check between program levels and Bloom’s taxonomy levels for correct answers by ChatGPT-4 showed a highly significant correlation (p< 0.001), reflecting a concentration of “remember-level” questions in preclinical and “evaluate-level” questions in clinical courses. Discussion: The study highlights ChatGPT-4’s proficiency in standardized tests but indicates limitations in clinical reasoning and practical skills. This performance discrepancy suggests that the effectiveness of artificial intelligence (AI) varies based on course content. Conclusion: While ChatGPT-4 shows promise as an educational tool, its role should be supplementary, with strategic integration into medical education to leverage its strengths and address limitations. Further research is needed to explore AI’s impact on medical education and student performance across educational levels and courses.

Introduction: Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. Design and Methods: A cross-sectional survey of HCP was conducted between February 14 and 27, 2021 using an online questionnaire. The questionnaire included demographic information, knowledge of novel coronavirus, intention to accept the COVID-19 vaccination, vaccine literacy (VL), and perceptions and attitudes regarding COVID-19 vaccines. Mean VL scores were calculated. The relationship between socio-demographic variables and vaccine intent was assessed using a multivariable logistic regression model. Results: Of 343 HCPs, 55.1% indicated they would accept the COVID-19 vaccine if it were available; 44.9% expressed hesitancy towards the COVID-19 vaccine. We assessed the impact of socio-demographic factors and previous vaccine behavior on vaccine intent; after adjustment of the multivariable logistic regression model, non-Barbadian nationality and previous flu vaccine uptake were statistically significant predictors of reported intent to take the COVID-19 vaccine. Persons who indicated that they would take the vaccine had a higher mean vaccine literacy score [3.46 95% CI (3.40, 3.52)] than those who were not ready to take the vaccine immediately [3.23 95% CI (3.15, 3.30)]. VL scores were higher among the 29.5% of HCPs who believed vaccines should be mandatory. Conclusion: This study highlighted vaccine hesitancy among HCPs in the sole public tertiary hospital of Barbados. As HCP perceptions may help or hinder the campaign to promote vaccine uptake in Barbados, vaccine promotion programs targeting HCPs are needed to ensure the success of the country’s COVID-19 vaccination drive.

Background: Medication adherence in systemic lupus erythematosus (SLE) reduces disease activity and the risk of flares.Objectives: We evaluated adherence in women with SLE who exhibit high morbidity and mortality. We evaluated demographic data and 2 conventional adherence predictors: self-efficacy and health literacy, along with 2 potential neuropsychiatric SLE complications: cognitive dysfunction and depression.Methods: One hundred six women randomly selected from the Barbados National Lupus Registry completed the Self-efficacy for Appropriate Medication Use Scale, Rapid Estimate of Adult Literacy in Medicine–Short Form, Cognitive Symptom Inventory, Beck Depression Inventory II, and Morisky’s Medication Adherence Questionnaire (MAQ). This study explored the effects of psychosocial and neuropsychiatric functioning on adherence using ordinal logistic regression.Results: Sixty percent reported high MAQ scores. The probability of high MAQ scores was lower among younger patients (P= 0.001) and those with shorter disease duration (P= 0.05). The probability of high MAQ scores fell with lower perceived self-efficacy (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.73–0.89;P< 0.001), worsening cognitive function (OR, 0.90; 95% CI, 0.84–0.97;P= 0.004), and increasing depression (OR, 0.93; 95% CI, 0.88–0.97;P= 0.002). There was no strong relationship between MAQ score and health literacy (OR, 0.37; 95% CI, 0.13–1.03;P= 0.06).Conclusion: Women with SLE who are younger and those with shorter disease duration should be assessed for medication adherence. Screening at diagnosis followed by routine assessment of cognitive dysfunction and depression along with perceived self-efficacy may further identify the most vulnerable subgroup who should be targeted with personalized intervention strategies.

Trauma is a complex and often contentious psychopathological construct. The term trauma has become ubiquitous within mental health literature and practice. It is often used interchangeably to describe the etiology and the reaction to it. In this article we describe its historical and contemporary conceptualization through a review of the disorders that claim a direct relation to traumatic events whether or not they are recognized by official psychiatric classification systems. We critically evaluate the extent to which current understandings of traumatic stress disorders capture the diversity and complexity in trauma experiences and responses across global contexts. Post Traumatic Stress Disorder continues to be the most used clinically and most studied academically. Other diagnoses such as Ongoing Traumatic Stress Reaction and Continuous Traumatic Stress are becoming more prevalent in psychiatry, and simultaneously, Complex PTSD is challenging the way we perceive and address some personality disorders. A realignment of the definition among the various mental health professions, in addition to a comprehensive evaluation of the relevance of current classification for the nature and timeline of traumatic events, in particular in war times, would ensure better research, interventions, and, ultimately, outcomes for individuals and communities affected by traumatic events.