The objective of the study is to investigate the long-term effect of a training course in communication for doctors and nurses. In pre- and post-design, we investigated the effect of Maguire's communication course. Parents'perceptions of the communications with the clinicians were monitored continuously for up to three years following the course using electronic questionnaires. Two hundred and seventy-one responses were obtained from the parents in 2004 (65%), 3712/4875 in 2006 (76%), and 3033/4395 in 2007 (69%). After the course, the proportion of satisfied parents increased significantly. The greatest improvements occurred in response to the statement: 'The clinician tried to understand how I experienced the problem' (OR: 6.4 and 6.3). There was no association between the time since the clinician had participated in the course and the mean score of the perceived communication and satisfaction. In conclusion parents'perceptions of communication improved significantly after the department implemented a communication program, and remained unchanged for up to three years. Electronic and continuous monitoring of quality of care is an appropriate method to evaluate new initiatives, such as training courses.