The objective of this study was to investigate student nurses' ability to handle a pain assessment situation. A systematic way of working based on knowledge within the area is emphasised in nursing education today. The performance of 32 student nurses at a university college in Sweden took place in an arranged assessment situation that closely simulated clinical practice. The conversation between the student and the patient (a voluntary patient) was videotaped and analysed with content analysis according to predetermined components of pain assessment. The results showed that one-third of the students had performed adequately based on the requirements for pain assessment in the curriculum for nursing education. Two-thirds of the group did not handle the situation systematically and also showed a lack of knowledge of pain assessment, and among these was a group of students whose performance was inadequate. The results indicate that during their education it is very important for student nurses to obtain experience and guidance in how to work systematically and to have their knowledge and skills in pain assessment evaluated. © 2003 Elsevier Science Ltd. All rights reserved.