Emergency medicine residents at William Beaumont Hospital are evaluated quarterly by the nursing staff. The nurse discuss each resident and reach consensus on each evaluation item. Copies of the evaluations are given to each resident, and a copy is used at the resident's biannual evaluation meeting with the program director. Between September 1985 and December 1987, 45 residents in all three years of training were evaluated by the nursing staff on four aspects of performance: managerial skills, communication, teamwork, and clinical organization. The nurses were able to evaluate behavior not usually seen by supervising physicians. Although the residents' attitudes toward these evaluations have not been entirely favorable, overall their behavioral interactions have improved markedly.