This study examined the impact of accelerated nursing direct entry master's programs on the development of clinical decision-making skills of new graduate nurses that completed the Performance Based Development System (PBDS) assessment during the study period of 2008-2012 at a healthcare organization. Healthcare today is practiced in a multi-complex environment with yet an overwhelming expectation that nurses do the patient no harm. The ability of nurses to think critically and execute appropriate clinical decision-making skills is more vital than ever. Appropriate clinical decision-making skills are thought to reduce medical errors that may result in patient death. However, with the shortage of nurses in the workforce combined with a steadily growing population of Americans requiring healthcare, programs of nursing have to incorporate creative strategies in curriculum development to produce a large quantity of competent nurses in as short a period as possible. The accelerated nursing direct entry master's program (AE-MSN) was introduced as a way to meet this need. However, there is limited review of the impact of incorporating an accelerated entry level into the nursing profession such as this. Results indicated that new graduate nurses with an AE MSN degree were most likely to have acceptable ability on the clinical decision-making PBDS assessment in comparison to Traditional degrees. While the association between degree and ability did not reach statistical significance, a trend was identified. During 2009, AE MSN and traditional programs experienced an increase from 2008 in acceptable ability on PBDS. In 2011, all degree programs experienced a decline in acceptable ability. Among new graduate nurses with traditional degrees, those with BSNs were more likely to be acceptable on the PBDS assessment than diploma or associate. In contrast, new graduate nurses with a Diploma were the least likely to have acceptable ability. [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.]