The primary objective of this study was to compare students’ self-assessment ratings with simulated patient (SP) assessment ratings of communication skills in a patient counseling Objective Structured Clinical Exam (OSCE). The secondary objective was to evaluate student perceptions of the importance of communication skills in the practice of pharmacy as well as the impact of a virtual OSCE format. First-year pharmacy students completed an OSCE focused on self-care product counseling. The evaluation was graded using a rubric covering both verbal and non-verbal communication. Students who completed the course were provided a 15-question, post-evaluation survey with questions related to self-assessment of communication skills and perceptions of the importance of communication skills. Of the 138 students in the course, 68 completed the optional post-assessment survey (49% response rate). There were no statistically significant differences between the ratings by students and SPs for the four communication elements included in the self-assessment. Most of the students recognized the importance of communication skills, including developing rapport and trust. Recognition of the importance of communication skills to future practice as a pharmacist positively correlated with performance on the evaluation (r2 = 0.5409, p-value = 0.0007). Student self-assessment is an effective and cost-effective mode of feedback for practice experiences as an alternative to the use of SPs.