The purpose of this study was to explore the relationship between computer-based clinical simulation performance and two commonly used methods of evaluation: cognitive examination and self-evaluation of expertise. The convenience sample of 68 critical care nurses completed the Basic Knowledge Assessment Tool for Critical Care (BKAT), a cardiovascular self-assessment tool [CST], and two computer-based clinical simulations requiring the management of myocardial infarction patients with tachydysrhythmias (atrial flutter and ventricular tachycardia). Simulation performance was measured by proficiency score and patient outcome (live/die). Proficiency on the atrial simulation was significantly correlated with knowledge as measured by the BKAT [r=0.4B, p 0.001) and with self-evaluation of clinical expertise [r=0.32, p=0.008). Atrial patient outcome was also significantly correlated with the BKAT [r=0.28, p=0.006) and the CST score (r=0.22, p=0.036). However, in the ventricular simulation only proficiency score and self-evaluation of expertise were significantly correlated [r=0.24, p=0.049). The modest relationships found in this study may indicate that, while clinical simulation performance is related to knowledge and self-evaluation of expertise, the constructs measured are not synonymous. This evidence provides support for the use of clinical simulations as an adjunct to other methods of evaluation.