Some education scholars view student self-esteem as very important to the learning process. However, in relation to clinical supervision, it has also been noted that supervisor overconcern about student self-esteem can lead to avoidance of negative feedback or giving feedback that is too vague to be useful. This article examines the role of self-esteem in relation to assessment and feedback practices in clinical training. A review of educational and clinical literature on self-esteem was undertaken, and suggested that differentiation between self-esteem and self-efficacy provides a more useful framework for supervisors than focus on self-esteem alone. Feedback about specific skills, and developing better coherence between supervisor and student assessment of the student's skills, are important components of clinical training. Suggestions are provided for guiding innovation in supervision and clinical training.