Evaluating a virtual simulation chatbot to improve communication for radiation therapy students: A pilot study.

BackgroundSimulation-based education is a well-established training technique in medical curricula, also for communication skills. Virtual reality (VR) technology can enhance this form of experience-based learning. How VR interacts with training communication skills for interpersonal and interprofessional medical encounters is, however, unclear. This study investigates how VR influences communication skills and behaviors in patient-student and team encounters in medical undergraduate simulations, in order to make recommendations for VR simulation-based communication skills training (CST).MethodsWe conducted a study with 22 third-year medical students completing a dyadic VR simulation (Smart Collaboration Tutor software). We coded communication skills and behaviors for team and patient-student communication in videorecorded VR simulations. We then analyzed communication patterns and finally developed themes for VR-mediated CST.ResultsOur findings revealed that students preferred the core communication skill of asking questions, informing, and thinking aloud as process communication skills in a VR simulation. Nonverbal and paraverbal behaviors were used with unclear intent. VR negatively impacted the focus of attention and flow of simulation-based communication skills training.DiscussionDyadic VR simulations tend to emphasize team and task-oriented communication. Its value for patient-student and relation-oriented communication is unclear. VR influenced conversational turn-taking by altering visual and auditory perceptions. Cognitive load was enhanced, potentially diverting attention from communication goals and observational focus.ConclusionMultiuser VR simulation shows certain possibilities for CST in medical undergraduate simulations. Recommendations on the contextual design of VR simulations, however, need to be taken into account to safeguard the focus of attention and flow of CST.Supplementary InformationThe online version contains supplementary material available at 10.1186/s41077-025-00386-8.

As a high-conflict setting for doctor-patient communication, the quality of communication in emergency departments directly impacts diagnostic and treatment orderliness and patient safety. This study employs discourse analysis and non-participatory observation within qualitative research to systematically collect doctor-patient interaction data from November 2024 to May 2025 across four Grade III Class A (the highest rank) hospitals in Nanchong City, Sichuan Province. Data collection focused on emergency departments (triage desk, resuscitation room, treatment area, and observation area), examining speech act characteristics and contextual associations during conflict-ridden doctor-patient communication. Findings reveal a significant spatial gradient in the distribution of conflict communication incidents: highest at triage desks (41.6%), followed by resuscitation rooms (30.7%), treatment areas (21.8%), and observation areas (5.9%), closely aligning with functional zone attributes. Conflict types were categorized into four major groups: disputes over process efficiency (48.51%), discrepancies in disease perception (24.75%), perceptions of service attitude (18.81%), and conflicts over resource allocation (7.92%). This study reveals the discursive triggers of emergency communication conflicts and their spatial-functional associations, providing clinical evidence for optimizing emergency department design, enhancing communication skills training for medical staff, and establishing conflict prevention systems.

Effective communication is essential for the delivery of quality cancer care; however, few clinicians receive formal communication training. There is a growing need for communication training tailored towards the interdisciplinary team's role in patient-centered care and addressing communication across all aspects of cancer care. The goals of this National Cancer Institute-funded training program were to (1) identify the eight domains of quality palliative care applicable across all stages of cancer, (2) demonstrate skills in key clinical areas of communication through lab sessions, and (3) develop goals for implementing communication skills training in practice through process improvement, staff education, and clinical care. The Interprofessional Communication Curriculum (ICC) training program, a train-the-trainer course for US-based adult oncology clinicians, included a 3-day training course with 1-year follow-up for ongoing support and to assess impact. Measures included pre-course institutional assessment, participant goal implementation, course evaluations, and surveys to assess communication training efforts post-course. Five training courses included 388 clinicians (nurses, social workers, and chaplains) in dyads from 38 US states. The project included 30% under-represented minority participants. The post-course results revealed participants trained an additional 9746 clinicians: 5872 nurses, 1276 social workers, 586 chaplains, 1128 physicians, and 884 others including students. The ICC training course resulted in increased effectiveness in communication practice across domains of care. ICC is an effective train-the-trainer program for interdisciplinary communication training.

