Mind the gap: a nationwide survey study of undergraduate medical communication curricula in Italy

Background: Effective clinical communication is essential to safe, patient-centered care, yet its integration into undergraduate medical curricula remains inconsistent worldwide. In Italy, no national-level evidence has been available to guide reform in line with local specificities. This study aimed to systematically map and analyze healthcare communication education in Italian medical and health professions programs, identifying strengths, gaps, and opportunities for innovation. Methods: The ComMedInItaly study adopted a two-phase design: (1) systematic mapping of undergraduate healthcare communication courses across accredited Italian universities; and (2) a national survey of course instructors exploring content, pedagogical approaches, assessment methods, and instructor expertise. Findings from both phases were descriptively analyzed and integrated. Results: Twenty-four courses were identified, most positioned in the early years of study, assigned limited credits, and often embedded in psychology modules. Teaching was predominantly lecture-based, with limited use of experiential learning or performance-based assessment. Course content emphasized relational and psychological aspects, while interactional and linguistic dimensions were underrepresented. Instructor profiles were heterogeneous, with few affiliations to professional societies in healthcare communication. Conclusions: Healthcare communication training in Italy is fragmented, under-resourced, and weakly connected to clinical practice. This is the first national-level analysis of communication education in Italy, establishing an empirical baseline for reform. The study introduces a replicable two-phase model, demonstrates the need for locally generated and culturally responsive evidence, and offers a pathway for aligning international frameworks with national realities. Together, these innovations position communication as a core, measurable competency in medical education.