A common challenge for clinical training programs is helping students apply academic knowledge to clinical settings. Authentic assessment using simulation offers a unique approach to bridging this gap. Miller's pyramid provides a framework for competency-based education that integrates formative assessment and feedback at each stage of student learning. A multi-part assignment that builds from gathering data following a specific protocol (i.e., basic level), moves through interpretation of data (i.e., intermediate level), and then using that data to direct next steps (i.e., advanced level) scaffolds student learning toward clinical practice. Review of past student assignments indicated better performance on intermediate and advanced skills when using a video-based, multicomponent assignment as compared to the original assignment design. Incorporating video components allows simulation of rare clinical populations, while also replicating current telepractice service provision. By simulating patient interactions, the instructor replicates real world challenges, allowing the students to demonstrate in-the-moment problem solving and clinical responsiveness.