Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

Document Type

Journal Article

Publication Date



Patient Education and Counseling








Breaking bad news; Communication training; Computer simulation; Computer-based conversational agent; Cultural competence; Doctor-patient relationship; Healthcare communication; Human-computer interaction; Intelligent tutoring systems; Inter-professional communication; Intercultural communication; Knowledge transfer; Mindful practice; Mixed methods research; Nonverbal communication; Reflection in action; Reflection on action; Simulation; Training transfer; Virtual Human


© 2016 Elsevier Ireland Ltd Objectives To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. Methods A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N = 210) to computer-based learning (N = 211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. Secondary outcomes: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. Results MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. Conclusions MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. Practice implications MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training.