Health and social care professionals are important for fostering behaviour change to improve population health. Behaviour change education is varied across university curricula, impacting practitioner preparedness to promote engagement in health behaviours. This study examined health and social care professionals’ perceptions of behaviour change education and training in their university course and the factors influencing their preparedness to engage in behaviour change conversations, guided by the Theoretical Domains Framework (TDF). Australian health and social care professionals (N = 153, Mage = 33.4, SD = 10.5) were surveyed on their perceptions of behaviour change training, knowledge, confidence, and six TDF domains. Sixty-one percent of participants reported that communication skills were highly integrated (‘a lot’ to ‘a great deal’) throughout their course, compared to behaviour change techniques (45.8%), behaviour change theories (45.8%), and counselling therapies (39.9%). Mental health/social care professionals differed significantly from primary care and allied health professionals in skills (p < 0.05) and beliefs about capabilities (p < 0.05 primary care only). Findings demonstrated strong professional identity and intentions for behaviour change but lower confidence in their own capability to deliver behaviour change interventions. University curricula should expand behaviour change content beyond current communication skills training, using discipline-specific approaches for improved graduate preparedness.

Introduction: Healthcare professionals need to recognise when someone is approaching the final days or hours of life and be confident to talk about death and dying. Undergraduate training in end-of-life care is inconsistent and students need more support [1]. In the UK, people are experiencing inequitable and suboptimal care before death, with delayed recognition of dying and poor communication resulting in inadequate support for symptoms [2]. Many students will not have a supported experience of caring for someone who is dying, whilst others will experience death frequently. Student nurses report fear, anxiety, and overwhelm about death on placement, feeling vulnerable and unprepared. This can lead to emotional trauma and dropping out before registration [3]. Simulation is used to specifically focus on increasing resilience and decreasing fear of death. A partnership simulation was designed to prepare student nurses for talking about death and dying, to improve end-of-life care experiences. Methods: Student nurses had an extended prebrief which aimed to breakdown the taboo of talking about death. Students participated in four simulation scenarios designed to develop confidence with conversations about death and dying. Scenarios were supported by end-of-life care educators and simulated patient actors to enable realistic conversations about dying. Student led debriefing was facilitated by clinicians with advanced communication skills training. Results: There was a significant increase in the number of student nurses who felt comfortable to talk with patients and their families/friends about death and dying, with more than 60% of participating students confident to talk about death and dying on their first placement. Students reported a reduction in fear and felt more emotionally prepared for placement. Students were able to apply their learning. One first year student responded, ‘My first death was in week one and I was able to draw directly from the simulation to support the family’. Students were able to recognise and understand dying enough to be able to bring reassurance to patients and families and support themselves and colleagues with the emotional response to death. Discussion: End of life care simulation benefits from extended prebrief, partnership with expert clinicians and simulated patient actors to provide a transferable experience. The use of simulated experiences with actors increases realism and provides opportunity to bridge the gap between theory and real world practice. This collaboration is empowering student nurses to recognise dying and be comfortable talking about death; fundamental to person-centred compassionate care at end of life. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Introduction: Effective communication remains a cornerstone of compassionate healthcare, closely linked to patient experience and care outcomes [1]. In 2022, the Comprehensive Communication Skills Training (CCST) course was developed at a medium-sized trust, in response to feedback from bereaved families and frontline staff, aiming to improve communication in emotionally complex scenarios [2]. Preceding the creation of the course, the facilitators attended a two-day training in experiential learning. Since its inception, the course has been refined; a Patient Advice and Liaison Service (PALS) component, produced through a listen-create-reconnect exercise with relatives with lived experience, has been added. This development helps attendees understand how to respond to complaints in the moment and highlights the function of PALS as a key support service for patients and families. Methods: The training uses immersive simulation, with actor role players enacting authentic patient and family encounters. This encourages deep emotional engagement and reflection. Participants follow the journey of an elderly inpatient, and his wife, encountering pivotal communication challenges during his final hospital stay. The effectiveness of this training is credited with the collaboration; scenarios and debrief content, which are shaped by the real stories of patients and bereaved relatives, whose voices are woven throughout the training. This ensures the course content remains both emotionally resonant and grounded in lived experience, a hallmark of meaningful communication education [3]. Results: Approximately 300 trust staff have participated, all describe an increased confidence in managing difficult conversations. The newly introduced PALS module has been a welcome addition with participants reporting a better understanding of the role of PALS in supporting patients. Participants have highlighted the value of the emotional realism, the protected space for self-reflection, and the power of hearing service user stories in their own words. In 2023/2024 poor communication was indicated as the primary theme in 100% of the complaints made in relation to end of life care. Current complaints data for the trust shows a significant reduction related to this theme, attributable to just 22% (1 April 2024 – 31 December 2024). Discussion: By blending experiential learning with patient-informed narrative and structured reflection, participants reconsider how they listen, respond, and empathise. CCST builds confidence, strengthening trust between staff and patients and attendees feel directly connected to the experiences. The simulation-based transformative I’s [4], involvement, inclusion and influence underpin this programme. CCST’s growing reputation is leading to the embedding of the training in multi-professional induction and continuing education. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

