title: Standardized patient-narrated web-based learning modules improve students' communication skills on a high-stakes clinical skills examination.
abstract: 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.
  
  
  OBJECTIVE
  We describe an innovative web-based SP module using detailed SP and faculty commentary to teach communication skills.
  
  
  METHODS
  A public medical school in 2008-2009.
  
  
  METHODS
  Fourth-year medical students.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. christinaaudreylee@gmail.com
authors.forename: Christina A
authors.initials: CA
authors.lastname: Lee
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.forename: Calvin L
authors.initials: CL
authors.lastname: Chou
authors.forename: Christy
authors.initials: C
authors.lastname: Boscardin
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hauer
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004059:Diffusion of Innovation; D004504:Education, Medical, Undergraduate; D006801:Humans; D020407:Internet; D007858:Learning; D033262:Narration; D010817:Physician-Patient Relations; D016730:Program Development; D015397:Program Evaluation; D012577:Schools, Medical; D013223:Statistics as Topic; D013337:Students, Medical / Q000523:psychology*