High Fidelity Simulation is a teaching strategy that is becoming well-entrenched in the world of nursing education and is rapidly expanding due to the challenges and demands of the health care environment. The problem addressed in this study is the conflicting research results regarding the effectiveness of HFS for students' knowledge acquisition after participating in simulation exercises. Specifically this researcher determined the effects of a formatted simulation scenario on knowledge acquisition among nursing students and the students' satisfaction and self-confidence with the simulation learning activity. Kolb's Experiential Learning Theory (1984) provided the framework for this study. This study used a quantitative quasi-experimental design, specifically, the Solomon Four Research Design with 43 first semester senior nursing students enrolled at a baccalaureate nursing program at a state university in the southeastern United States. The results of the study found that there was not a statistically significant difference between the experimental group (E1) who received HFS (z = -1.47, p = 0.143) in cognitive gains when compared to the students who did not receive the intervention of HFS (C1) (z = -1.78, p = 0.75). The students' overall perception of HFS was very positive and the simulation activity increased their self-reported level of self-confidence. The results of this study imply that simulation should not be used with the exclusive goal to increase knowledge but rather for students to increase their confidence and to demonstrate their ability to care for a patient at the bedside. It is our duty as nurse educators to systematically evaluate new teaching efforts such as simulation to determine the effectiveness of this remarkable but expensive technology to ensure that we are providing the best learning opportunities possible for our nursing students. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]