Communication skills are essential for clinical medicine yet, unlike in general practice, trainees in specialist and general medicine are not formally trained in them. We have used videotaped recording of simulated consultations to evaluate their acceptability and usefulness for training neurology specialist registrars. Twelve specialist registrars in neurology participated; their perceptions of the method were assessed using quantified scales and focus groups. All but one of the 12 trainees found the exercise useful both for improving clinical skills and for the imparting of information. The median visual analogue scores (0=useless, 100=very useful) for history taking and for imparting information were 91 and 90%, respectively. The median scores [and interquartile range (IQR)] of perceived usefulness for communication skills increased before to after (for use of video) from 68 (58-78) to 88 (80-92)% (P < 0.02), and (for use of simulated patients) from 51 (40-71) to 86 (79-89)% (P < 0.02). The focus groups provided additional qualitative data supporting the technique. We conclude that videotaped consultations with simulated patients are valued by most neurology trainees, both for improving their history-taking skills and for imparting information. The technique could be used more widely in neurology training, and may have a role in assessment.