BACKGROUND AND OBJECTIVES: Learning procedural skills requires supervised practice with feedback. Observation of performance provides an opportunity for feedback, but the quality of feedback is often poor. We developed an instrument to improve feedback during procedural skills training in residency. METHODS: The Global Procedural Skills Evaluation (GPSE) was drafted based on qualitative date from field notes and literature on procedural skills training. Interview and focus group data described the current state of feedback and guided revisions to the instrument. An iterative process incorporated evidence from education research and input from teachers and learners to optimize the credibility and dependability of the instrument. RESULTS: The final GPSE includes a self-assessment prompt, five criteria (items) assessing performance, a rating scale quantifying the degree of intervention by the teacher, a global assessment, a rating of case difficulty, and suggestions for improvement. Discussion: The GPSE is designed to improve feedback during procedural skills training and encourage learner self-assessment. Its development process may be of interest to those who use or produce performance assessment tools