Competencies for nurse practitioner students have been published with the goal of preparing graduates who are ready to meet the challenges of an increasingly complex health care system. Standardized preclinical assessment of graduate-level competencies have been suggested as a means to optimize the student experience in clinical rotations and maximize the preceptor's time toward preparing students for the transition to independent practice. The main objectives of this study are to describe progressive assessment and competency evaluation as an integral framework for integration of simulation in graduate-level curriculum and present the feasibility and challenges to consider during implementation of Progressive Assessment and Competency Evaluation‒directed simulations.