The latest artificial intelligence models can perform advanced reasoning, providing more sophisticated ways to help lecturers plan and prepare teaching sessions. Here, I outline the approach I used to brainstorm ideas for a pre-reading/tutorial session for medical students, adhering to adult learning principles.
AI prompting is a critical skill that all lecturers, academics and students need to learn and practice. Although AI models and tools are improving extremely quickly, the prompts we use and the direct oversight we provide will likely still be needed in the foreseeable future.
Selecting the right AI model
Non-reasoning AI models such as OpenAI Chat GPT-4o are extremely knowledgeable about most topics and respond predictably to well-recognised prompting methods, as outlined in my 2023 article here.
GPT-o1 is an advanced reasoning model because it spends extra time ‘thinking’ about problems, working through potential solutions and ranking and comparing options before finally responding. This makes it particularly suited to complex tasks, such as brainstorming high-level solutions to problems. It’s stronger at strategy than details.
Like earlier models, Open AI’s GPT-o1 responds best to a structured prompt but does not require ‘chain-of-thought’ instructions (e.g., ‘Think carefully, step-by-step to solve this problem’), an approach that improves output with GPT-4o. However, this leads to degraded output with GPT-o1.
A prompt is the text we enter into the AI chatbot window to give it instructions. Here is my prompt for the task at hand - education strategies for my tutorials with year 5 students. Courier font is used here to demark prompts but is not required. A detailed explanation follows.
# ObjectiveDevelop educational interventions and materials for medical students studying Obstetrics & Gynaecology. The outputs you provide will be varied and can be for both the pre-session work and interactive face-to-face segments.## ContextYou are an expert Professor in obstetrics and gynaecology with specialised skills and training in medical education and instructional design. Our students are final year of medical school in Queensland, Australia, completing a 6 week attachment in O&G. I have 45 minute face-to-face sessions, but typically ask students to complete ‘pre-reading’ for 30-45 minutes beforehand in a *flipped classroom* style. Currently I use some didactic sessions with Q&A but also practice OSCE sessions (10 minutes) involving role play, replicating the style of one aspect of their final exams.## Topic for learningBreech presentation## Key concepts students need to learnHow to diagnose breech presentation - who is at greater risk, clinical palpation, bedside ultrasound. When to diagnose breech - largely unimportant before 34-35 weeks gestation unless a patient is in labour. Appropriate diagnosis and management at term is keyManagement when breech is diagnosed at term - including formal ultrasound and why, information sharing utilising BRAIN (benefits, risks, alternatives, intuition, nothing) & shared decision making with the patientECV vs caesarean section vs planned vaginal breech delivery **See Content Framework below for enhanced detail to guide content, extracted from the Queensland Health Guideline on Breech Presentation.**## Output formatAlways British English spelling, including medical terms, e.g. fetal not foetal, fetus not foetus.Always sentence case for headings.Tables can be used to summarise concepts and strategies where appropriate. This is not to say you must use tables. Structured output using headings and bullet points as needed to improve readability.#Task oneWe recognise that optimal learning for adult learners occurs when they are actively involved in the material and in control of *how* they learn. What approaches could we use for linked pre-work material and tutorial sessions? Brainstorm a minimum of 5-6 options that will lead to high levels of engagement. Ideas should link pre-work and in-person learning strategies.I have omitted the Content Framework section to make the prompt easier to understand, but I have included it below in a separate paragraph. Points to note:
Use of markdown to structure the prompt. These are the levels of #heading ##subheading that are within the prompt and *keywords* highlighted by an asterisk. All language models benefit from a structure such as this, particularly GPT-o1. You can also use more complex options, such as XML if you know how to write it, but markdown is simple. If you want to work on a long document, you can use https://dillinger.io
Clear objectives, context, background information and content to a relevant depth. The AI will respond much more productively if you tell it relevant details about your context, particularly in this case, information about session length, year of study, what I am trying to achieve, etc. I did include more detail about the knowledge structure (see below) because if I ask it to generate material for me, this will guide the AI to generate content relevant to my exact context (i.e based on Queensland clinical guidelines).
