The utility of tabletop exercises as tools to identify areas for improvement and make improvements on these problems is still evolving. Our ability to evaluate exercise performance is hampered by the lack of an evidence base about what constitutes optimal performance and by the lack of standards for assessing public health preparedness. There is a need to move beyond qualitative performance measures to ones that are quantifiable and can be measured over time. These quantifiable measures can range from simple checklists to Likert rating scales to scorecards. For example, in a series of our exercises we used checklists to assess the performance of health departments related to surveillance, risk communication and other functions.