# An Innovative Approach to Assess Medical Student Perceived Compassionate Communication Skills Before and After High Acuity Simulation Cases

## TL;DR

Medical students felt less confident in compassionate communication after high-pressure simulations, highlighting a need for more practical training.

## Contribution

A novel curriculum assessing compassionate communication in high-acuity simulations revealed self-perception gaps in medical students.

## Key findings

- Post-simulation self-assessments showed an 18.5-percentage-point decrease in students rating themselves as 'often' or 'always' able to demonstrate compassionate communication.
- Students expressed a strong desire for more practice in high-pressure environments, finding compassionate communication more challenging than anticipated.
- Findings suggest integrating longitudinal, high-fidelity compassionate communication training earlier in medical curricula.

## Abstract

It can be difficult to translate learned compassionate communication skills in a patient encounter while also managing a high acuity patient. We created a novel curriculum that assesses compassionate communication during challenging high acuity medical simulations for medical students.

This study was conducted in March 2025 at a large academic medical center during the 4-week Residency Transition Course for all 4th-year medical students (n = 120). Participants completed the Sinclair Compassion Questionnaire—Healthcare Professional Ability Self-Assessment (SCQ-HCPASA) prior to simulation and the Sinclair Compassion Questionnaire—Trainee Self-Assessment (SCQ-TSA) immediately after participation. Each student engaged in 5 high-fidelity simulations combining acute medical management with communication challenges involving standardized patients and family members. Data was analyzed descriptively to compare pre- and post-simulation self-perceptions of compassionate communication.

Across all 15 SCQ domains, post-simulation self-assessments demonstrated a mean 18.5-percentage-point decrease in students rating themselves as “often” or “always” able to demonstrate compassionate communication. During debriefs, students shared that their prior education in compassionate communication was limited and primarily classroom-based. They felt confident in their abilities when surveyed initially, however when required to use these skills in real-time while also managing critically ill patients, they found the experience challenging. Students expressed a strong desire for more opportunities to practice compassionate communication in a high-pressure environment, as they found it significantly more challenging than anticipated.

Embedding compassion training within high-acuity simulation identified unrecognized gaps in students’ self-perceived communication abilities. Findings support integrating longitudinal, high-fidelity compassionate communication training earlier in the medical curriculum to better prepare learners for emotionally and cognitively demanding clinical encounters.