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ObjectivesTo quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and to qualitatively explore the educational benefits of this training programme.DesignA convergent mixed-methods study, including an intervention trial with a quasi-experimental design, was conducted to quantitatively analyse the communication skills of physicians. Qualitative data were collected via physicians’ responses to an open-ended questionnaire administered after the training.SettingAn acute care hospital.ParticipantsA total of 23 physicians.InterventionsIn a 4-week multimodal comprehensive care communication skills training programme, including video lectures and bedside instruction, from May to October 2021, all the participants examined a simulated patient in the same scenario before and after their training. These examinations were video recorded by an eye-tracking camera and two fixed cameras. Then, the videos were analysed for communication skills by AI.Main outcome measuresThe primary outcomes were the physicians’ eye contact, verbal expression, physical touch and multimodal communication skills with a simulated patient. The secondary outcomes were the physicians’ empathy and burnout scores.ResultsThe proportion of the duration of the participants’ single and multimodal types of communication significantly increased (p<0.001). The mean empathy scores and the personal accomplishment burnout scores also significantly increased after training. We developed a learning cycle model based on the six categories that changed after training from the physicians’ perspective: multimodal comprehensive care communication skills training; increasing awareness of and sensitivity to changes to geriatric patients’ condition; changes in clinical management; professionalism; team building and personal accomplishments.ConclusionsOur study showed that multimodal comprehensive care communication skills training for physicians increased the proportions of time spent performing single and multimodal communication skills by video analysis through AI.Trial registration numberUMIN Clinical Trials Registry (UMIN000044288;https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050586).

A 57-year-old Japanese man presented to our hospital with progressive gait disturbance for 4 months. He had a history of alcohol use disorder. There was a loss of vibratory sensation in the lower extremities, and the Romberg sign was positive. Laboratory studies revealed that the hemoglobin level was 6.3 g/dL (reference range, 13.5 to 17.6 g/dL), the mean corpuscular volume was 127.7 fL (reference range, 82.7 to 101.6 fL), the vitamin B12 concentration was below the level of detectability, and the patient was positive for anti-intrinsic factor antibodies. Upper gastrointestinal endoscopy revealed atrophic gastritis. Cervical, thoracic, and lumbar spine magnetic resonance imaging (MRI) showed high intensity of the posterior cord (Panel A, C). We diagnosed subacute combined degeneration of the spinal cord and initiated vitamin B12 supplementation (1). The clinical symptoms gradually improved with treatment, and ambula-