Aims: This assessment scenario measured senior nursing student ability to assess, evaluate and recognize the development of an emergent patient condition. Background: In a traditional paper/pencil test, nursing students had difficulty recognizing the signs and symptoms of a pulmonary embolism early in the spring semester 2009. The lead instructor wanted to evaluate whether students would act and independently administer appropriate care in the simulation lab setting when given the same signs and symptoms. Method: Using the Blackboard platform, a patient chart was prepared for students. This chart was made available to the student one hour prior to the simulation. The simulation was a hybrid product of an NLN developed scenario and the instructor's objectives. Twenty minute sessions were allotted for each of the 27 students. The instructor did not participate in the simulation, but debriefed each student individually afterwards. Students took a computer post test and turned in written paperwork following the debriefing. Results: Of the 27 students assessed, four did not meet the instructors established criteria for standard of care. An unexpected finding from this simulation indicated that students at this level could not prioritize care from written orders. The post-test score mean was 21 out of 25. Conclusions: Student feedback indicated this was an opportunity for self-evaluation. Students who did poorly recognized their own errors without prompting during the debriefing. The implication for practice is that students should be given more opportunity to prioritize care in the clinical setting without instructor or preceptor prompting.