Nursing education faces many challenges such as faculty shortages, inadequate clinical site placements, the inability to accept qualified students because of limited resources, and how to effectively educate students who are tech savvy, confident, highly motivated yet have differing needs from previous generations. This study sought to explore how nurse educators can engage students when traditional teaching methods such as lecture may not work. The use of simulation, a method where students perform nursing skills on interactive mannequins, may provide significant insights into this issue. Yet there is limited research on this relatively new method. This study evaluates two distinct groups of students in the clinical environment and outcomes produced from two different methods of learning based on skill performance, competency, and confidence perception. A total of 56 senior level nursing students, 23 traditional group and 33 simulated guided, were evaluated. Quantitative and qualitative data collection included surveys ("NLN Student Satisfaction and Self-Confidence in Learning"), questionnaires, and a researcher developed measurement tool. Data was analyzed using SPSS v.19 statistical software. Findings indicate that although there were small differences seen between the groups, the use of simulation as a method of teaching along with traditional practices are beneficial in taking a learner centered approach in educating today's nursing student. [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.]