Table 1.

Organization of a Communication Skills Course for 10 Weeks

	Topics	Instructional methods	Homework
Week 1	The importance of patient-physician communication	Lecture	None
Week 2	Listen to patient	1:1 SP encountera)	Reflective write-up on the videorecorded performance
Week 3	Elaboration of and reflection on SP encounter	Small group discussion facilitated by tutors	Reflective write-up on the small group activity
Week 4	Expressing empathy and building relationship	1:1 SP encountera)	Reflective write-up on the videorecorded performance
Week 5	Talking with mother or father of a pediatric patient	10 Students: 1 SP encounter using "time-in time-out" techniqueb)	None
Week 6	Delivering bad news	10 Students: 1 SP encounter using "time-in time-out" techniqueb)	Reflective write-up on the small group activity
Week 7	How to say "sorry" and deal with medical errors	Lecture, role play Large group discussion	None
Week 8	Building teamwork skills	Lecture Large group discussion	None
Week 9	Informed consent	Lecture	None
Week 10	Performance assessment with two cases using SP encounter (7 minutes for each) ＝ Case A: low back pain and Case B: thyroid cancer (bad news delivery) ＝ All students’ performance was video-recorded.

SP: Standardized patient.

^a)Each student met a standardized patient, and the encounter was video-recorded,

^b)After a group of 10 students worked with a standardized patient for a certain period of time, the tutor or the student can call a “time-out” for discussion.

When the tutor says “time in,” the group can continue with the patient as if nothing happened in between time-out and time-in.