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There is growing evidence that simulation testing is appropriate for assessing nursing competence. We compiled evidence on the validity and reliability of the Nursing Performance Profile (NPP) method for assessing competence.Participants (N = 67) each completed 3 high-fidelity simulation tests; raters (N = 31) scored the videotaped tests using a 41-item competency rating instrument.The test identified areas of practice breakdown and distinguished among subgroups differing in age, education, and simulation experience. Supervisor assessments were positively correlated, r = .31. Self-assessments were uncorrelated, r = .07. Inter-rater agreement ranged from 93% to 100%. Test-retest reliability ranged from r = .57 to .69.The NPP can be used to assess competence and make decisions supporting public safety.