Introduction The ability to self-assess is essential to the practitioner who often works independently, and reflective practice is entrenched within the paramedic process of care. In order to develop these practices a paramedic student must be able to self-identify mistakes and learn from their errors. However, student assessment has traditionally focused heavily on outcomes, with errors being penalised. Justification for traditional approaches to assessment of paramedic students acknowledges the potentially catastrophic consequences associated with mistakes being repeated in the real world out-of-hospital setting. Responding to the challenge of balancing the reflective practice skills set with ‘real world’ implications of a paramedic’s mistakes, an assessment process was re-designed. The ‘Student-Tutor Consensus Assessment’ (STCA) was created to rebalance assessment weighting from being exclusively outcomes focussed, and encourage students to apply similar critical lens to events as the paramedics who are assessing them. Parallel tutor and student self-assessments are applied to simulated scenarios, with scores awarded to criteria where consensus has been reached between student and tutor judgements. Methods Final year undergraduate Bachelor of Paramedic Science students enrolled in a capstone topic were invited to complete a paper-based questionnaire at the end of their studies. Questions sought student perceptions about the STCA features and effectiveness. Results There was a 95% response rate (n=90). Responses to the six different questions showed a range of 85.6–95.6% broad agreement regarding the value, effectiveness and suitability of the method. Conclusion The pilot STCA approach proved highly successful, with student endorsement for the continued and expanded application of this teaching approach.