A novel use of an artificially intelligent Chatbot and a live, synchronous virtual question

The COVID-19 pandemic has brought sweeping changes to how we recruit residents and fellows. Due to travel restrictions, social distancing and limits on gatherings, the norm of in-person interviews has been replaced by virtual interview platforms. Multiple regulatory bodies, including the Accreditation Council for Graduate Medical Education (ACGME), have called accredited programs to “commit to online interviews and virtual visits” (https://www.aamc.org/system/files/202005/covid19_Final_Recommendations_Executive%20Summary_Final_05112020.pdf). Although web based interviews (WBIs) have substantial cost and time benefits, they do pose their own new challenges; mainly due to the lack of in-person, face-to-face interactions and the difficulty in picking up non-verbal cues on a screen [1, 2]. However, despite these short-comings, WBIs may signal the start of changes and innovation to the traditional interview format and may even become a commonly used modality post-pandemic. As Graduate Medical Education programs pivot towards WBIs, a focus on other virtual recruitment tools has also gained traction.

In addition to WBIs, recruitment tactics have also shifted to more digital media-centric content [2]. Academic departments universally communicate information about their programs and about the department in general, using static websites. Residency websites have been shown to influence applicants’ first impression of a program and are a critically important factor in decision making [3]. In addition to websites, some programs have even ventured out into social media (SM) such as Twitter and Instagram to offer more engaging and detailed content [4]. Most applications of this type of SM are unidirectional, meaning that the host specifically curates information to present. However, opportunities for bidirectional communication can potentially pave the way for additional innovative uses. Very few programs use this type of SM interaction either in an asynchronous or synchronous manner. An example of synchronous, bidirectional use of SM is Google Hangouts [5]. These bidirectional forms of SM interaction show great promise; even hosting a live Question and Answer (Q&A) session has the potential to improve the overall perception of a program. Hass, et al. recently mentioned that traditional strategies of recruitment including branding, fostering a national reputation, developing a website, and utilizing a SM presence have been emphasized in the past [2]. The COVID-19 pandemic brought upheaval to these traditional methods of recruitment and has forced us to reimagine innovative ways to recruit residents and fellows. Virtual program branding has become essential and SM use, along with Q&A sessions, could be a key component to the type of branding that is necessary for virtual residency recruitment [6].

SM appears to have an increasing influence on residency decisions [7]. With the concurrent expansion of SM, technological development in the realm of Artificial Intelligence (AI) has grown exponentially as well. AI is a field which combines computer science and robust datasets, to enable problem-solving (https://www.ibm.com/cloud/learn/what-is-artificial-intelligence). With the growth of AI, its effects have permeated into various aspects of our lives, including the medical field. AI is changing traditional methods of medical imaging analysis, health data acquisition, and even medical education. AI has practical uses for distance learning and various inquiry systems, however AI for the application of trainee recruitment has not been reported [8]. AI usage in the form of a chatbot or virtual concierge agent has expanded on websites and in SM. A chatbot is defined as “a computer program designed to simulate conversation with human users, especially over the Internet” and is also known as a smart bot or digital assistant [9]. Chatbots can mimic human conversation and are useful in applications such as information retrieval and education [10]. While there are uses of chatbot as recruiters in the business world, there are no reports of chatbot use in Graduate Medical Education [10]. While much of the technology behind these uses are continuously being developed and applied, the potential use of AI and chatbots, for the purposes of trainee recruitment, is novel and underutilized. The proposed benefits of AI include relieving and splitting work performed by humans as well as replacing and augmenting human work [11]. AI and chatbots are continuously pushing the limits of the tasks machines can take over from humans and can potential save time and human resources.

In order to adapt to changes brought on by the pandemic, we recently employed an artificially intelligent chatbot on the department website to engage users in a bidirectional exchange. The chatbot is a conversational AI agent which uses natural language to understand phrases. It was tested by a third party to create the appropriate flow of information and allow users to ask questions and search for information. For example, applicants could ask the chatbot “Show me faculty that trained at or where do fellows live?” The chatbot would then return profiles of faculty that met criteria and an interactive google map of where fellows live, respectively. In addition, we used the chatbot to schedule and coordinate live, synchronous Question and Answer sessions about our program. Instead of using separately purchased scheduling software which would still rely on human monitoring, we employed the use of a chatbot to aid in some of the work usually performed by a human coordinator. We used these new technologies to complement the traditional strategies that are used to engage potential applicants. With this preliminary study, we aimed to answer the questions; can the use of an Artificially Intelligent Chatbot and a Virtual Question-and-Answer Session aid in recruitment in a Post-COVID-19 era and how will AI change what tasks machines can perform?