The Virtual Birth Centre was created to provide student midwives with an opportunity to develop their midwifery knowledge and skills through a variety of teaching and learning strategies including role-play with peers in a safe, flexible, immersive learning environment. Role-play in the virtual environment has been shown to create a sense of presence or "really being there," which is associated with increased knowledge transfer from virtual to real world. Assessment in this project focused on formative "service user" (peer) feedback along with self-assessment against midwifery professional standards. The approach to assessment was shaped by a number of factors including the philosophical underpinnings and pedagogy of the programmes involved and the opportunities and limitations of the virtual world environment. Using the Virtual Birth Centre and midwifery as a case study, this chapter explores the factors influencing the development of assessments for the practice discipline of midwifery in a simulated, virtual environment.