Objectives: ACPE standards emphasize developing student ability to accurately self-examine knowledge and skills. This study aimed to determine if students accurately assess motivational interviewing (MI) skills by comparing student 1) perceived baseline competence before and after educational sessions, and 2) self-assessment and faculty evaluation of MI skills. Method: During a secondyear Cardiology module, students reviewed MI concepts previously introduced, practiced skills with a trained facilitator, and completed a videotaped standardized patient encounter. A pre- and retrospective post-test survey (13 items, 6 point Likert-type, agreement) assessed student-perceived ease of performing MI skills. Students and faculty evaluated the videotaped encounter using the modified Motivational Interviewing Treatment Integrity (mMITI) instrument. Students were divided into quartiles based on overall faculty mMITI score. Data was analyzed usingWilcoxon signed-rank test and Spearman’s correlation, as appropriate. Results: Students’ (N532, 100% response rate) retrospective assessment significantly declined on 5 items (showing interest p50.007, reflective listening p50.030, permission to share p50.011, patient control p50.002, and open-ended questions p50.001). Students in the upper quartile rated themselves significantly lower on mMITI total score (p50.024) and the empathy/understanding subscale (p50.026). The lower quartile rated themselves significantly higher on every mMITI measure (Total: p50.012, Empathy/Understanding: American Journal of Pharmaceutical Education 2016; 80 (5) Article S2. 109 p50.033, Spirit and MI Adherence: p50.024) except the open-ended questions subscale. Implications: Pharmacy students may have dif- ficulty self-assessing their MI skills. Students with better skills viewed themselves as less competent than faculty did, whereas students with poorer skills viewed themselves as more MI competent than they actually were. This suggests that self-assessment training should be improved