Residency and fellowship
Communication practice that grows with clinical responsibility
Last updated: September 2026
Every resident works the same sequence, from clear information delivery through uncertainty, family meetings, and leadership. Each conversation is scored against the competency standard and communication framework approved for the case, with the resident's own words quoted under every score.
The arc across training
Increasing complexity, emotional intensity, and leadership demand from intern year through fellowship.
Communicate safely
Discharge counseling, normal results, and safety-netting, using frameworks like teach-back and HEEADSSS. The goal is clear, accurate information delivery.
Adapt under pressure
New diagnoses, parental disagreement, and communicating uncertainty. The learner moves from information delivery to the relational work of a high-stakes conversation.
Lead and guide
Goals-of-care discussions, ICU escalation, and error disclosure involving harm. Learners lead family meetings and begin coaching juniors.
One record across training
Participants get feedback they can use on the next attempt, while programs review agreed individual or cohort views.
On demand, not on schedule
Voice-based AI patient encounters available 24/7 from any device. No standardized patient to recruit, no sim center to book, no faculty observer required to practice.
Rubric-scored feedback, in the learner's words
Each conversation is scored against the standard approved for the case, and every score quotes the learner's own words, so a faculty member or CCC can inspect the feedback rather than rely on a rating alone.
A program view for coaching
Review repeated practice and transcript-linked feedback by participant or cohort, with institution-defined access, so coaches can see strengths and choose the next practice focus.
Private, repeatable practice
Learners can repeat a case in private before sharing the report with a faculty member, coach, or program.
Frequently asked questions
Is ClinicalSim a remediation tool or a core curriculum platform?
ClinicalSim is built to run as a core communication curriculum for every learner, with remediation as one high-intensity use of the same cases. The arc on this page is the deployment model: interns practice clear information delivery, PGY-2 residents work on uncertainty and family disagreement, and senior residents and fellows lead goals-of-care discussions and error disclosure. A program that starts with remediation is running a subset of that sequence, and the cases, rubrics, and reports are the same either way.
How is the curriculum mapped to our competency standards?
Each scenario can use the competency standard that your program supplies or approves. Rubric scores trace back to that standard, so a learner's progress reads in the same language your Clinical Competency Committee already uses.
Does this replace bedside teaching and faculty feedback?
No. ClinicalSim scores each practice conversation against the rubric on the case and quotes the learner's words under every score, so a faculty member arrives at coaching knowing which element needs attention. A faculty mentor observing a real family meeting provides human judgment that ClinicalSim does not replace.
Related insights
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.
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.
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.