As more schools of nursing begin and/or continue to implement the use of human patient simulation, an objective evaluation tool needs to be used to measure nursing students' clinical judgment competency level. Assessment of nursing students' competency level is important because it identifies the students' strengths and weaknesses. This allows nurse educators to remediate content areas to make sure the student is clinically competent upon program completion and successful on the NCLEX-RN exam. The purpose of this study was to compare the accuracy of students' self-assessment of clinical judgment skills with faculty assessment of students' clinical judgment skills upon completion of a high-fidelity simulation experience. This study also compared the relationship between students' self-assessment and faculty assessment of clinical judgment competency levels during HPS and students' scores on a customized HESI nursing exam. Furthermore, the researcher investigated how high-fidelity simulation influences baccalaureate nursing student's clinical judgment competency level. The researcher collected quantitative data using a pretest/post-test experimental design. Participants included students in the third semester of upper division in a baccalaureate nursing program. The findings indicated that there was a slightly significant positive correlation between the faculty's assessment of students' clinical judgment skills score and the students' self-assessment of clinical judgment skills score. Secondly, there was a significant positive correlation between the faculty's assessment of students' clinical judgment skills score and students' HESI scores (post intervention). Thirdly, there was no correlation between students' self-assessment score and HESI score (post-intervention). Lastly, the data revealed that the experimental group scored significantly higher than the control group on the HESI exam (post-intervention). The results of this study indicate that students who undergo a cardiovascular HPS clinical experience perform significantly better on a customized cardiovascular parallel HESI exam than those students who do not receive a HPS experience.