ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
This article is part of the Research TopicInsights in Healthcare Professions Education: 2025View all 17 articles
"Face-to-face" is not superior to "face-to-screen": Comparing effects of online and offline communication skills course in postgraduate medical students
Provisionally accepted
- Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, China
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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 hours 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. Conclusions: 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.
Keywords: Empathy, Medical students, Online Education, Communication Skills, Patient-doctorrelationship
Received: 14 Aug 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Geng, Cao, Hu, Duan, Li, Jiang, Shi and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jinya Cao
Jing Wei
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