Output format - helpful if you have specific requirements.
Task clarity - a specific task is included at the end. If you seek honed and specific outputs from AI, you need to do some work to generate high-quality instructions.
So, how did the AI do? Here’s the output it generated and the follow-up asking the AI to expand on one of the ideas.
Approaches to link pre-work with face-to-face sessions
1. Interactive online modules with self-assessment
• Description: Provide brief, focused e-learning modules (10–15 minutes) on breech presentation. These could include interactive graphics, short case vignettes, and self-assessment quizzes.
• Link to face-to-face: In the classroom, review quiz results and clarify common misconceptions. Use the results to tailor the in-person discussion to the areas students found challenging.
• Why it works: Interactive modules encourage active engagement, allowing learners to assess and track their own understanding prior to the session.
2. Guided video observation with discussion prompts
• Description: Create or curate a short (10–15 minute) video of simulated breech births (including different breech presentations). Accompany it with structured discussion prompts or reflective questions.
• Link to face-to-face: Start the tutorial by comparing student reflections. Encourage them to highlight the challenges they noted in the video and then connect these observations to clinical practice.
• Why it works: Videos help visual learners and serve as powerful triggers for discussion, enabling students to see clinical nuances in a safe environment before direct engagement in practical sessions.
3. Key article or guideline reading with a collaborative online discussion board
• Description: Assign a short reading from a reputable guideline (e.g., Queensland Health Guideline on Breech Presentation). Ask students to post a question or comment on a discussion board.
• Link to face-to-face: Use the student questions from the board to guide an in-person Q&A, ensuring clarity and deeper exploration of tricky points.
• Why it works: Encourages students to read thoroughly and think critically. The discussion board fosters collaboration and peer learning even before the in-person tutorial.
4. Case-based problem-solving activity
• Description (pre-work): Provide a mock scenario (e.g., a 38-week pregnant woman diagnosed with frank breech) with incomplete data. Students brainstorm the next steps or possible complications.
• Link to face-to-face: Present updated clinical data in class (e.g., new ultrasound findings). Ask students, in small groups, to determine an appropriate management plan.
• Why it works: Case-based learning stimulates critical thinking, ties theoretical knowledge to clinical reasoning, and helps students understand real-life clinical decision-making processes.
5. Peer teaching and mini-presentations
• Description (pre-work): Divide students into small teams. Assign each team a sub-topic (e.g., ECV, types of breech, ultrasound criteria) to research, then create a concise presentation (3–5 minutes).
• Link to face-to-face: Students deliver their mini-presentations to one another. The tutor clarifies inaccuracies and supplements with additional detail.
• Why it works: Peer teaching requires students to understand material thoroughly in order to teach it. Presenting and responding to questions consolidate their knowledge.
6. Virtual simulation or gamification
• Description: Provide an online interactive module or a simulation game where students virtually manage a labour scenario involving breech presentation.
• Link to face-to-face: In the tutorial, debrief on the simulation results and use role-play or OSCE-style demonstrations to rehearse key clinical skills.
• Why it works: Simulations and games are highly engaging and promote experiential learning, giving students a chance to practise decision-making in a risk-free environment before applying skills in real clinical settings.
References
• Queensland Health. (2022). Guideline: Breech presentation (Version 2). Queensland Clinical Guidelines.
• Knowles, M. S. (1980). The Modern Practice of Adult Education: From Pedagogy to Andragogy. Wilton, CT: Association Press.
• McLeod, S. A. (2017). Kolb’s Experiential Learning Cycle. Simply Psychology.
These approaches facilitate active learning, helping students explore content in advance and then engage more deeply during face-to-face sessions.
My prompt:
Great! Provide 5 more please
Output:
7. Reflective journaling and question generation
• Description (pre-work): Ask students to keep a brief reflective journal after reading through the breech guidelines or watching a relevant case video. They should also generate two questions they would like to see answered during the face-to-face session.
