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The use of simulation in nursing has increased substantially in the last few decades. Most schools of nursing have incorporated simulation into their curriculum but few are using simulation to evaluate clinical competency at the end of a semester or prior to graduation. Using simulation for such high stakes evaluation is somewhat novel to nursing. Educators are now being challenged to move simulation to the next level and use it as a tool for evaluating clinical competency. Can the use of simulation for high-stakes evaluation add to or improve our current evaluation methods? Using patient simulation for evaluation in contrast to a teaching modality has important differences that must be considered. This article discusses the difficulties of evaluating clinical competency, and makes the case for using simulation based assessment as a method of high stakes evaluation. Using simulation for high-stakes evaluation has the potential for significantly impacting nursing education.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors can decrease risk for heart failure in patients with type 2 diabetes and can decrease risk of major cardiovascular events in patients with heart failure (HF)and diabetes. Specifi c SGLT2 inhibitors can also decrease major cardiovascular events in patients with HF only.