Medical simulators provide a controlled environment for training and assessing clinical skills. However, as an assessment platform, it requires the presence of an experienced examiner to provide performance feedback, commonly preformed using a task specific checklist. This makes the assessment process inefficient and expensive. Furthermore, this evaluation method does not provide medical practitioners the opportunity for independent training. Ideally, the process of filling the checklist should be done by a fully-aware objective system, capable of recognizing and monitoring the clinical performance. To this end, we have developed an autonomous and a fully automatic speech-based checklist system, capable of objectively identifying and validating anesthesia residents’ actions in a simulation environment. Based on the analyzed results, our system is capable of recognizing most of the tasks in the checklist: F1 score of 0.77 for all of the tasks, and F1 score of 0.79 for the verbal tasks. Developing an audio-based system will improve the experience of a wide range of simulation platforms. Furthermore, in the future, this approach may be implemented in the operation room and emergency room. This could facilitate the development of automatic assistive technologies for these domains.