The course is a partnership between the Eastern Association for the Surgery of Trauma and a team of communication experts. Now in its sixth year, the program is delivered entirely online across five weekly modules using Zoom technology. Each session concentrates on a single, distinct communication skill, and every class includes one hour of deliberate skills practice with professional actors, facilitated by a physician. That structure reflects a growing consensus in medical education that communication is not a personality trait students either possess or lack, but a clinical skill that can be explicitly taught, rehearsed, observed, and refined, much like suturing or operative technique.

The scale of the collaboration is notable. Twenty-four students and ten faculty members drawn from seventeen medical schools in Saudi Arabia and the United States participated in the course, supported by nineteen simulated patient actors. The actors, many of them former patients, portray individuals in clinically realistic scenarios, allowing students to conduct medical interviews that feel authentic without any risk to real patients. Physician facilitators then guide debriefing sessions in which learners dissect what worked, what faltered, and how the encounter might have felt from the patient’s perspective. This combination of simulation, immediate feedback, and physician mentorship mirrors the deliberate-practice model that has transformed training in surgery and procedural medicine.

To evaluate the course’s impact, the research team conducted, recorded, and transcribed three focus groups designed to elicit students’ reflections on the class and its influence on their patient-centered communication. Twelve students, including both Saudi and US-based participants, took part in the focus groups. The researchers then applied thematic analysis, a qualitative method in which coded segments of transcript data are iteratively grouped into broader patterns, to identify recurring themes across the discussions. The analysis surfaced three broad domains: communication skills, cultural competency, and professionalism.

Across the focus groups, participants consistently reported increased self-confidence in executing important patient-centered medical interviews. Patient-centered communication, a framework in which the clinician elicits the patient’s own concerns, values, and expectations rather than simply extracting a symptom checklist, has been repeatedly associated in the literature with better adherence, improved health outcomes, and reduced disparities in care. Yet studies of medical training have long documented a curricular disconnect: students learn communication frameworks in the classroom but struggle to apply them during clinical clerkships, where observation and structured feedback are often scarce. The international course appears to narrow that gap, with students specifically appreciating the clinical relevance of what they learned in the virtual classroom and describing opportunities to apply those concepts in practice.

The cross-cultural dimension of the course proved to be one of its most powerful elements. Students reflected on the influence of cultural context in areas such as gender roles and family authority, recognizing that a question or behavior that seems neutral in one cultural setting may carry very different weight in another. In some families, for example, medical decisions may be shaped by senior family members rather than the patient alone, and students learned to navigate these dynamics respectfully rather than dismissing them as obstacles. By pairing learners from two distinct healthcare cultures, the course exposed students to varied cultural expectations and practices firsthand, turning the virtual classroom itself into a living exercise in intercultural exchange.

The program also functioned as an early proving ground for medical professionalism. Participants demonstrated positive attributes of professionalism during class participation, an outcome the authors consider significant because professionalism, like communication, is increasingly treated as a competency to be cultivated and assessed throughout medical education rather than absorbed by osmosis. Prior research has explored peer evaluation and self-evaluation as tools for assessing professionalism in early training, and the course’s emphasis on respectful, sensitive responses to patients from diverse cultures gave students a concrete stage on which to practice those attributes under observation.

The study’s findings arrive against a well-documented backdrop. Reviews of cultural competency in medical education have concluded that such training is essential for minimizing disparities in healthcare access and quality, and a Cochrane systematic review of interventions to improve medical students’ interpersonal communication in consultations underscores both the importance and the difficulty of doing this well. Questions have also been raised about whether patient-centered cultural competency training can be effective in non-Western countries, making a course that genuinely bridges US and Saudi institutions particularly relevant. By operating virtually, the program sidesteps the cost and logistics of international travel, suggesting a scalable model that other specialties and regions could adapt.

The researchers are careful about the limits of their evidence. The evaluation rests on qualitative focus group data from twelve students, which can illuminate how learners experienced the course and what they believe changed, but cannot by itself quantify improvements in clinical performance or patient outcomes. Data from the study are available by request, and the authors note that all contributors, including the many actors who portrayed patients, were essential to the program’s success. Still, the consistency of the themes across both Saudi and US participants lends weight to the conclusion that the course prepared students to respond respectfully and sensitively to patients from diverse cultures.

