The purpose of this quantitative pretest posttest quasi-experimental research study was to explore the effect of the NESD on clinical judgment in associate degree nursing students and compare the differences between groups when the Nursing Education Simulation Design (NESD) guided simulation in order to identify educational strategies promoting clinical judgment. The development of clinical judgment in nurses is crucial to the provision of safe care, yet opportunities for clinical experiences can be diminished due to competition for clinical sites. Exposure to simulated clinical scenarios can provide an opportunity for students to practice nursing skills in a safe learning environment without the fear of harming a patient, but there is limited evidence of quantitative educational methods that promote clinical judgment. Quantitative data were collected using the Lasater Clinical Judgment Rubric (LCJR), the educational practices scale, and the Simulation Design Scale. The Statistical Package for Social Sciences (Version 21) was used to analyze descriptive statistics and t tests to determine the effect of simulation on the clinical judgment. The results indicated that the total mean score improved in both groups, but significant differences (p < 0.05) were found in five of the eleven LCJR subscale scores for only the intervention group and the null hypothesis was rejected. Recommendations include exploring measures to increase clinical judgment in the interpreting and reflecting categories of the LCJR, utilizing a more formalized structure for debriefing, and continuing to use tools to quantitatively measure clinical judgment. [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.]