@Article{info:doi/10.2196/jmir.6299,
author="Liu, Chunfeng
and Lim, Renee L
and McCabe, Kathryn L
and Taylor, Silas
and Calvo, Rafael A",
title="A Web-Based Telehealth Training Platform Incorporating Automated Nonverbal Behavior Feedback for Teaching Communication Skills to Medical Students: A Randomized Crossover Study",
journal="J Med Internet Res",
year="2016",
month="Sep",
day="12",
volume="18",
number="9",
pages="e246",
keywords="nonverbal communication; nonverbal behavior; clinical consultation; medical education; communication skills; nonverbal behavior detection; automated feedback; affective computing",
abstract="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. ",
issn="1438-8871",
doi="10.2196/jmir.6299",
url="http://www.jmir.org/2016/9/e246/",
url="https://doi.org/10.2196/jmir.6299",
url="http://www.ncbi.nlm.nih.gov/pubmed/27619564"
}