title: EQClinic: a platform for learning communication skills in clinical consultations.
abstract: BACKGROUND
  Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training.
  
  
  METHODS
  We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires.
  
  
  RESULTS
  Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform.
  
  
  CONCLUSIONS
  It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of EQClinic with larger numbers will ascertain learning gains and application in health professional training. Developing a standard model for the assessment of non-verbal behaviour in tele-consultations and providing students with more valuable evaluation and suggestions are part of our future work.
authors.affiliation: School of Electrical and Information Engineering, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Liu
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Scott
authors.affiliation: School of Electrical and Information Engineering, The University of Sydney, Sydney, NSW, Australia.|Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Renee L
authors.initials: RL
authors.lastname: Lim
authors.affiliation: Office of Medical Education, UNSW Medicine, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Silas
authors.initials: S
authors.lastname: Taylor
authors.affiliation: School of Electrical and Information Engineering, The University of Sydney, Sydney, NSW, Australia; rafael.calvo@sydney.edu.au.
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Calvo
mesh_terms: D003142:Communication; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010817:Physician-Patient Relations; D010865:Pilot Projects; D019114:Remote Consultation / Q000379:methods*
keywords: automated feedback; communication skills training; medical education; non-verbal behaviour recognition; non-verbal communication; tele-consultation