Development of the General Practice Video Review Assessment Tool (GP-VRAT): a rapid prototyping approach to formative assessment of communication skills in residency training

Video review is widely used to support communication skills training in undergraduate and postgraduate medical education. However, in Japan, few assessment tools have been developed specifically to support video-based reflection in general practice residency training, particularly through clearly described development processes. We developed General Practice Video Review Assessment Tool (GP-VRAT) for general practice residents using rapid prototyping and the nominal group technique (NGT). First, communication domains were identified through a literature review of existing communication assessment instruments and educational frameworks, with reference to the Kalamazoo Consensus Statement. Evaluation items were then generated and refined through two NGT sessions involving experts in general practice. A web-based survey was conducted to assess the importance of each item and the stage of training at which the corresponding competency was expected to be attained. Subsequently, iterative prototyping and refinement were conducted using video recordings of actual outpatient consultations by residents. A total of 127 evaluation items were extracted from 12 existing communication assessment instruments and educational frameworks and consolidated into 41 behavioral descriptors through NGT and expert review. A web-based survey involving 93 physicians confirmed the importance of all 41 items. The items were subsequently reorganized into 15 domains aligned with the structure of the medical interviews, and a rubric-based assessment tool with three developmental levels was developed. We developed a structured assessment tool to support video review in general practice residency training and described its development process. The GP-VRAT provides a shared framework for observation and feedback and may support reflective learning through video review. Further studies are needed to examine its feasibility, reliability, validity, and educational usefulness in practice.