Standardized Patient-Narrated Web-Based Learning Modules Improve Students' Communication Skills on a High-stakes Clinical Skills Examination

BACKGROUND: Use of web-based standardized patient (SP) modules is associated with improved medical student history-taking and physical examination skills on clinical performance examinations (CPX), but a benefit for communication skills has not been shown. AIM: We describe an innovative web-based SP module using detailed SP and faculty commentary to teach communication skills. SETTING: A public medical school in 2008-2009. PARTICIPANTS: Fourth-year medical students. PROGRAM DESCRIPTION: A 90-minute web-based module with three simulated clinical encounters was narrated by an expert clinician and SP to explain expected history-taking, physical examination, and communication skills behaviors. All 147 students were encouraged to review the module one month before the CPX. PROGRAME VALUATION: One hundred and six students (72%) viewed the web-based module. Students who watched the module performed significantly higher on the CPX communication score (+2.67%, p < 0.01) and overall score (+2.12%, p = 0.03), even after controlling for USMLE Step 1 and clerkship summary ratings. Use of the module did not significantly affect history/physical examination scores (+1.89%, p = 0.12). DISCUSSION: Students who watched an optional web-based SP module prior to the CPX performed higher than those who did not on communication skills. The web-based module appears to be an effective CPX preparatory activity to enhance communication performance.