For a specialty like surgery, where time-pressured encounters and high-stakes decisions amplify the consequences of miscommunication, the implications are striking. If a five-week virtual course built on simulation, physician facilitation, and international peer exchange can measurably boost students’ confidence and cultural awareness, medical schools may have a low-cost, exportable blueprint for embedding multicultural competence into undergraduate training. As the course enters future iterations, the challenge will be to track whether these self-reported gains translate into durable changes in behavior at the bedside, and ultimately into more equitable care for the increasingly diverse populations that modern medicine serves.

Subject of Research: A virtual international communication skills course for US and Saudi medical students and its effects on cultural competency and patient-centered care

Article Title: Multicultural competence education improves care: an international communication course for medical students

Article References: Newcomb, A. B., Mashbari, H., Abbaker, R., Stidham, M., Elhadi, K., Muzaiiadi, S., March, E., Appelbaum, R. D., Wells, K. M., & Mohess, D. (2026). Multicultural competence education improves care: an international communication course for medical students. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 133. https://doi.org/10.1007/s44186-026-00538-y

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00538-y

Keywords: medical education, cultural competency, communication skills, patient-centered care, virtual learning, simulation, Saudi Arabia, United States, surgical education, professionalism, healthcare disparities, qualitative research

The review, led by Polina Perlman, a child and adolescent psychiatrist at the University of Toronto’s Temerty Faculty of Medicine, together with health sciences librarian Jessie Cunningham and senior author Mark D. Hanson, set out to map the full landscape of pandemic-era educational change in postgraduate psychiatry. The team followed Arksey and O’Malley’s five-phase scoping review framework and reported their findings according to the PRISMA extension for scoping reviews. Two comprehensive searches, conducted in May 2022 and May 2023 across MEDLINE, Embase, APA PsycINFO, Web of Science, and the World Health Organization’s COVID-19 database, identified 775 records. After deduplication, title and abstract screening, full-text review, and manual citation searching, 19 studies met the team’s strict eligibility criteria: each had to describe an educational development—including teaching, assessment, or structured well-being programs—that was actually implemented in response to the pandemic and involved residents, fellows, or physicians.

The deliberate exclusion of commentaries, editorials, needs assessments, and opinion pieces distinguishes this review from earlier broad syntheses of pandemic-era medical education. Perlman and colleagues wanted evidence of deployed change, not calls for change. The final corpus, comprising studies published between 2020 and 2023, was dominated by research from the United States, with additional contributions from Sweden, Ireland, the United Kingdom, New Zealand, Singapore, and Thailand. Most studies relied on descriptive, survey-based, or qualitative designs, and the team classified each curricular change as either reactive—introduced in direct response to pandemic conditions—or premeditated, meaning planned or accelerated by the crisis but conceived independently of it.

The dominant theme was unmistakable: fifteen of the nineteen included studies described transitions to virtual or hybrid didactics and clinical encounters. Programs converted lectures, seminars, case conferences, and even psychotherapy supervision to videoconferencing platforms within days or weeks. Remarkably, these hasty adaptations were generally reported as feasible, and in several studies both trainees and faculty expressed a preference for retaining hybrid formats even after the emergency subsided. National survey data cited in the review indicate that many psychiatry residency programs have indeed kept hybrid elements in place. A virtual clinical skills examination developed for general psychiatry was reported as both feasible and acceptable, suggesting that some core competency assessments can be delivered remotely without sacrificing rigor.

Beyond format, the pandemic also changed what was taught. Several programs expanded content on disaster psychiatry, telehealth ethics, and resilience, reflecting the reality that psychiatrists were being asked to support patients, colleagues, and health systems through an unprecedented collective trauma. Telepsychiatry training expanded substantially, with programs integrating focused seminars on remote therapeutic engagement, supervised virtual clinics, and remote case discussions. One notable example of premeditated change was the American Association for Geriatric Psychiatry’s comprehensive online geriatric psychiatry curriculum, a resource conceived before the pandemic but rapidly accelerated by it, which the review’s authors suggest could serve as a model for embedding specialty-specific online modules as core content for all general psychiatry residents, regardless of local service availability.

