Introduction: Today’s healthcare is complex and the need for quick decisions and care can be crucial for the patient’s well-being. For the students, it is essential to develop clinical competence during their nursing education. Aim: The aim of the study was to explore how an individual written academic reflection as an examination after high-fidelity simulation can support student nurses’ learning experiences of clinical competence when a developed questionnaire was used to stimulate in-depth reflection. Method: After the intervention of using an academic reflection as an examination after high-fidelity simulation during the fourth semester of the nursing programme, 107 individually written academic reflections were collected from students during 2017-18. A questionnaire with seven open-ended questions was developed to stimulate the reflection of students’ learning experiences of clinical competence. Based on Kolb’s experiential learning cycle, a deductive content analysis was used with focus on the students’ learning experiences. Results: The students expressed that the performed simulated scenario in connection with the individual written academic reflection made them aware of the strengths and weaknesses in their ability to clinical reasoning and patient safety. Furthermore, the importance of communications skills emerged. The students highlighted the use of the closed loop structure for communication in the team, and the necessity to involve the patient more in clinical situations. During the simulation scenarios, the students appreciated in having the opportunity to be an observer for developing knowledge concerning clinical competence. Conclusion: By implementing an examination that provides an opportunity for time for an in depth-reflection, creates effectively professional development. The academic reflection as an examination appears to be a good learning experience such as the clinical competence became visible for the students. Integrating reflective writing continuously during the nursing education can contribute progression of students’ skills to write an academic reflection. Copyright © 2020 by authors and Scientific Research Publishing Inc.