Objective: Comparison of the medical students' self-assessment and the evaluation of students by simulated patients regarding students' communication skills in Family Medicine OSCE. Introduction: Communication is the act of conveying a message to another person, and it is an essential skill for establishing physician-patient relationships and effective functioning among health care professionals. Effective communication can positively influence patient satisfaction and outcomes. Health professional communication skills do not necessarily improve over time but can improve with formal communication skills training. Method: A cross sectional study done at Oman Medical College. All of the medical students who signed up for an Objective Structured Clinical Examination (OSCE) in Family Medicine were included. As a part of the OSCE, the student performance was evaluated by a simulated patient. After the examination, the students were asked to assess their communication skills. The Calgary Cambridge Observation Guide formed the basis for the outcome measures used in the questionnaires. A total of 12 items were rated on a Likert scale from 1-5 (strongly disagree to strongly agree). Results: 68 students participated in the examination, 88% (60/68) of whom responded to the questionnaire. The response rate for the simulated patients was 100%. Over all comparison showed that students marginally over estimated in few areas as compared to simulated patients. Measures of reliability show that it is a reliable measure with Cronbach's Alpha from the 12 items being 0.89. When comparing between the experience and new simulators only one item (q12) showed a statistically significant difference, with t(16)=3.08, p<0.05, with experienced simulators giving a higher score 4.55, when compared with the new simulators 3.86. Conclusion: Students' and simulated patients' assessment has some agreements. Self-assessment is guiding the future learning, providing reassurance, and promoting reflection which helps them to perform appropriately.