I tend to use the technology communication tools for smaller sized courses since I often only have a few students at a time. Technology tools for effective communication are essential. A study has demonstrated that virtual clinical simulation can improve communication skills in nursing students (Foronda, Gattamorta, Snowden, & Bauman, 2013) Reference 
Foronda, C., Gattamorta, K., Snowden, K., & Bauman, E. B. (2013). Use of virtual clinical
simulation to improve communication skills of baccalaureate nursing students: A
pilot study. Nurse Educ Today.