Public health relies on well trained nurses and clinical experience is an important component of that training. However, clinical experience training for student nurses also has significant challenges, as it can place patients at risk. Also it is difficult to schedule/predict patient conditions and procedures. Human patient simulation (HPS) can offer nursing students situational clinical experience in a controlled, consistent, and risk-free environment. HPS consists of student hands-on interactions with a patient substitute (example: mannequin) as well as a debriefing with an instructor. HPS has been widely adopted for nursing training, yet its overall efficacy and component (hands-on interaction and debriefing) contributions to clinical knowledge, critical thinking, self-efficacy, and nursing skills are uncertain. Therefore, the specific aims of this study were to: (1) determine if HPS of a common adult clinical situation (heart failure [HF]) improves HF acute care knowledge of pre-licensure nursing students; (2) determine where in the process of HPS (hands-on interaction with a high-fidelity mannequin or debriefing session) the greatest clinical knowledge is gained; and (3) identify predictors of higher scores on HF clinical knowledge (age, gender, school, critical thinking, self-efficacy, learning style). Using an experimental, randomized design, 1 examined the impact of HPS on 162 prelicensure students from 3 schools of nursing. The instruments used in this study included the Kolb Learning Style Inventory (LSI), the California Critical Thinking Disposition Inventory (CCTDI), the Health Sciences Reasoning Test, Self-Efficacy for Nursing Skills Evaluation Tool, a Heart Failure Clinical Knowledge Questionnaire, a Simulator Skills Checklist, and a Satisfaction Questionnaire. Three different heart failure acute care cases were simulated using the Sim Man manikin by Laerdal. Results will be disseminated in the nursing literature. The results from this study supported knowledge gains from HPS with those gains occurring after the debriefing component. There was no relationship between self- efficacy and those knowledge gains. In addition, the findings suggest students who had higher self-efficacy scores prior to HPS actually scored lower on the knowledge tests. These findings and others are important to nursing science as advancement in simulation technology has exceeded the available evidence that proves its effectiveness. However, the future value of HPS is exciting for educators and clinicians as this method of instruction may revolutionize the way nurses are taught. [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.]