Digitally-Enhanced Communication Competencies: Preparing the Next Generation of Healthcare Professionals: A Systematic Review
DOI:
https://doi.org/10.21009/jtp.v28i2.69594Keywords:
Communication Competence, Digital Interventions, Telehealth, Health Students, Systematic ReviewAbstract
The adoption of digital technologies such as telehealth in health education requires the development of digital communication competencies among future healthcare professionals. Although health students generally demonstrate positive attitudes toward digital health, their readiness and practical communication skills remain limited. This systematic review aimed to identify the role of digital interventions in improving communication competencies (knowledge, skills, and attitudes) and to describe the characteristics of their implementation. A systematic search was conducted in five databases (PubMed, EBSCOhost, ScienceDirect, Scopus, and Sage Journals) for primary studies published between October 2020 and October 2025 following the PRISMA 2020 guidelines. Twelve studies met the inclusion criteria, with most conducted in the United States (41.7%) and Germany (25.0%), and the majority using quantitative designs (58.3%). Digital interventions—including telehealth modules, telemedicine simulations, telenursing training, virtual OSCEs, and video-based learning—consistently improved communication competencies. Knowledge scores increased significantly, with post-test scores reaching 57.1% in digital module interventions and telenursing knowledge scores increasing from 6.84 to 8.42 (Cohen’s d = 0.76). Communication skills also improved, with 100% of participants applying the Ask–Tell–Ask strategy after training and 98% recommending telemedicine simulation courses. Attitude outcomes showed increased confidence and readiness, with preparedness for telehealth rising from 37% to 78% and telenursing training demonstrating a large effect size (Cohen’s d = 1.04). However, ethical competencies, particularly informed consent, patient privacy, and virtual physical examination, remained relatively weak across studies. These findings suggest that digital interventions are effective in strengthening communication competencies among health students, but sustainable competency development requires structured integration of telehealth curricula with simulation-based learning, supervised practice, and explicit training in ethical and patient-centered communication.
References
Abou Hashish, E. A., & Alnajjar, H. (2024). Digital proficiency: assessing knowledge, attitudes, and skills in digital transformation, health literacy, and artificial intelligence among university nursing students. BMC Medical Education, 24(1), 508. https://doi.org/10.1186/s12909-024-05482-3
Ali-Saleh, O., Massalha, L., & Halperin, O. (2025). Evaluation of a Simulation Program for Providing Telenursing Training to Nursing Students: Cohort Study. JMIR Medical Education, 11, e67804–e67804. https://doi.org/10.2196/67804
Alshammari, A., Alanazi, M. F., & Bahari, G. (2024). Nursing students’ awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare: A cross-sectional study. Nurse Education Today, 142, 106359. https://doi.org/10.1016/j.nedt.2024.106359
Bajra, R., Srinivasan, M., Torres, E. C., Rydel, T., & Schillinger, E. (2023). Training future clinicians in telehealth competencies: outcomes of a telehealth curriculum and teleOSCEs at an academic medical center. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1222181
Barksdale, S., Stark Taylor, S., Criss, S., Kemper, K., Friedman, D. B., Thompson, W., Donelle, L., MacGilvray, P., & Natafgi, N. (2023). Improving Patient Health Literacy During Telehealth Visits Through Remote Teach-Back Methods Training for Family Medicine Residents: Pilot 2-Arm Cluster, Nonrandomized Controlled Trial. JMIR Formative Research, 7, e51541. https://doi.org/10.2196/51541
Boardman, D., Wilhite, J. A., Adams, J., Sartori, D., Greene, R., Hanley, K., & Zabar, S. (2021). Telemedicine Training in the COVID Era: Revamping a Routine OSCE to Prepare Medicine Residents for Virtual Care. Journal of Medical Education and Curricular Development, 8. https://doi.org/10.1177/23821205211024076
Chan, S. C. C., Choa, G., Kelly, J., Maru, D., & Rashid, M. A. (2023). Implementation of virtual OSCE in health professions education: A systematic review. Medical Education, 57(9), 833–843. https://doi.org/10.1111/medu.15089
Chao, C.-Y., Lin, T.-K., Hung, N.-Y., Hsu, C.-L., & Kao, L.-T. (2025). Advancing Pharmacy Students’ Communication Skills through Real-Time Feedback in Innovative Simulations. American Journal of Pharmaceutical Education, 89(6), 101414. https://doi.org/10.1016/j.ajpe.2025.101414
