We tested whether a computerized dental simulator (CDS) pre-test could predict preclinical operative dentistry examination scores. Thirty-eight first-year students completed cavity preparations during a single four-hour CDS pre-test prior to the operative dentistry course and during subsequent practical examinations. Masked, calibrated faculty members scored the preparations in both settings. Pass rates for the CDS pre-test, Exam 1, and Exam 2 were 50 percent, 66 percent, and 86 percent, respectively. Students who passed the CDS pre-test were more likely to pass Exam 1 (95 percent vs. 37 percent, p=0.0004) but not Exam 2 (89 percent vs. 83 percent, p=0.66) and had better mean scores on Exam 1 (73.4 vs. 68.3, p<0.0001), but not Exam 2 (76.2 vs. 74.7, p=0.35). As a diagnostic, success on the CDS pre-test predicted success on Exam 1 with 72 percent sensitivity and 92 percent specificity (positive predictive value 95 percent, negative predictive value 63 percent). As a diagnostic for Exam 2 performance, the CDS pre-test was a weaker predictor and not statistically significant. These findings suggest that a pre-course CDS test may help to identify students in need of early instructional intervention. Future studies are warranted to further define and implement the use of simulation technology in the assessment of students' psychomotor learning potential.