A web-based telehealth training platform incorporating automated nonverbal behavior feedback for teaching communication skills to medical students: A randomized crossover study

Background: in the interests of patient health outcomes,it is important for medical students to develop clinical communication skills. we previously proposed a telehealth communication skills training platform (eqclinic) with automated nonverbal behavior feedback for medical students,and it was able to improve medical students' awareness of their nonverbal communication. objective: this study aimed to evaluate the effectiveness of eqclinic to improve clinical communication skills of medical students. methods: we conducted a 2-group randomized crossover trial between february and june 2016. participants were second-year medical students enrolled in a clinical communication skills course at an australian university. students were randomly allocated to complete online eqclinic training during weeks 1-5 (group a) or to complete eqclinic training during weeks 8-11 (group b). eqclinic delivered an automated visual presentation of students' nonverbal behavior coupled with human feedback from a standardized patient (sp). all students were offered two opportunities to complete face-to-face consultations with sps. the two face-to-face consultations were conducted in weeks 6-7 and 12-13 for both groups,and were rated by tutors who were blinded to group allocation. student-patient observed communication assessment (soca) was collected by blinded assessors (n=28) at 2 time points and also by an sp (n=83). tutor-rated clinical communications skill in face-to-face consultations was the primary outcome and was assessed with the soca. we used t tests to examine the students' performance during face-to-face consultations pre- and postexposure to eqclinic. results: we randomly allocated 268 medical students to the 2 groups (group a: n=133; group b: n=135). soca communication skills measures (score range 4-16) from the first face-to-face consultation were significantly higher for students in group a who had completed eqclinic training and reviewed the nonverbal behavior feedback,compared with group b,who had completed only the course curriculum components (p=.04). furthermore,at the second face-to-face assessment,the group that completed a teleconsultation between the two face-to-face consultations (group b) showed improved communication skills (p=.005),and the one that had teleconsultations before the first face-to-face consultation (group a) did not show improvement. conclusions: the eqclinic is a useful tool for medical students' clinical communication skills training that can be applied to university settings to improve students clinical communication skills development.