Chike-Harris, K. E., Garber, K., & Derouin, A. (2021). Telehealth Educational Resources for Graduate Nurse Faculty. Nurse Educator, 46(5), 295–299. https://doi.org/10.1097/NNE.0000000000001055
Coelho, M. de M. F., Miranda, K. C. L., Melo, R. C. de O., Gomes, L. F. de S., Monteiro, A. R. M., & Moreira, T. M. M. (2021). Use of a therapeutic communication application in the nursing undergraduate program: Randomized clinical trial. Revista Latino-Americana de Enfermagem, 29. https://doi.org/10.1590/1518-8345.4461.3456
Eckhoff, D. O., Guido-Sanz, F., & Anderson, M. (2022). Telehealth across nursing education: Findings from a national study. Journal of Professional Nursing, 42, 308–314. https://doi.org/10.1016/j.profnurs.2022.07.013
Elendu, C., Amaechi, D. C., Okatta, A. U., Amaechi, E. C., Elendu, T. C., Ezeh, C. P., & Elendu, I. D. (2024). The impact of simulation-based training in medical education: A review. Medicine, 103(27), e38813. https://doi.org/10.1097/MD.0000000000038813
Fernández-Alcántara, M., Escribano, S., Juliá-Sanchis, R., Castillo-López, A., Pérez-Manzano, A., Macur, M., Kalender-Smajlović, S., García-Sanjuán, S., & Cabañero-Martínez, M. J. (2025). Virtual Simulation Tools for Communication Skills Training in Health Care Professionals: Literature Review. JMIR Medical Education, 11, e63082–e63082. https://doi.org/10.2196/63082
Golden, B. N., Elrefaay, S., McLemore, M. R., Alspaugh, A., Baltzell, K., & Franck, L. S. (2024). Midwives’ experience of telehealth and remote care: a systematic mixed methods review. BMJ Open, 14(3), e082060. https://doi.org/10.1136/bmjopen-2023-082060
Harendza, S., Bußenius, L., Gärtner, J., Heuser, M., Ahles, J., & Prediger, S. (2023). “Fit for the finals” - project report on a telemedical training with simulated patients, peers, and assessors for the licensing exam. GMS Journal for Medical Education, 40(2), Doc17. https://doi.org/10.3205/zma001599
Hoffert, M. M., Newman, J., Mortimore, A., Passalacqua, K. D., & Abreu Lanfranco, O. (2024). Explicit Training in Systematic Communication Strategies: A Pilot Study Exploring the Incorporation of Communication Tools by First-Year Residents in Simulation and in Clinical Practice. Journal of Medical Education and Curricular Development, 11. https://doi.org/10.1177/23821205241256042
Hussien, R. H., Ahmed, G. K., & Abdullah, S. O. (2025). Knowledge, attitude and readiness toward telehealth among nursing staff: a cross-sectional study. BMC Medical Education, 25(1), 1448. https://doi.org/10.1186/s12909-025-07921-1
Jadoon, M., Naushad, K., Aman, F., Khan, Y., Durrani, M., & Ali, S. (2025). Virtual Patients for Communication Skills Training: A Mixed Methods Evaluation. Cureus. https://doi.org/10.7759/cureus.91005
Jones, H. M., Ammerman, B. A., Joiner, K. L., Lee, D. R., Bigelow, A., & Kuzma, E. K. (2023). Evaluating an intervention of telehealth education and simulation for advanced practice registered nurse students: A single group comparison study. Nursing Open, 10(6), 4137–4143. https://doi.org/10.1002/nop2.1620
Karkache, W., Halman, S., Tran, C., Nie, R., & Pugh, D. (2024). Designing a touchless physical examination for a virtual Objective Structured Clinical Examination. Canadian Medical Education Journal. https://doi.org/10.36834/cmej.74261
Kaya Kaçar, H., Kaçar, Ö. F., & McCullough, F. (2024). Nutrition Messaging by Healthcare Students: A Mixed-Methods Study Exploring Social Media Usage and Digital Competence. Nutrients, 16(10), 1440. https://doi.org/10.3390/nu16101440
Khraisat, O. M. A., Al-Bashaireh, A. M., & Alnazly, E. (2023). Telenursing implications for future education and practice: Nursing students’ perspectives and knowledge from a course on child health. PLOS ONE, 18(11), e0294711. https://doi.org/10.1371/journal.pone.0294711
Kleib, M., Arnaert, A., Nagle, L. M., Ali, S., Idrees, S., Costa, D. da, Kennedy, M., & Darko, E. M. (2024). Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review. JMIR Nursing, 7, e58170. https://doi.org/10.2196/58170
Lee, J., Kim, H., Kim, K. H., Jung, D., Jowsey, T., & Webster, C. S. (2020). Effective virtual patient simulators for medical communication training: A systematic review. Medical Education, 54(9), 786–795. https://doi.org/10.1111/medu.14152
McCarrick, C. A., Moynihan, A., McEntee, P. D., Boland, P. A., Donnelly, S., Heneghan, H., & Cahill, R. A. (2025). Impact of simulation training on communication skills and informed consent practices in medical students- a randomised controlled trial. BMC Medical Education, 25(1), 1078. https://doi.org/10.1186/s12909-025-07671-0
Mulcare, M., Naik, N., Greenwald, P., Schullstrom, K., Gogia, K., Clark, S., Kang, Y., & Sharma, R. (2020). Advanced Communication and Examination Skills in Telemedicine: A Structured Simulation-Based Course for Medical Students. MedEdPORTAL. https://doi.org/10.15766/mep_2374-8265.11047
