A "modified essay examination" was used to help teach and to assess clinical problem-solving skills with 11 first trimester doctoral students. This examination provided a paper-and-pencil simulation of problems encountered in case management. Students were required to generate hypotheses, formulate questions, discuss issues, and make management decisions in a sequential manner. Examination reliability was 0.80 and scores shared significant (p less than 0.01) common variance with instructors' ratings of clinical skills; years of clinical experience; and a pre-admission rating of "clinical potential." The material was a valuable aid in stimulating class discussion, and students had positive opinions concerning the process. A statistical table and an example of the essay examination are included. (Author/SLD)