Effectiveness of Attitude, Ethics, and Communication (AETCOM)-Based Medical Education in Improving Informed Consent and Patient Communication Skills Among Medical Students: A Systematic Review

The Attitude, Ethics, and Communication (AETCOM) curriculum is intended to develop medical graduates who can communicate effectively and practice ethically; however, evidence for informed-consent-specific competence has not been clearly distinguished from general communication outcomes, learner satisfaction, and attitudes.This systematic review evaluated AETCOM-based education in relation to patient communication performance and informed-consent competence among undergraduate medical students and interns.Searches were standardized through July 31, 2026.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search identified 149 records across PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, Web of Science, Embase, and Education Resources Information Center (ERIC); after removal of 51 duplicates, 98 records were screened, 40 reports were sought for retrieval, 38 full-text reports were assessed, and 13 studies met the eligibility criteria.Seven studies used structured before-after performance assessments and reported directionally improved posttraining communication scores.Notable findings included increases from 54.89 ± 11.55 to 94.4 ± 19.3 in a six-college study of 240 third-year students, from 3.04 to 7.36/10 in a prospective study of 79 second-year students, and from 58.3 ± 10.2 to 91.4 ± 12.1 six weeks after a structured 12-hour program in 180 interns.Role-play, simulated encounters, structured checklists, video-supported practice, skills-laboratory activities, and feedback were commonly associated with favorable short-term learning outcomes.However, most effectiveness studies were non-randomized and uncontrolled, limiting causal interpretation.Direct evidence for competence in performing the complete informed-consent process was sparse, because consent was generally embedded within broader communication, autonomy, ethics, or professional-attitude outcomes rather than assessed as a standalone performance outcome.Overall, AETCOM-based education was associated with improved short-term patient communication performance, but the certainty of this evidence was low.Evidence for informed-consent-specific competence and longer-term clinical transfer remained very low.The review was not prospectively registered, and no separate protocol was published.