Simulation-based medical education (SBME) offers opportunities for trainees to learn how to perform procedures and to be assessed in a safe environment. However, SBME research studies often lack robust evidence to support the validity of the interpretation of the results obtained from tools used to assess trainees' skills. The purpose of this paper is to describe how a validity framework can be applied when reporting and interpreting the results of a simulation-based assessment of skills related to performing procedures. The authors discuss various sources of validity evidence because they relate to SBME. A case study is presented.