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Anthony Back, MD; Robert Arnold, MD; James Tulsky, MD

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Kaushik and Pothier raise 2 important issues. First, how should researchers assess communication skills training? We think that assessment should occur at 2 levels: (A) Does the training change physician communication behaviors? and (B) Do the changes improve patient-level outcomes? Our study was designed to address question A. Our study design using standardized patients to answer this question has strengths and weaknesses. A weakness of using standardized patients is that physicians in real life may behave differently than in a simulated situation. Clearly, an important next step would be to examine trained physicians in their own clinics, as was done by Fallowfield et al,¹ who showed that physicians given a similar type of training (small groups with trained facilitators) in fact used their new skills in real settings at statistically significant levels. An important strength of using standardized patients . . . [Full Text of this Article]

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