How I Do It: Avoiding the Cognitive Trap Fundamentals of Surgery Curriculum.

Abstract Background Effective doctor-team communication is a critical skill for medical professionals, However, teaching these skills to large groups of students within limited time frames is challenging. Role-play video demonstrations offer potential solutions. Objective This study aimed to design role-play video demonstrations as a teaching tool for the Doctor- Team Communication Course, evaluate their impact on the academic performance of 5th-year medical students at Ain Shams University, and assess student satisfaction with this teaching method. Methods An Interventional study was conducted involving 5th-year medical students. Participants attended an online course supplemented with role-play video demonstrations illustrating key doctor- team communication scenarios. Exam scores were collected after the course to evaluate the academic performance of students, and their satisfaction with the role-play video demonstrations was assessed through a structured survey Results The intervention group achieved significantly higher overall percentage scores (94.4%±6.3) compared to the control group (88.1%±8.3) indicating enhanced learning of communication skills. Satisfaction scores were significantly higher in the intervention group compared to the control group highlighting enhanced engagement and understanding of practical scenarios. Conclusion Role-play video demonstrations enhance learning communication skills training in online courses, addressing challenges like large class sizes and limited teaching time. This method holds promise for effective medical education. Further studies are needed to throw more light on the effect of role play videos on enhancement of communication skills.

BackgroundMedical students are commonly taught two counselling protocols: breaking bad news and brief motivational interviewing for behaviour change. They must demonstrate advanced skills such as empathy, active listening, clear communication, offering support and creating a safe space for patients and their families to express their emotions. Medical students are taught communication skills through various methods, including peer role-play.AimThis study aimed to document medical students’ communication skills as evident across recorded peer role-play scenarios and observe how students engage with this approach to practice communication skills.SettingFinal-year medical students at a medical school in Gauteng, South Africa.MethodsThe study involved an observational approach to analyse 45 video- and audio-recorded student-led peer role-play scenarios that included breaking bad news and brief motivational interviewing skills, as part of an exploratory qualitative design. Thematic analysis was conducted.ResultsThe three main challenges students experienced were basic information giving and clinical correctness, doctor-centred versus patient-centred talk and providing psychosocial support and showing empathy. The authenticity of the peer-role-play was also a challenge.ConclusionMaking the transition from communication theory to practice may be difficult for students to achieve and learning how to integrate these complex communication skills is not straightforward. Training in communication and counselling skills must start early for medical students.ContributionFamily Medicine often takes responsibility for training communication and counselling skills in medicine, and our study can contribute to the discussion on training communication skills.