• Link to face-to-face: Collect the most frequently asked or pertinent questions at the start of the tutorial and address these through open discussion, small group brainstorming, or instructor-led clarification.
• Why it works: Reflection encourages deeper engagement with the content and helps learners identify personal knowledge gaps. Using their questions directly in class validates student contribution and targets instruction where it’s most needed.
8. Concept mapping
• Description: Provide a basic concept map outline (e.g. headings: ‘Diagnosis’, ‘Timing’, ‘Management Options’). Ask students to complete and expand on it after reading the pre-session materials.
• Link to face-to-face: In small groups, students compare their concept maps and combine them into one consolidated map. Each group then explains their map to the class, highlighting key connections and clarifying any misconceptions.
• Why it works: Concept maps help students organise and link information visually, demonstrating relationships among key concepts of breech presentation. They also serve as an effective tool for recall.
9. Collaborative infographic assignment
• Description (pre-work): Assign small groups to create a one-page infographic summarising a specific subtopic (e.g. ‘Risk factors for breech’ or ‘ECV vs. caesarean section’). Students can use online tools such as Canva or PowerPoint.
• Link to face-to-face: Display each group’s infographic in class. Students rotate through stations, analysing and critiquing each other’s work. The tutor then provides clarifications and additional content.
• Why it works: Creating an infographic requires students to distil information into digestible bites. Peer review fosters deeper engagement and cross-group learning.
10. Think–pair–share guided by case vignettes
• Description (pre-work): Distribute short clinical vignettes (e.g., a 35-year-old G2P1 at 38 weeks with a frank breech). Students identify their proposed management steps in writing.
• Link to face-to-face: In the tutorial, students first think individually about the case for one minute (recapping their pre-work). Next, they pair with a partner to compare approaches and rationale. Finally, pairs share with the entire group.
• Why it works: This simple structure allows students to organise their thinking, test their reasoning with a peer, and then refine their understanding through group feedback and tutor input.
11. Team-based learning (TBL) approach
• Description (pre-work): Provide reading materials on breech presentation guidelines. Students complete an individual readiness assurance test (iRAT) online (multiple-choice questions) before class.
• Link to face-to-face: In class, students form teams, re-take a team readiness assurance test (tRAT), and immediately compare with the correct answers. Follow with group application exercises using clinical scenarios.
• Why it works: TBL harnesses accountability (individual prep plus group collaboration), ensuring active participation and deeper exploration of clinical decision-making pathways.
References
• Queensland Health. (2022). Guideline: Breech presentation (Version 2). Queensland Clinical Guidelines.
• Knowles, M. S. (1980). The Modern Practice of Adult Education: From Pedagogy to Andragogy. Wilton, CT: Association Press.
• Michaelsen, L. K., Knight, A. B., & Fink, L. D. (Eds.). (2002). Team-Based Learning: A Transformative Use of Small Groups. Praeger.
My prompt:
Let's progress with 8. concept maps. Generate for me the map structure, headings for the map (include a couple of second level details), and the student instructions. Ensure they document any questions that arise during reading.
Output:
Below is a suggested structure for a concept map on breech presentation. Each main heading is followed by second-level details to guide students in organising their ideas.
Concept map structure
Student instructions
1. Pre-reading materials:
• Review the Queensland Health Guideline on Breech Presentation (or similar reputable guideline).
• Pay special attention to risk factors, methods of diagnosis, management options, and how to involve patients in shared decision-making.
2. Construct your concept map:
• Use the headings above as the backbone of your map.
• Under each heading, expand the key points based on what you learned from the readings. For example:
• Risk factors → group maternal factors together, then fetal, then placental or amniotic factors.
• Diagnosis → outline the steps of clinical palpation and how ultrasound findings refine management.
• Draw arrows or connector lines to show relationships between concepts. For instance, connect “ECV” to “Ultrasound confirmation” to illustrate how ultrasound findings can impact decisions on ECV.
