Comparing the Effectiveness of Online and Face-to-Face Teaching for Medical Students in Shared Decision-Making Communication Skills Training

Background: Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking.

Objective: This study aims to assess the effectiveness of online versus face-to-face SDM CST on medical students' decision-making proficiency and communication skills over time.

Design: This study employs a retrospective quasi-experimental design, analyzing 323 questionnaires from the CST training database.

Participants: Participants (fourth-year medical students) were divided into two groups: face-to-face CST (n = 160) and online CST (n = 163).

Main measures: Assessments were conducted before (T0) and immediately after (T1) CST. Paired t-tests and generalized estimating equations were used to evaluate within-group and between-group differences in SDM decision-making proficiency and communication skills.

Key results: In the within-group comparison, both groups showed a significant improvement in SDM decision-making proficiency and communication skills. For SDM decision-making proficiency, the face-to-face group demonstrated a large effect (t = 12.9, p < 0.001, d = 0.87), and the online group achieved a moderate effect (t = 8.98, p < 0.001, d = 0.64). In terms of communication skills, both groups reached a moderate effect (face-to-face, t = 9.77, p < 0.001, d = 0.67; online, t = 8.00, p < 0.001, d = 0.54). No significant differences were found between groups in SDM decision-making proficiency and communication skills.

Conclusions: This study has demonstrated that both online and face-to-face SDM CST effectively enhance the SDM decision-making proficiency and communication skills of medical students. The effectiveness of online CST is on par with face-to-face CST. It is recommended to use online CST when face-to-face classes are not feasible, especially during epidemics or budget constraints. Future research should explore the long-term impacts of these CST methods on students' skills, considering additional follow-up time points.