Since the Liaison Committee on Medical Education formalized a standard for cultural competence in 2000 [1], medical schools have been challenged with how to effectively teach and assess this topic in the undergraduate medical curriculum. In the University of Virginia School of Medicine UME pre-clerkship curriculum, an instructor lectured annually on cultural competence; however, many students considered the topic ‘soft’ by comparison to anatomy, physiology and other biosciences and few attended. The educational effectiveness of the lectures was difficult to determine, given the inadequacy of the multiple choice question format for assessing students on cultural competence with pre-clerkship exams, and the absence of any other form of meaningful assessment.