3. Second-level details:
• Add at least 2–3 points under each main heading (e.g., under ‘Planned vaginal breech delivery’, note the eligibility criteria and mention the recommended labour management protocols).
• Consider how each piece of information overlaps. For example:
• Risk factors may influence Diagnosis (e.g., fibroids obscuring clinical palpation).
• Timing often dictates which Management pathways are most appropriate.
4. Document your questions:
• As you read, note any questions that come to mind (e.g., “How does polyhydramnios specifically increase the risk of breech?” or “When is ECV contraindicated?”).
• Include these questions on the side of your concept map or in a separate notes section. This helps you track areas needing clarification.
5. Sharing and refinement:
• Bring your concept map and questions to the next face-to-face session.
• In small groups, compare and discuss your maps:
• How do they differ?
• Which connections or ideas are similar?
• Collectively refine the map for completeness and clarity.
• Raise your documented questions during the session. The tutor will clarify them and ensure all students have a solid understanding of the topic.
Use this framework to integrate your pre-session reading into a visual representation of breech presentation, clarifying key relationships and clinical decision points.
Further AI prompting and model choice
Further prompting could be used to expand on individual ideas and, with careful guidance, generate additional material for the educational sessions. This methodology requires strong oversight and input from a content expert to ensure the output provided meets your required specifications and is accurate.
If I were to go deeper into content production in this conversation, I would switch to GPT-4o in the same chat window. This ensures the prior discussion/context is maintained, but the correct AI model is selected.
The ## Content Framework I used is outlined here. GPT-4o generated the text of the framework, based on my local, reputable source of information. I cut-pasted the whole of the Queensland Health Breech Clinical Guideline below into the prompt, as indicated below.
Using a lower-level (but still highly intelligent) AI model in this way highlights the importance of selecting the right tool for the job. GPT-o1 is not suited to standard ‘office tasks’ and should only be used when complex reasoning or thinking is required.
The final output of this initial AI call generated my ## Content Framework - a summarised, high-quality text to include in the GPT-o1 task above. I didn’t just cut-paste directly from the PDF into the GPT-o1 task prompt because all AIs work best with structured information, and this two-stage approach would provide a better final output. It also didn’t need the full clinical guideline - just a summary.
My prompt:
Please extract relevant concepts and recommendations for medical student learning from the Qld breech guideline. I'm particularly interested in the following framework:How to diagnose breech presentation - who is at greater risk, clinical palpation, bedside ultrasoundWhen to diagnose breech - largely unimportant before 34-35 weeks gestation unless a patient is in labour. Appropriate diagnosis and management at term is keyManagement when breech is diagnosed at term - including formal ultrasound and why, information sharing utilising BRAIN (benefits, risks, alternatives, intuition, nothing) & shared decision making with the patientECV vs caesarean section vs planned vaginal breech delivery Material that is postgraduate level need not be included or included only in appropriate details.Generate output in British English spelling always and sentence case headings.<full text of PDF pasted here>…Great, increase length by 100% and output in markdown format in a code window.Output:
# Framework for Medical Student Learning on Breech Presentation
## Diagnosis of breech presentation
### Who is at greater risk
Certain conditions predispose women to a higher likelihood of breech presentation:
- **Maternal factors:**
- Uterine anomalies such as bicornuate uterus or fibroids.
- Prior breech presentation or caesarean delivery.
- High parity, which can cause uterine overdistension and reduced tone.
- **Fetal factors:**
- Structural abnormalities like hydrocephalus or anencephaly.
- Chromosomal anomalies.
- **Placental or amniotic factors:**
- Placenta previa restricting engagement of the fetal head.
- Polyhydramnios allowing excessive fetal movement or oligohydramnios limiting movement.
### Clinical palpation
- Clinical examination remains a key tool in diagnosing breech presentation, especially in resource-limited settings.
- During abdominal palpation:
- A soft, non-ballotable mass (the head) may be felt in the uterine fundus.
