Development of clinical curriculum with simulated patients and objective assessment method

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(1)Development of curriculum with simulated patients (SP).In Japan, medical interview training is limited to the situation of first visit patient with simple symptom at a clinic. We developed patients' scenarios at variety of clinical situations including ‘explain the lab and exam data and induce patients autonomy', ‘patient education', and ‘break bad news'. We created scenario with SP and medical doctors. SP training and effective learning program with lecture and practice by role play with SPs at small group was implemented to our 4^<th> year medical school curriculum and faculty development. Assessment sheet by SP, which could assess the communication skills at various clinical settings was also created.(2)Evaluation of medical interview by SP at OSCE.SP rating is not required at Common National OSCE for preclinical medical students. Role of SP was only ‘player' but not raters in Japan. We set up SP rating sheet for medical interview at OSCE, and compare with faculty's assessment by analyzing Cronbach alpha, consistency with standard assessment (checked by video), Peason Correlation. SP assessment showed high reliability as faculty, high consistency with standard rating, significant correlation with faculty rating for areas of information gathering, interview framework, and communication skills. Relatively low correlation with faculty in communication skills indicates that SP rating expresses patient's standpoint and it should be different from faculty rating. SP rating has value using as learner's assessment. Our results indicate that SP rating is reliable and could be used as raters at OSCE including high stakes examinations. Our research is the first report to show the evidence of reliability and validity of SP rating in Japan.