The Air Force Nurse Transition Program (NTP) prepares new graduates for their role as a military nurse through an 11-week didactic and clinical program. The purpose of this study was to examine student performance outcomes for a 15 year old program utilizing high-fidelity human patient simulation (HPS). In addition, the study examined the reliability of a new instrument for evaluating student performance during an HPS scenario. The sample consisted of 181 new Air Force nurses who completed the NTP program at 10 global Air Force training sites. Using a multi-site, pre-test/post-test design, NTP students took part in two HPS scenarios reflecting content of the program (anaphylaxis; bomb blast) prior to training, as well as at completion of the program. Evaluation of student performance during these HPS scenarios was conducted by two experienced nurses using the researcher-developed Simulation Evaluation Instrument. Results indicate an increase in performance scores after the program and a Cohenís Overall Kappa for interrater reliability of 0.78 for the performance instrument. This study will add to knowledge of the NTP Program and psychometric properties of a new simulation performance instrument. Results provide perioperative nurses with evidence for use of HPS for clinical training, competency development, and evaluation.