- A firmer, round, and ballotable mass (the buttocks) may be palpated in the lower uterine segment.
- **Limitation:** Clinical palpation may not always be accurate, particularly in women with high BMI, anterior placentas, or uterine fibroids.
### Bedside ultrasound
- Bedside ultrasound should be used to confirm the diagnosis in cases where clinical examination is inconclusive or unreliable.
- A detailed obstetric ultrasound is recommended once breech is confirmed to:
- Assess fetal anatomy for anomalies.
- Evaluate fetal size, type of breech presentation (e.g., frank, complete, footling), and amniotic fluid levels.
- Identify placental location and umbilical cord position.
---
## Timing of diagnosis
### Before 34–35 weeks gestation
- Breech presentation is relatively common in mid-pregnancy (up to 20% of pregnancies at 28 weeks) and resolves spontaneously in most cases.
- Intervention is rarely required unless the woman is in preterm labour or there is another obstetric indication.
### At or after 37 weeks gestation
- Diagnosis of breech at term is critical for delivery planning.
- Breech presentation should be confirmed with ultrasound and managed based on shared decision-making between the clinician and the patient.
---
## Management when breech is diagnosed at term
### Ultrasound confirmation
- Confirming presentation via ultrasound ensures that breech is accurately identified and any contributing factors are noted.
- The scan should include:
- Detailed assessment of fetal anatomy to rule out anomalies.
- Estimation of fetal weight, ensuring it falls within the range compatible with vaginal delivery (2.5–3.8 kg).
- Liquor volume assessment.
- Position of the placenta and umbilical cord to rule out complicating factors like placenta previa or cord prolapse risk.
### Information sharing and shared decision-making
- Counselling should be conducted using the BRAIN framework:
- **B**enefits: Explain the potential outcomes associated with each delivery method, including reduced neonatal trauma with caesarean section.
- **R**isks: Discuss maternal risks such as surgical complications or uterine rupture in future pregnancies after caesarean section.
- **A**lternatives: Provide information on ECV as a strategy to convert breech to cephalic presentation and outline the risks and benefits of both planned caesarean and vaginal breech delivery.
- **I**ntuition: Encourage the patient to express their feelings and preferences about delivery modes.
- **N**othing: Acknowledge that awaiting spontaneous labour might be an option if clinical circumstances permit.
- Document all counselling and decisions clearly to ensure transparency and compliance with medico-legal standards.
---
## Delivery options
### External cephalic version (ECV)
- **Indications and timing:**
- Offered at or beyond 36–37 weeks.
- Success is higher in multiparous women compared to nulliparous women.
- **Prerequisites:**
- Performed in a hospital with facilities for emergency caesarean section.
- Tocolysis (e.g., nifedipine or terbutaline) may be used to improve success rates.
- **Risks and contraindications:**
- Absolute contraindications include placenta previa, recent antepartum haemorrhage, multiple pregnancy, or abnormal fetal heart patterns.
- Relative contraindications include oligohydramnios, uterine anomalies, or suspected fetal growth restriction.
### Planned caesarean section
- Recommended for most breech presentations at term, with the procedure scheduled around 39 weeks.
- Benefits include reduced perinatal mortality and trauma. However, maternal risks such as surgical complications and implications for future pregnancies must be addressed.
### Planned vaginal breech delivery
- Considered for select cases in appropriately equipped centres with experienced staff.
- **Criteria for eligibility include:**
- Frank or complete breech presentation.
- Normal fetal anatomy and no evidence of fetal compromise.
- Estimated fetal weight between 2.5–3.8 kg.
- Absence of hyperextension of the fetal head or cord presentation.
- **Labour management should include:**
- Continuous electronic fetal heart rate monitoring.
- Avoidance of induction or augmentation of labour.
- A hands-off approach during the delivery of the breech, with intervention only if complications arise.
This article was written by a human with no AI input, except the examples shown and Grammarly for minor edits.