Performance-based assessments (PBAs) are an ideal methodology of training and assessment that contributes to a multitude of individual and programmatic benefits. They can provide the opportunity to practice solving common pragmatic dilemmas as well as expose learners to uncommon clinical scenarios. PBAs also facilitate program evaluation by identifying programmatic strengths and gaps and allow educators to address core curricular deficiencies. OSCE trainings and assessments can be nimbly adapted as treatment protocols emerge or change, while annual and longitudinal OSCE programs can produce useful data for administrative dashboards and scholarship. All health professions educators can draw on their creativity and clinical experience to create cases that enrich the learning environment and ensure competency, and the process of creating cases and assessment forms and engaging faculty observers for feedback builds both a shared mental model for assessment and a community for learning.