The review also documented a striking acceleration of well-being curricula. Four studies described structured interventions tailored to the specific stressors of the pandemic era, including redeployment anxiety, social isolation, and pervasive uncertainty. These ranged from structured peer support systems and virtual Balint groups—reflective discussion forums long used in medical training—to a mindfulness-based cognitive therapy-informed well-being program for psychiatry trainees in New Zealand. The authors note that psychiatry has historically been sparsely represented in the broader wellness-curriculum literature, making the appearance of four psychiatry-specific well-being programs in this small corpus particularly notable. They interpret this as a possible cultural shift toward normalizing ongoing emotional support and reflective practice within psychiatric education, rather than treating wellness as an occasional, stigmatized add-on.

Perhaps the most sobering findings concerned redeployment. In heavily affected regions such as New York City, psychiatry residents were reassigned to general medical services, caring for patients with acute COVID-19 far outside their specialty training. The studies documenting these experiences revealed substantial gaps in preparedness, supervision, and ethical frameworks for reallocating psychiatric trainees to frontline medical roles. The review argues that future national health emergencies should not be managed as ad hoc disruptions to psychiatric training but as scenarios for which programs can prepare in advance—with clearer redeployment frameworks, defined supervision pathways, structured emotional support, and recognition of psychiatry’s distinctive crisis contributions, including staff support, family communication, and management of acute psychological distress. Telepsychiatry and remote response skills, the authors contend, should be considered core elements of emergency preparedness rather than incidental pandemic adaptations.

The review also surfaced stark global inequities. While programs in higher-income settings such as Sweden and the United States often found digital and hybrid models feasible and worth retaining, the study from Thailand highlighted pronounced logistical barriers and considerable trainee dissatisfaction with remote learning. The success of pandemic-era educational adaptations, the authors conclude, depends heavily on local infrastructure and institutional capacity—a discrepancy that calls for international collaboration on resource sharing and digital infrastructure development so that post-pandemic educational gains do not widen existing divides. These findings carry implications for accreditation bodies as well: if virtual assessment, telepsychiatry exposure, and hybrid formats proved educationally valuable, regulators may need to reconsider how core training experiences are defined and whether competencies can be achieved through a broader range of educational formats.

An unexpected observation threaded through the review is the near-absence of postgraduate psychiatry from earlier broad syntheses of COVID-19-related educational change, even though online learning, telehealth, assessment changes, redeployment, and learner support were prominent themes in those reviews. The authors propose several possible explanations—timing gaps between rapid-response reviews and the later emergence of psychiatry-specific scholarship, and the tendency for pandemic-era changes to be implemented at the hospital or mental health team level rather than within psychiatry programs alone, obscuring psychiatry-specific data—while cautioning that these remain hypotheses. Whatever the cause, the finding underscores the value of discipline-specific knowledge synthesis: without focused reviews, innovations in psychiatric education risk remaining under-recognized in wider conversations about medical education reform.

The review is candid about its limitations. Consistent with scoping review methodology, no formal quality assessment of the included studies was performed, and the restriction to English-language, peer-reviewed publications describing implemented developments may have omitted early descriptive accounts, particularly from resource-limited settings. Most of the included studies were descriptive or survey-based, with little controlled evaluation or longitudinal follow-up—a gap the authors identify as the field’s most pressing research need. Looking forward, they outline priorities for post-pandemic psychiatric education: embedding telepsychiatry and hybrid learning as permanent flexible tools, sustaining well-being initiatives, expanding content to include crisis psychiatry and systems-based care, developing clear redeployment policies, addressing global digital inequities, and rethinking accreditation standards. Although artificial intelligence did not feature in the pandemic-era literature they reviewed, the authors note that AI literacy and its ethical implications for clinical reasoning, teaching, and assessment will likely need a place in future curricula. The pandemic, in their assessment, created an unusual opportunity to reconsider not merely the delivery of psychiatric training but its fundamental aims—and the challenge now is to evaluate which emergency innovations genuinely strengthen it, and to keep the ones that do.

Subject of Research: Changes in postgraduate psychiatric education implemented in response to the COVID-19 pandemic

Article Title: Postgraduate Psychiatric Education During the COVID-19 Pandemic: A Scoping Review

Article References: Postgraduate Psychiatric Education During the COVID-19 Pandemic: A Scoping Review. (n.d.). https://doi.org/10.1007/s40596-026-02424-7

Image Credits: AI Generated

DOI: 10.1007/s40596-026-02424-7

Keywords: psychiatry, medical education, COVID-19, scoping review, telepsychiatry, residency training, trainee well-being, virtual learning, redeployment, assessment, graduate medical education, emergency preparedness