This article focuses on how video assignments presenting clinical situations can be implemented in digital summative assessment to enhance the integration of practical and conceptual knowledge. The underlying perspective is that sustainable assessment should comprise evaluative practices that equip students for the challenges they will face in their future professional lives. Drawing on the literature and on empirical results of a qualitative longitudinal research study at a Norwegian university, the integrative potential and challenges of video assignments are examined. The study confirms that video-based assignments are well suited for assessing integrated competencies. However, the complexities of videos' visual displays have clear consequences that indicate how these resources should be produced. To optimise the potential of video use in enhancing sustainable summative assessment, we must strike a balance between technical accommodation, task clarity and integrative potential.