ArticleBMC medical education2026
What the performance of multimodal LLMs on a national licensing exam teaches us about occupational therapy education.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
- Generative artificial intelligence in medical education: from knowledge assessment to clinical reasoning and professional competence.Frontiers in medicine · 2026Review
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Authors and funding
3 authors.
Funding
Abstract
backgroundMultimodal large language models (LLMs) are increasingly adopted in occupational therapy (OT) education, offering new opportunities for learning and assessment. However, their ability to handle professional licensing examinations remains unexplored. This study aimed to provide educational insights for OT educators by analyzing how multimodal LLMs perform on the Japanese National Examination for Occupational Therapists (JNEOT), particularly focused on visually-based questions.
methodsThe complete 199-item 2025 JNEOT (consisting of 177 text-only questions and 22 visually-based questions) was presented to OpenAI o3, Gemini 2.5, GPT-4.5, and Claude 3.7 in a zero-shot manner. Official answer keys served as the reference standard. Overall correct response rates and subscores were calculated for text-only versus visually-based and general versus practical items. We examined differences using Cochran's Q, and significant omnibus results were followed by Bonferroni-corrected McNemar tests.
resultsAll models achieved passing-level scores (82.4-91.0%) on text-based questions but showed a marked decline on visually based items (50.0-68.2%). No significant inter-model differences were found for visual tasks. Ten OT-specific questions were answered incorrectly by all models.
conclusionsThese findings suggest that LLMs can effectively reinforce foundational OT knowledge but remain limited in visual interpretation and contextual reasoning. For educators, the results offer practical guidance on using LLMs to enhance theoretical learning while maintaining OT educator-guided approaches for reflective and experiential competence development.
trial registrationNot applicable.
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