Context: Patient encounters related to acute care skills rarely occur in clinical education, leaving a potential gap in students' skills and confidence. Objective: Investigate the effects of an acute care simulation requiring football helmet facemask removal on clinical skill application and confidence in athletic training students. Design: Cross-sectional. Patients or Other Participants: Forty-four students (16 male, 28 female; age = 20.9 ± 1.12 years) enrolled in 2 accredited professional athletic training programs. Intervention(s): Participants completed a confidence assessment survey and were pretested on football helmet facemask removal skills. Pairs of participants engaged in a simulation where they evaluated and managed a football player who required facemask removal, followed by a debriefing session. Participants repeated the confidence assessment survey and were posttested to evaluate skills. Main Outcome Measure(s): Dependent variables were clinical skills scores and confidence, as measured by a confidence assessment survey. Simulation served as the independent variable. Paired samples "t" test determined changes in clinical skills scores. Wilcoxson Signed-Rank Test determined changes in confidence. Results: Paired samples t test revealed a significant increase in performance on the posttest, including: primary survey (t[subscript 43] = 4.13, P < 0.001), facemask removal (t[subscript 43] = 4.00, P < 0.001), vital signs assessment (t[subscript 43] = 5.57, P < 0.001), and secondary survey (t[superscript 43] = 8.85, P < 0.001). Wilcoxon Signed-Rank Test revealed increased confidence in participants' recognition of (Z = 4.96, n = 44, P < 0.001), knowledge of (Z = 5.03, n = 44, P < 0.001), and skills (Z = 4.78, n = 43, P < 0.001) needed for football helmet facemask removal. Conclusions: With the inability to ensure students have authentic, real-time evaluation of acute care skills during clinical experiences, a simulation can assist in acquisition of skills, while also improving confidence in managing acute care conditions.