In December, 2005, the Air Force Auditing Agency conducted an interview of 282 nurses and physicians stationed in Iraq. The majority of the nurses from the interview reported they were not prepared to care for critically injured soldiers. This study investigated whether a new training technology, using scenario-based simulations, could improve nurses' performance. Based on those interviews, this quantitative quasi-experimental research study investigated the effect the training programs, using scenario-based simulation (independent variable), executed on a high-fidelity patient simulator, had on clinical performance of nurses (dependent variable). A nonparametric Wilcoxon test and parametric tests, specifically a t-test and ANCOVA, were used to compare the pre and post scenario-based simulation raw test scores. Kirkpatrick's four levels of evaluation and Benner's Dreyfus model of skill acquisition were the theoretical foundations for this study. Randomly selected data was collected on 80 active duty nurses who trained at one of two locations. Findings revealed a significant improvement in the performance of nurses when scenario-based simulation was integrated into their training curriculum. Data from this study demonstrates the ability to train and evaluate performance in a reproducible fashion. This information provides a pathway for social change starting within the Air Force, by driving the development of a comprehensive and standardized trauma training program. This program will foster opportunities for cross-disciplinary collaboration with military and civilian nurse training programs as a means of better preparing all nurses to care for critically injured patients. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]