Objectives: Resident physicians report insufficient experience caring for patients with substance use disorders (SUDs). Resident training in Screening, Brief Intervention, and Referral to Treatment (SBIRT) has been recommended. We describe the development of a standardized patient (SP) assessment to measure SBIRT skills, resident perceptions of the exercise, and confidence in SBIRT skills. Methods: Fifteen Internal Medicine residents participated in the pre-curriculum SP assessment and 12 participated in the post-curriculum assessment. Results: Residents reported that SP encounters were similar to patients seen, and resident satisfaction was high. Residents felt confident screening for alcohol abuse, but less confident developing SUD treatment plans. Conclusion: An SP assessment can evaluate SBIRT skills and is well received. Residents may need additional practice to improve confidence in making SUD treatment plans. (Contains 5 tables.)