BackgroundEffective communication is fundamental to high-quality health care delivery, influencing patient satisfaction, adherence to treatment plans, and clinical outcomes. However, communication skills training for medical undergraduates often faces challenges in scalability, resource allocation, and personalization. Traditional methods, such as role-playing with standardized patients, are resource intensive and may not provide consistent feedback tailored to individual learners’ needs. Artificial intelligence (AI) offers realistic patient interactions for education.ObjectiveThis study aims to investigate the application of AI communication training tools in medical undergraduate education within a primary care context. The study evaluates the effectiveness, usability, and impact of AI virtual patients (VPs) on medical students’ experience in communication skills practice.MethodsThe study used a mixed methods sequential explanatory design, comprising a quantitative survey followed by qualitative focus group discussions. Eighteen participants, including 15 medical students and 3 practicing doctors, engaged with an AI VP simulating a primary care consultation for prostate cancer risk assessment. The AI VP was designed using a large language model and natural voice synthesis to create realistic patient interactions. The survey assessed 5 domains: fidelity, immersion, intrinsic motivation, debriefing, and system usability. Focus groups were used to explore participants’ experiences, challenges, and perceived educational value of the AI tool.ResultsSignificant positive responses emerged against a neutral baseline, with the following median scores: intrinsic motivation 16.5 of 20.0 (IQR 15.0‐18.0; d=2.09, P<.001), system usability 12.0 of 15.0 (IQR 11.5‐12.5; d=2.18, P<.001), and psychological safety 5.0 of 5.0 (IQR 5.0‐5.0; d=4.78, P<.001). Fidelity (median score 6.0/10.0, IQR 5.2‐7.0; d=–0.08, P=.02) and immersion (median score 8.5/15.0, IQR 7.0‐9.8; d=0.25 P=.08) were moderately rated. The overall Immersive Technology Evaluation Measure scores showed a high positive learning experience: median 47.5 of 65.0 (IQR 43.0‐51.2; d=2.00, P<.001). Qualitative analysis identified 3 major themes across 11 subthemes, with participants highlighting both technical limitations and educational value. Participants valued the safe practice environment and the ability to receive immediate feedback.ConclusionsAI VP technology shows promising potential for communication skills training despite the current realism limitations. While it does not yet match human standardized patient authenticity, the technology has achieved sufficient fidelity to support meaningful educational interactions, and this study identified clear areas for improvement. The integration of AI into medical curricula represents a promising avenue for innovation in medical education, with the potential to improve the quality and effectiveness of training programs.

Goals-of-care communication (GCC) is not commonly performed despite evidence that it contributes to better end-of-life outcomes. Clinician behavioral and organizational factors associated with GCC have not been systematically measured. This study aimed to develop and evaluate a survey instrument to assess these factors. We adapted items from the "Determinants of Implementation Behavior" Questionnaire to develop the Goals of Care Communication survey (GCC Survey). We conducted cognitive interviews at two healthcare systems (University of California-Los Angeles, VA Greater Los Angeles Healthcare System). We administered the instrument cross-sectionally, and before and after serious illness communication skills training. We performed item-scale correlation analysis, confirmatory factor analysis, and assessed responsiveness to change on completed surveys. Health professionals from both institutions participated in cognitive interviews, the administration of a cross-sectional survey, and surveys administered before and after serious illness communication training. GCC survey item responses. The final instrument includes 31 items representing six domains-1) Knowledge, skills, and beliefs (11 items); Expectations (3 items); 3) Beliefs about consequences (2 items); 4) Intentions (3 items); 5) Organizational context (8 items); and 6) Social influences and roles (4 items)-and 5 additional items that do not fall into any of the six domains. Confirmatory factor analysis indicated good fit for the 6 factors (confirmatory fit index = 0.939, root mean square error of approximation = 0.076). Four of the six domains improved following training in serious illness communication skills. A short form was found to have acceptable psychometric properties. Internal consistency reliabilities for the 3-item Knowledge, Skills, and Beliefs and 4-item Organizational Factors short-form scales were 0.93 and 0.95, respectively. This study supports the reliability and validity of the GCC Survey, which can be utilized to inform quality improvement and research in the GCC.

