Simulation has been considered a valid pedagogy for health professionals in education and actual practice. Its proper execution is vital for proper assimilation of knowledge, skills, and attitudes within the pre-licensure students throughout their curricular journey. High fidelity and multi-patient simulation scenarios were employed for beginner fundamental and advanced senior level nursing students with significant quantitative increases in clinical judgment found between groups using an independent t test and the Lasater Clinical Judgment Rubric (LCJR). The LCJR is based upon the Tanner's clinical judgment model and has been extensively used throughout the world demonstrating solid reliability and validity. Qualitative responses were also compared between groups for each subset within the LCJR. Additional qualitative data was found to support the LCJR qualitative subset findings using post simulation reflection logs. Recommendations for educators and administrators will include the promotion, design,and execution of simulation across the nursing curriculum by well-trained nursing educators. Sincere intention to implement and sustain long lasting program change will be for the benefit of nursing students to help them be better prepared in the area of clinical judgment upon graduation prior to entry to practice. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]