Determining the quality of student learning is an ongoing challenge to all educators. However, for educators and students in the health professions, evaluation of learning takes on a different dimension in terms of ensuring that graduates are competent, and thus safe, practitioners. This paper outlines the processes and methods by which student learning has been evaluated throughout a 22-year period at a large school of nursing in a Australian university. First, a historical overview of the major methods used demonstrates how relevant educational theories and sociopolitical forces and movements have influenced the whole curriculum including evaluation methods. Second, examples of current evaluation methods for undergraduate clinical and theoretical units are described. Reflections about past successes and future challenges conclude the paper.