This study presents a comprehensive bibliometric analysis to chart global research trends on the OSCE and residency training. Data were sourced from the Web of Science Core Collection database, covering research conducted from January 1999 to June 2024. CiteSpace and VOSviewer were employed to analyze the selected studies, evaluating publication trends, key contributors, and emerging topics through the co-occurrence mapping and network visualization. In total, 211 publications were identified. From 2005 to 2024, there was an increase in publications related to the OSCE and standardized residency training. The United States and Canada emerged as dominant contributor. Institutional collaborations were led by the University of Ottawa, New York University, and the University of Toronto. The most frequent keywords included "OSCE" (71 occurrences), "residents" (56 occurrences), "performance" (51 occurrences), "competence" (35 occurrences), "skills" (35 occurrences), "education" (31 occurrences), "medical education" (29 occurrences), "reliability" (23 occurrences), "medical students" (17 occurrences), "validity" (17 occurrences), and "clinical competence" (17 occurrences). Cluster analysis of the keywords identified nine clusters, mainly covering residency programs in different disciplines, communication skills, core competencies, and the reliability and validity of the OSCE for residency education. Initial studies emphasized terms such as "performance," "competence," "reliability," and "assessing surgical residents," and recent research continues to emphasize the quality of residency training, instructional effectiveness, and development of communication skills. The application of the OSCE in standardized residency training research is in its developmental phase, and further cross-regional collaboration is necessary. Future research should focus on improving the competence of residents and developing innovative, practice-oriented educational models that align with the evolving needs of residency training.

Do people want to talk to a doctor about multicancer detection testing? Findings from a National Survey.

Improving the quality of professional interaction between medical staff and patients and their relatives is an important aspect of the transition to human-centered management of medical organizations. According to statistics, the total number of patient complaints is increasing every year. The level of communication skills among medical professionals in primary healthcare settings does not meet the requirements of the partnership model for most of its elements. Training in professional communication skills enhances their application by doctors in various specialties.

Methods of Conducting Communication Skills Training at a Medical University: Difficult Teacher Vs. Difficult Student

IntroductionCommunication regarding serious illness is an integral part of Pulmonary and Critical Care Medicine (PCCM) fellows' day-to-day practice, however routine communication skills training is not consistently built in PCCM fellowship curricula nationwide. Geritalk, a previously validated interactive curriculum, can be adapted to address unique communication challenges in critical illness.MethodsIn 2024, after performing a needs assessment among PCCM fellows at Mount Sinai Hospital, a two-part curriculum was adapted from Geritalk through collaborations between PCCM and palliative care specialists. The curriculum consisted of a one-hour didactic followed by a one-hour small group workshop with case discussion and role-play. Pre- and post-curricular surveys were conducted among the fellows to assess changes in self-reported comfort levels in different components of communication during a family meeting.ResultsAmong 17 eligible PCCM fellows, a total of 14 (82.4%) fellows completed the pre-curricular survey, and 8 fellows (47.1%) completed the curriculum and post-curricular survey. Prior to the curriculum, fellows reported lower comfort levels in communicating prognosis (mean[SD] 3.8[1.0] on a 5-point Likert scale), responding to emotions (mean[SD] 4.0[0.8]), eliciting values (mean[SD] 3.8[0.8]), and describing comfort care (mean[SD] 3.9[1.0]). After the training, fellows reported moderate to significant increase in comfort levels, especially in responding to emotions (mean[SD] 4.3[0.7]) and eliciting values (mean[SD] 4.4[0.5]).ConclusionA two-part, critical care-focused curriculum adapted from Geritalk showed feasibility in communication training among PCCM fellows with improved self-assessed comfort levels in leading a family meeting. Future studies should incorporate objective assessment of competency and evaluate generalizability to other training programs.

