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Face-to-face” is not superior to “face-to-screen”: comparing effects of online and offline communication skills course in postgraduate medical students

Year: 2025

Type: article

Abstract: Background The integration of online education in medical training has raised questions about its effectiveness for communication skills training (CST), which traditionally relies on face-to-face interaction to cultivate empathy and patient-centered doctor-patient relationship (DPR) orientation. This study aimed to compare the efficacy of online versus offline CST in postgraduate medical students. Methods A quasi-experimental pretest-posttest design was conducted with 435 second-year clinical postgraduates, divided into an online group (2022 cohort) and an offline group (2023 cohort). Both groups completed 28 h of CST covering seven communication scenarios, including role-plays and Balint groups. Online sessions used meeting software with mandatory camera use. Empathy was assessed via the Jefferson Scale of Empathy (JSE), and DPR orientation via the Patient-Practitioner Orientation Scale (PPOS). To analyze the effects of the intervention over time and between groups, a two-way repeated-measures ANOVA was conducted. Results Both the online and offline groups showed significant increases in PPOS scores after teaching, and the online group had a significant improvement in JSE scores. The main effect of group and the interaction effect between intervention and group on JSE and PPOS were not significant, while the main effect of intervention was significant (JSE: F = 6.916, p = 0.009; PPOS: F = 15.785, p < 0.001). Subgroup analyses revealed reduced inter-specialty disparities in patient-centered attitudes post-training, with male and surgical students exhibiting notable shifts toward patient-centeredness. Conclusion Online CST yields comparable outcomes to offline training in enhancing empathy and DPR orientation when incorporating interactive elements and visual cues. These findings support integrating online modalities into medical curricula to improve accessibility, with potential for specialty-tailored modules. Further research is needed to explore long-term skill retention.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1685789