Hi John: Simulation testing is very common in many health realted fields of study. It has shown to be an effective method of learning and reinforcing the teaching concepts expected of students. Pros include involvement, hands on, practical application, better retention. Cons include more time to prepare simulation set-up, possible dominance by stronger students, and difficulty arriving at an objective grading strategy for this type of assessment. All said, I would encourage you to continue exploring this helpful addition to assessing knowledge gained from your instruction. Regards, Barry