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ICCs for mean scores for pairs among the three remaining raters was 0.81 to 0.84. Mean JSEO scores from the four raters correlated with the JSPPPE (rho = 0.45, p = 0.03) and IC (rho = 0.68, p less then 0.001), but not the EEC (rho = 0.345, p = 0.1). Conclusions We found validity evidence for the use of a modified JSPPPE for an observer to assess empathy in a recorded encounter with a SP. This may be useful as medical educators shift toward competency-based tracking. The brevity of this tool and potential assessment using video are also