The release of GPT-4 Omni (GPT-4o), an advanced multimodal generative artificial intelligence (AI) model, generated substantial enthusiasm in the field of higher education. However, one year later, medical education continues to face significant challenges, demonstrating the need to move from initial experimentation with the integration of multimodal AIs in medical education toward meaningful integration. In this Viewpoint, we argue that GPT-4o’s true value lies not in novelty, but in its potential to enhance training in communication skills, clinical reasoning, and procedural skills by offering real-time simulations and adaptive learning experiences using text, audio, and visual inputs in a safe, immersive, and cost-effective environment. We explore how this innovation has made it possible to address key medical educational challenges by simulating realistic patient interactions, offering personalized feedback, and reducing educator workloads and costs, where traditional teaching methods struggle to replicate the complexity and dynamism of real-world clinical scenarios. However, we also address the critical challenges of this approach, including data accuracy, bias, and ethical decision-making. Rather than seeing GPT-4o as a replacement, we propose its use as a strategic supplement, scaffolded into curriculum frameworks and evaluated through ongoing research. As the focus shifts from AI novelty to sustainable implementation, we call on educators, policymakers, and curriculum designers to establish governance mechanisms, pilot evaluation strategies, and develop faculty training. The future of AI in medical education depends not on the next breakthrough, but on how we integrate today’s tools with intention and rigor.

Background/Objectives: Workplace violence remains an important vocational psycho-social risk for nurses employed in the emergency department (ED). We investigated the characteristics of workplace violence against ED nurses, and associations with self-assessed resilience, socio-demographic and vocational parameters, including turnover intention. Methods: ED nurses employed in all public hospitals in the Republic of Cyprus (RC) participated. After obtaining informed consent, data were collected using census sampling (January–June 2024) via the translated 2016 Italian National Survey on Violence towards Emergency Nurses Questionnaire (QuINVIP16) for investigating workplace violence characteristics, and the Connor-Davidson Resilience Scale (CD-RISC-25) for assessing self-perceived resilience. Results: A total of 132 nurses (53.0% response rate) participated. Verbal violence was reported by 70.5% to 92.4% of participants. Long waiting times, overcrowded EDs, and perception of inadequate attention from healthcare professionals were reported as the primary triggers for violence towards participants by patients/visitors. One-third of participants reported that violence-reporting systems were unclear, while 1 out of 4 reported inadequate safety measures against violence. Participants with higher scores of self-perceived resilience were less likely to report turnover intention due to workplace violence (p < 0.001), while those with lower self-perceived resilience reported a significant decrease in work motivation (p = 0.005). Those who experienced decreased work motivation after exposure to a violent episode were more likely to consider a) leaving the profession [OR (95%CI): 79.1(17.7–353.2); p < 0.01], and b) moving to a different work setting [OR (95%CI): 17.0(3.8–76.2); p < 0.01], and actually applying to be transferred to a different work setting [OR (95%CI): 19.6(4.2–91.5); p < 0.01]. Moreover, those who had not attended communication skills training were 4 times more likely to consider leaving the profession following exposure to violence [OR (95%CI): 4.2(1.1–16.2); p = 0.04]. Conclusions: This study is among the few to link workplace violence with both resilience and actual turnover behaviors among emergency nurses, in general and particularly in the post-pandemic era. By showing how personal resilience in the face of violence is shaped by organizational support, such as reporting systems and training, the present findings move beyond individuals-level explanations, and highlight workplace violence as a systematic administrative challenge. This insight represents an important advance in current knowledge, and calls for multifaceted interventions that strengthen both personal and institutional capacity to address violence.

Problem-based learning (PBL) is an effective method to develop problem analysis and solving ability for students, and Seminar teaching focuses on critical thinking and interpersonal communication skill training through assigned questions and issues discussion. Immunology is an important compulsory course for medical and most biology-major undergraduates. In this study, we introduced both PBL and Seminar approaches (PBL-Seminar) into the flipped classroom teaching of an immunology course. In pre-class phase, students completed self-directed learning mainly via self-built micro-course materials and formed different learning groups for presentation preparation according to the selected Seminar topics. In the classroom, the teacher and students fully discussed the assigned topic based on group presentation. Furthermore, a series of evaluations were conducted by the teacher and students after class, and questionnaires were distributed to the students for the PBL-Seminar experience investigation using a 5-point Likert scale. The responses indicated the effectiveness of PBL-Seminar teaching model, which enhanced student’s comprehensive ability to solve complex problems. This teaching model solved the problem of the inadequacy of classroom hours efficiently, transformed teacher-centered model to student-centered model and eventually promoted both teachers’ and students’ long-term development. This study also provides a new theoretical basis for the teaching reform of immunology course.