Evidence and practical guidance for clinical communication training
Research summaries, implementation guides, and clear limits on what the evidence can support. Written for the people who design, run, and assess medical education.
All articles
Building rapport is a set of behaviors, not a personality
Clinicians elicited the patient's agenda in 36% of 112 recorded encounters and interrupted after a median of 11 seconds. Rapport lives in that half minute, and three hours of training moved patient ratings in a randomized trial.
Six of 105: the measurement gap in end-of-life communication training
A systematic review of 105 studies found only 6 with clear training objectives — none sharing the same outcomes. A pediatric intensivist and palliative care physician explains what this means for fellows learning to navigate the hardest conversations in medicine.
Lauren Rissman, MD
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.
What programs lost when Step 2 CS disappeared, and what hasn't replaced it
USMLE discontinued Step 2 CS in 2021. No national successor now assesses clinical communication, so programs have built local methods around Milestones 2.0 with uneven time, tools, and evidence.
The faculty hour problem with communication remediation
One published clinical reasoning remediation program required a mean of 29.6 specialist contact hours. The figure is not a universal estimate, but it shows why programs should separate the decisions that need faculty judgment from the repetitions that do not.
Simulation can preserve affirming care practice as exposure shrinks
Sixty percent of surveyed residency program directors reported no rotation with direct clinical exposure to transgender patients. A team presenting at IPSS Rome designed an AI patient scenario for structured communication practice when clinical exposure is limited.
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.
How to choose a medical simulation method
Standardized patients, mannequins, screen-based cases, text, and voice each show different parts of clinical performance. Choose by the behavior learners need to practice or faculty need to assess, not by fidelity.
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.
What the evidence says about communication training
Candello found a communication factor in 40% of asserted malpractice cases, and Chung's review of 20 training studies rated the evidence very low to low quality. Neither supports an ROI headline. What a program can measure is its own learners, scored against a named framework.