Objectives: To assess the ability of emergency medicine (EM) residents to obtain informed consent (IC) for an invasive procedure using a standardized patient (SP). Methods: This was an observational study in which participants were initially blinded to the objectives of the study. All EM residents from Regions Hospital were invited to participate. Each participant conducted a video-recorded history and physical exam with an SP needing tube thoracostomy due to a 40% spontaneous pneumothorax diagnosed by chest radiograph. Two faculty EM physicians independently reviewed the videos and evaluated the participants’ IC skills in two ways: first, they gave an overall impression of whether or not IC was obtained; second, they evaluated the participants using a 30 point score based on the five elements of IC (decision-making capacity, disclosure, voluntariness, understanding, and physician recommendation). Once all participants completed the case, the true objectives of the study were revealed and participants were given the option to withdraw from the study. Descriptive statistics and kappa coefficient were generated from the data collected. Results: Twenty-two residents completed the study. Twenty residents (91%) obtained IC based on both reviewers’ overall impression. One disagreement occurred between reviewers (kappa=0.64). The mean IC score (range 0-30) was 18.5 +/- 0.5. Conclusions: In a simulated setting, most EM residents at this training program possess the knowledge and skills necessary to obtain IC prior to an invasive procedure.