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Am J Surg. 2009 Jan;197(1):113-8. doi: 10.1016/j.amjsurg.2008.09.006.

Teaching communication skills using the integrated procedural performance instrument (IPPI): a randomized controlled trial.

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  • 1Wilson Centre, Faculty of Medicine, University of Toronto, Ontario, Canada.



The Integrated Procedural Performance Instrument (IPPI) uses various bench-top models positioned to standardized patients (SP) to recreate realistic clinical encounters. This study assessed the effectiveness of using an IPPI format as a teaching tool for communication skills.


Thirty-two participants underwent 2 videotaped IPPI scenarios before randomization into 2 groups--experimental (SP-led feedback) or control (no feedback). Participants then completed 2 further IPPI format scenarios. Videotapes were scored by 2 blinded independent raters using validated assessment scales (communication and technical).


The experimental group performed significantly better on the communication scores following feedback compared with the control group (mean 77% vs 66%, P < .05). No difference in scores for technical skills post-intervention were demonstrated (checklist: experimental mean = 64% vs control = 59%, P = .40; global ratings: experimental mean = 66% vs no control = 62%, P = .37).


The IPPI is an effective tool for teaching communication skills in residents and medical students and should be considered for incorporation into undergraduate and surgical curricula.

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