As educators in the Masters of Medicine (critical care) program, our students are busy working medical practitioners taking mostly online courses. Practical based assessments are common in our working environment and very important to show applied understanding. The pandemic, our students increased shift work, and our passion for innovative online education encouraged us to design and use practical based asynchronous online assessments for our courses. We highlight various modalities we have used including Pecha Kuchas, uploaded video and audio assessments. We discuss some of the common pitfalls, marking issues and how we intend to incorporate VR and AI in the future.