Open Access Research article

Teaching communication skills in clinical settings: comparing two applications of a comprehensive program with standardized and real patients

Irene P Carvalho12*, Vanessa G Pais1, Filipa R Silva1, Raquel Martins1, Margarida Figueiredo-Braga1, Raquel Pedrosa1, Susana S Almeida1, Luís Correia1, Raquel Ribeiro-Silva1, Ivone Castro-Vale1, Ana Teles1 and Rui Mota-Cardoso1

Author Affiliations

1 Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, School of Medicine, University of Porto, Porto, Portugal

2 Psicologia Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal

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BMC Medical Education 2014, 14:92  doi:10.1186/1472-6920-14-92

Published: 9 May 2014



Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers’ communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients.


A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants’ confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures.


Improvements were statistically significant in both years in all measures except in simulated patients’ assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant.


The program’s positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients.

Communication program; Competence; Healthcare professionals; Standardized patients; Real patients; Replication