Background: Neurology Residency training in Canada is transitioned to competence based medical education (CBME) in July 2020 and the Royal College Neurology Specialty Committee has identified “providing consultation for and managing patients at outlying centres,” to be an entrustable professional activity (EPA). At Western University, neurology telephone consultations from outlying centres are attended by both the resident and the staff Neurologist. This scenario provides the ideal situation for direct observation and immediate formative feedback. The resident’s performance was assessed using an entrustment scale along with a short narrative portion. Methods: This mixed methods study aims to determine the reliability and validity of the entrustment scale with narrative feedback in assessing the performance on the telephone consultation by senior neurology residents. Informed consent was obtained from residents (9) and staff (7) involved. Scores on the entrustment scale and narrative comments were analyzed. Results: Information on 37 encounters (involving 9 residents) was collected. Assessment results demonstrated higher entrustment scores in PGY4 and PGY5 levels. Overall, ratings were consistent across the 7 consultant assessors. Conclusions: The use of an entrustment scale appears to be reliable and valid in assessing competence in the telephone consultation and provide coaching feedback to help learners improve their performance.