From single simulation events to programmatic assessment: Reframing competency-based assessment in nursing simulation

Background Simulation is increasingly used to evaluate competence in nursing education, yet current assessment practices often rely on isolated events and checklist-based rubrics that limit defensible judgments about readiness for practice. Purpose This discussion paper argues that simulation-based assessment must be reframed as a programmatic, inferential process grounded in the Assessment Triangle and operationalized across developmental frameworks such as Miller's Pyramid. Discussion Competence requires longitudinal patterns of evidence across time, contexts, and encounters, with inferences informed by holistic expert readiness judgments and supervisory entrustment scales aligned with competency-based education goals. Positioning simulations as structured sources of scaffolded longitudinal evidence rather than discrete evaluative events, alongside operational drivers such as faculty alignment and competency mapping, provides a stronger basis for interpreting learner progression. Conclusion A programmatic approach to simulation-based assessment can strengthen progression decisions and support more defensible claims of practice readiness.