Objectives. To determine the ability of first-year students to self-assess communication skills and measure the impact of video review on students' self-assessment. Design. Students participated in a digital video-recorded, counseling-simulation exercise and completed self-assessment before and after viewing their video. A faculty member evaluated the students using the same counseling assessment tool. Assessment. Correlation between the students' self-assessment scores and the faculty member's scores were poor (pre-video: r 5 0.38, post-video: r 5 0.46). The largest portion of the students overestimated their skills in comparison to the faculty member's evaluations (47.1% pre-video and 67.9% postvideo). Those in the lowest quartile overestimated their skills, while those in the upper quartile underestimated their skills (pre-video). Video review brought about an increase in the self-assessment scores for nearly two-thirds (62.1%) of the students. Conclusion. First-year pharmacy students had difficulty self-assessing, and video review increased their perception of skill achievement. A curriculum should include opportunities for students to develop self-assessment skills early in the program, and this should be reinforced throughout the curriculum.