Context: Athletic therapy students learn emergency skills through a variety of modes, including students portraying injured athletes and cardiopulmonary resuscitation manikins. Although acceptable and satisfactory forms of teaching, these methods are limited in their ability to create realistic physiological symptoms of injury. Objective: To assess how athletic therapy students perceive their learning needs (LNs) relative to the use of high-fidelity manikin simulation (HFMS) compared with student simulation (SS) in the laboratory setting. Design: Pretest-posttest study design. Setting: Nursing Simulation Centre, Sheridan College, Brampton, Ontario, Canada. Patients or Other Participants: Thirty students from the Bachelor of Applied Health Science (Athletic Therapy) program at Sheridan College in years 2 and 4. Intervention(s): Perceived LNs related to the use of the Laerdal Medical SimMan3G HFMS contrasted with the use of SS for learning to respond to a prescribed emergency scenario. Main Outcome Measure(s): Participants completed questionnaires for both the SS and HFMS environments that consisted of 16 specific LNs spanning the cognitive, psychomotor, and affective domains of learning. Paired t tests and a 2-way analysis of variance were used to analyze the questionnaire data. Results: Participants reported all LNs as being equally important in both environments, but HFMS was identified as a better environment for achieving 13 of the 16 LNs. The mean change from pretesting to posttesting of all LNs in the affective domain improved significantly (P < 0.05) in the HFMS environment. Year 4 participants deemed HFMS to be a more effective means of learning in the cognitive and psychomotor domains (P < 0.05). Conclusions: The HFMS experience enhanced athletic therapy students' perceptions of their confidence, base of knowledge, decision-making skills, and overall acute management of critical lifesaving situations. The HMFS environment is a more effective tool for addressing the LNs in the affective domain, which includes skills related to confidence, attitudes, values, and appreciations.