Medical school (UME)
Build communication skill across all four years
Last updated: September 2026
Sequence voice-based practice from history taking to diagnosis disclosure, score every conversation against the framework named on the case with the student's own words under each score, and follow each student across clerkships in one dashboard. ClinicalSim adds repetition between SP encounters and OSCEs.
What's at stake
The national communication exam is gone
USMLE Step 2 CS was permanently discontinued in 2021. No national successor now assesses spoken clinical communication, so medical schools have built local methods.
Standardized-patient encounters don't scale
SP encounters remain important for high-stakes assessment, but each session requires a trained actor, space, faculty support, and advance scheduling. That limits how often students can practice before clerkships.
Curricula need a visible sequence
A school can sequence communication practice from history taking through diagnosis disclosure and keep each student's work in one program view.
More live practice is hard to schedule
Each SP encounter requires a trained actor, space, faculty support, and scheduling, which limits the repetitions available between OSCEs.
The numbers
Step 2 CS, the national communication exam, was discontinued
USMLE / NBME
of sequenced practice, from history-taking to diagnosis disclosure
on-demand practice between standardized-patient encounters
generates structured, rubric-scored feedback
How ClinicalSim helps
A four-year arc
Sequence scenarios so communication complexity rises with clinical knowledge: structured history-taking in the preclinical years, updating families on a plan in M3, and delivering a new diagnosis in M4.
Practice between SP encounters
ClinicalSim adds voice-based practice between scheduled standardized patient sessions and OSCEs. Live coaching and assessment stay with people.
A dashboard through clerkships
Review each student's simulated practice across four years alongside OSCEs and other program evidence.
Built on published frameworks
Every conversation is scored against a published framework named on the case, such as SPIKES, teach-back, or Calgary-Cambridge, with the student's own words quoted under each score, so students learn structures they'll carry into residency and see exactly which step they skipped.
Undergraduate medical education
Sequence practice from the first patient history through diagnosis disclosure and clerkship conversations, including the communication stations students meet in an OSCE. Each conversation is scored against the communication framework named on the case and recorded against the AAMC Foundational Competencies.
Related insights
How to design an OSCE case that shows what a learner can do
Start with the decision the station should support, define observable behaviors, give learners a fair chance to show them, train the SP, and pilot the scoring before the station counts.
What 12 medical students want from AI patient simulation
Researchers interviewed 12 clinical-year medical students and ran three codesign workshops. The students put feedback, case quality, and faculty involvement ahead of novelty.
Breaking bad news is a practice problem, not a knowledge problem
A framework can organize a conversation, but learners still need repeated spoken practice with feedback. The evidence shows how little formal training many residents receive and what a program can do about it.
Questions we get from this seat
How do medical schools assess spoken clinical communication now that Step 2 CS is gone?
USMLE Step 2 CS was permanently discontinued in 2021 (USMLE / NBME) and no national successor assesses spoken clinical communication, so schools have built local methods, usually around standardized patient encounters and OSCEs. Those stay the high-stakes assessment, and the gap most schools describe is repetition between them.
How can a school sequence communication practice across four years?
Sequence the scenarios so communication complexity rises with clinical knowledge: structured history-taking in the preclinical years, updating a family on a plan in M3, and delivering a new diagnosis in M4. Each student's simulated practice sits in one view across all four years, so a clerkship director can read it alongside OSCE results and other program evidence rather than reconstructing it per rotation.
Which communication frameworks do undergraduate medical education scenarios use?
Every case names the published communication framework it scores against, including SPIKES, teach-back, and Calgary-Cambridge, and every score quotes the student's own words. Students learn structures they carry into residency rather than a scoring scheme local to one platform.