Mun, M., Choi, S., & Woo, K. (2024). Investigating perceptions and attitude toward telenursing among undergraduate nursing students for the future of nursing education: a cross-sectional study. BMC Nursing, 23(1), 236. https://doi.org/10.1186/s12912-024-01903-2
Muntz, M. D., Franco, J., Ferguson, C. C., Ark, T. K., & Kalet, A. (2021). Telehealth and Medical Student Education in the Time of COVID-19—and Beyond. Academic Medicine, 96(12), 1655–1659. https://doi.org/10.1097/ACM.0000000000004014
Norlita, D., Nageta, P. W., Faradhila, S. A., Aryanti, M. P., Fakhriyah, F., & Ismayam. A, E. A. (2023). SYSTEMATIC LITERATURE REVIEW (SLR) : PENDIDIKAN KARAKTER DI SEKOLAH DASAR. JISPENDIORA Jurnal Ilmu Sosial Pendidikan Dan Humaniora, 2(1), 209–219. https://doi.org/10.56910/jispendiora.v2i1.743
O’Connor, S., Odewusi, T., Smith, P. M., & Booth, R. G. (2022). Digital professionalism on social media: The opinions of undergraduate nursing students. Nurse Education Today, 111, 105322. https://doi.org/10.1016/j.nedt.2022.105322
O’Connor, S., Zhang, M., Honey, M., & Lee, J. J. (2021). Digital professionalism on social media: A narrative review of the medical, nursing, and allied health education literature. International Journal of Medical Informatics, 153, 104514. https://doi.org/10.1016/j.ijmedinf.2021.104514
Perle, J. G., Zheng, W., Gardner, L., & Law, K.-B. (2024). Editorial: Education, training, and competency development for mental health-focused telehealth providers. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1443750
Rettinger, L., Putz, P., Aichinger, L., Javorszky, S. M., Widhalm, K., Ertelt-Bach, V., Huber, A., Sargis, S., Maul, L., Radinger, O., Werner, F., & Kuhn, S. (2024). Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students’ Perceived Knowledge, Skills, Attitudes, and Experience. JMIR Medical Education, 10, e51112. https://doi.org/10.2196/51112
Seemann, R. J., Mielke, A. M., Glauert, D. L., Gehlen, T., Poncette, A. S., Mosch, L. K., & Back, D. A. (2023). Implementation of a digital health module for undergraduate medical students: A comparative study on knowledge and attitudes. Technology and Health Care, 31(1), 157–164. https://doi.org/10.3233/THC-220138
Shafizadeh, H., Larijani, B., Mojtahedzadeh, R., Shamsi Gooshki, E., & Nedjat, S. (2022). Initial drafting of telemedicine’s code of ethics through a stakeholders’ participatory process. Journal of Medical Ethics and History of Medicine. https://doi.org/10.18502/jmehm.v14i24.8184
Shawwa, L. (2023). The Use of Telemedicine in Medical Education and Patient Care. Cureus. https://doi.org/10.7759/cureus.37766
Teerawongpairoj, C., Tantipoj, C., & Sipiyaruk, K. (2024). The design and evaluation of gamified online role-play as a telehealth training strategy in dental education: an explanatory sequential mixed-methods study. Scientific Reports, 14(1), 9216. https://doi.org/10.1038/s41598-024-58425-9
Thomas, D. C., Sutherland, R., Munro, N., Ibric, M., Pacey, F., Purcell, A., & Bourne, E. (2025). Telehealth and in‐person placements: Same, same, but different. A mixed methods investigation of speech and language therapy students’ and practice educators’ experiences and perceptions. International Journal of Language & Communication Disorders, 60(2). https://doi.org/10.1111/1460-6984.70009
Vogt, L., Schmidt, M., Follmann, A., Lenes, A., Klasen, M., & Sopka, S. (2022). Telemedicine in medical education: An example of a digital preparatory course for the clinical traineeship - a pre-post comparison. GMS Journal for Medical Education, 39(4), Doc46. https://doi.org/10.3205/zma001567
Wittenberg, E., Goldsmith, J. V., Chen, C., Prince-Paul, M., & Capper, B. (2021). COVID 19-transformed nursing education and communication competency: Testing COMFORT educational resources. Nurse Education Today, 107, 105105. https://doi.org/10.1016/j.nedt.2021.105105
Wright, H. H., O’Shea, M.-C., Sekula, J., & Mitchell, L. J. (2022). Assessment of communication skills using telehealth: considerations for educators. Frontiers in Medicine, 9, 841309. https://doi.org/10.3389/fmed.2022.841309
Yang, J., & Kim, S. (2022). An online communication skills training program for nursing students: A quasi-experimental study. PLOS ONE, 17(5), e0268016. https://doi.org/10.1371/journal.pone.0268016
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Anis Novitasari, Ari Indra Susanti, Dewi Marhaeni Diah Herawati, Nita Arisanti , Hadi Susiarno , Vita Murniati Tarawan

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Jurnal Teknologi Pendidikan is an Open Access Journal. The authors who publish the manuscript in Jurnal Teknologi Pendidikan agree to the following terms.
Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.




