Learners, teachers, and programs need to be evaluated. This article reviews the purpose and the current methods for evaluating all 3. Clinical impressions of the learner are yielding increasingly to direct observation and skill assessment. The Reporter, Interpreter, Manager, and Educator (RIME) method offers a unique way of assessing and providing formative feedback to the learner. Learning portfolios help document achievements and provide a collection for self-assessment and growth. Teachers benefit from feedback especially if followed up with consultation. Programs need both quantitative and qualitative data to document performance. National data gathered locally from exit surveys now exist that facilitate comparison of programs (eg, clerkships) within and across institutions. The emphasis on institutional accountability makes it critical to directly evaluate learners and their educational programs. © 2005 Elsevier Inc. All rights reserved.