Development of clinical curriculum with simulated patients and objective assessment method

（1）模拟患者（SP）课程的开发在日本，医疗面谈培训仅限于症状简单的初次就诊患者在诊所的情况。我们在各种临床情况下开发了患者场景，包括“解释实验室和检查数据并诱导患者注意力”，“患者教育”和“打破坏消息”。我们与SP和医生一起创建了场景。在四年制医学院课程和教师发展中，我们实施了SP培训和有效学习计划，包括与SP进行小组角色扮演的讲座和实践<th>。还创建了SP评估表，可以评估各种临床环境中的沟通技能。（2）OSCE的SP对医学面试的评估。在普通国家OSCE，对临床前医学生不要求SP评级。在日本，SP的角色只是“玩家”，而不是评级者。建立了OSCE医学面试SP评分表，并与教师评分进行Cronbach α、与标准评分一致性（通过录像检查）、Peason相关分析。SP评估结果显示，教师的高可靠性，与标准评级的高度一致性，与教师的信息收集，面试框架和沟通技巧领域的评级显着相关。沟通技能与教师的相关性较低，表明SP评分表达了患者的观点，应该与教师评分不同。SP评分作为学习者评价具有一定的使用价值。我们的研究结果表明，SP评分是可靠的，可以作为评分员在欧安组织，包括高风险的考试。本研究是第一份在日本证明SP量表信度和效度的报告。

(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.