The increasing implementation of simulation-based Emergency Medicine training in Malaysia have been using simulation in the Master of Medicine (Emergency Medicine) examination since its inception in 2002. Since then, simulation is used in the National Conjoint Board Examination as part assessment method, not only in the summative assessment in the form of Objective Structured Clinical Examinations (OSCE) of high stake examinations, but proved to be valuable in the continuous assessment throughout the four years training. Standardized patients, anatomical models, task trainers and high fidelity mannequins are commonly utilized to assess the domain of clinical consultations, specific clinical skills or physical examinations.Although there are many advantages in adopting simulation-based assessment, examiners must be aware of the limitations and how to improve the reliability and validity of such method including the need to combine it with other methods of assessment to distinguish between overall excellent and poor performers, allowing for safe practice. I will also discuss the two common sim-based assessment tools: Global Rating Scale and Checklists in terms of inter-rater reliability, construct reliability, feasibility to administer and discriminatory ability.
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