Simulated Patients for Clinical Communication Training

Overview

How a clinician talks to a patient is part of the care, not a skill layered on top of it. Communication quality determines whether trust is built, whether a patient discloses what matters, and whether bias is enacted in the room. While that much is established, the opportunity to practice a difficult conversation, and to learn afterwards how it went, is scarce for clinicians and trainees alike.

Our UnBIASED work established that these dynamics are measurable: dominance, warmth, engagement, interactivity, and turn-taking can be extracted from real clinical conversations and modeled against how the interaction was experienced. This project turns that measurement into a training platform. Large language models and expressive speech synthesis drive simulated patients that behave like people rather than assistants: they hold information back, and their affect shifts in response to how they are treated, so trust has to be earned before a patient’s underlying needs surface. Each rehearsed conversation is analyzed with the UnBIASED pipeline and returned through ConverSense feedback, pairing time-aligned visualizations of the interaction with prompts that ask the learner to interpret their own behavior.

ConversHIVe applies the platform to HIV care teams, where implicit bias linked to sexual orientation and race affects access to care for people who have already faced stigma, and where clinics and community-based organizations work under limited time, staffing shortages, and turnover. Its second phase, ConversHIVe-Live, embeds the training in routine HIV service delivery.

EmpathIQ applies it to pre-clinical medical students, where empathy declines during training precisely as students meet the emotional load of clinical work, and where standardized patients and faculty-led workshops are effective but too resource-intensive to scale. EmpathIQ identifies the markers that distinguish empathic communication, varies patient affect within a single encounter, and evaluates whether the resulting feedback changes measured empathy and compassion.

Funding and External Collaborations

ConversHIVe is funded by the California HIV/AIDS Research Program (CHRP) under its Low Barrier Technology Interventions for HIV Prevention and Care program, with a second phase supporting real-world implementation. It is a collaboration between the HXI Lab and the Owen Clinic at UC San Diego, the AntiViral Research Center (AVRC) Community Advisory Board, and San Diego community-based organizations including Christie’s Place, San Ysidro Health Center, and Father Joe’s Villages.

EmpathIQ is supported by a Sanford Research Fellowship from the T. Denny Sanford Institute for Empathy and Compassion at UC San Diego, awarded to Manas Bedmutha, and is conducted with Drs. Lisa Eyler and Federica Klaus of the Sanford Institute and with Dr. Charles Goldberg, Associate Dean for Graduate Medical Education.