Standardized Patient-Narrated Web-Based Learning Modules Improve Students’ Communication Skills on a High-stakes Clinical Skills Examination

  • Christina A. Lee
  • Anna Chang
  • Calvin L. Chou
  • Christy Boscardin
  • Karen E. Hauer
Innovation and Improvement: Innovations in Medical Education



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.


We describe an innovative web-based SP module using detailed SP and faculty commentary to teach communication skills.


A public medical school in 2008–2009.


Fourth-year medical students.


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.


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).


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.


medical education clinical skills standardized patient communication 


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Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Christina A. Lee
    • 1
  • Anna Chang
    • 2
    • 3
  • Calvin L. Chou
    • 2
    • 3
  • Christy Boscardin
    • 2
  • Karen E. Hauer
    • 2
  1. 1.Palo Alto Medical FoundationPalo AltoUSA
  2. 2.University of CaliforniaSan FranciscoUSA
  3. 3.San Francisco Veterans Affairs Medical CenterSan FranciscoUSA

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