The problem use of alcohol causes over 100,000 deaths in the United States per year and has substantial negative impact on family structure, the economy and the criminal justice system. Screening and early treatment of individuals with problem use of alcohol by health professionals can significantly reduce mortality and morbidity. Students from all health and human service disciplines should have basic clinical training on the integration of substance use screening and assessment questions into routine encounters with patients/clients. The OSCE is a well-researched, experiential methodology most widely used in medical and nursing education as a tool for evaluating the demonstration of clinical competencies by students. The OSCE is ideally suited to skills-based educational goals and allows learners to practice and refine their clinical technique. Proponents of performance or skills-based assessment argue that current examination formats focus too heavily on the student "knowing how" instead of "showing how", and that skills-based assessments like the OSCE do not replace traditional knowledge based tests, but they do provide direct evidence of competence that knowledge-based tests cannot.