In addition to the usual training in communication skills, a systematic and digitalized guide will be used that included the "health literacy practices" qualified by Coleman et al. [10] as a training complement and self-assessment of its performance. They will also receive feedback from independent observers (according to the systematic guide).

The CG will receive the usual training (consisting of two weekly meetings of two hours each with seven sessions whose main topics were social skills for clinical interviews: opening and closing of the clinical interviews, non-verbal communication, active listening, empathy, helping relationship, giving information about the nature of the disease and rationality of the therapeutic measures, health education, and negotiation). Furthermore, throughout the course, they will self-assess their performance using the opening video recording without systematic guidance and they will receive feedback about their communication practices during this first performance.

Thus, CG will receive the full intervention after being evaluated (post-test 1 assessment), becoming the delayed Experimental Group 2 (EG2)

In summary, students in EG1 received the following multimodal intervention flow: 1) Health communication training, 2) Structured educational simulation using standardized patients (SPs), and 3) simulation feedback and self-assessment using a systematic guide that included the "health literacy practices".

Clinical relationship developed between a healthcare professional and a patient was measured through CICAA scale (pre-test, post-test 1, and post-test 2).

The CICAA scale is a measure instrument designed to assess the clinical relationship (CR) developed between a health professional and a patient. It can be used to evaluate global or partial aspects of CR, is based on an external evaluation through observation of the interaction and can be used for teaching purposes. For all 29 items (scored 0, 1, 2), the minimum score is 0, and the maximum score is 58. The higher the score, the better the communication skills in the consultation.