a 24 y / o single , educated , mother is hesitant to have her 12 mo daughter vaccinated for measles , mumps and rubella ( mmr ) due to concerns of her developing autism .
student objectives : to discuss the actual risks and benefits of the mmr vaccine and to debunk the link the between the mmr vaccine and autism by describing recent medical literature on the topic .
a 7 y / o boy has been having more frequent asthma exacerbations and his divorced parents are arguing in the office over the situation and both are potentially at fault .
student objectives : to manage the interview effectively keeping the patient s interest and not the parental issues at the center of the discussion .
a 16 y / o healthy female ( or male ) , from a middle - class background , comes to the office for a sports physical .
the patient s social history is significant for increasing marijuana use , occasional sexual intercourse , and brief periods of depression in her past .
student objectives : to gain the trust of the patient and to complete a thorough psychosocial history with interventional guidance as appropriate .
 as medical students enter the role of physician , clinical outcomes not only rely on their mastery of clinical knowledge , but also on the effectiveness in which they can communicate with patients and family members . while students typically have 
 numerous opportunities to practice clinical communication with adult patients , such practice in pediatric settings is limited . 
 this study examines if simulated patient ( sp ) encounters strengthen third - year medical students communication skills during the pediatrics clerkship . during 2011 - 2013 , 
 three sp encounters ( comprising 3 pediatric scenarios ) were incorporated into a pediatrics clerkship at one united states medical school to give students a safe venue to practice advanced communication with observation and direct feedback . 
 third - year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter . with irb approval , students self - perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem , likert scale questionnaire administered pre and post the sp encounter . 
 pre- and post - questionnaires ( n=215 ; response rate , 96% ) analyzed using a wilcoxon - matched pairs signed - rank test demonstrated statistically significant increases in students perception of their confidence and abilities regarding their performance ( p<0.05 ; bonferroni correction , p<0.006 ) . 
 there was an increases in student confidence and self - perceived ability in : first , communicating with children and family members of young patients ; second , managing confrontational situations involving parents ; third , performing a thorough psychosocial history with an adolescent ; and fourth , using evidence based medicine to motivate parents . 
SUPPLEMENTARY MATERIAL
Case #1. MMR vaccination
Case #2. Parental conflict
Case #3. Adolescent psychosocial history