There is now increased interest in developing con tinuing education and career training progams in quality assurance and utilization review. These pro grams frequently involve on-site practicum experi ences for which the performance appraisal system described here was developed. Incorporating a new evaluation technology known as the rating grid, this system is discussed here in terms of its underlying rationale, its rating factors, and the observation and scoring factors used by the observer-evaluator. The system can be used by observers to give feedback to physicians and others undergoing training in quality assurance and utilization review.