The study was conducted using junior students in their first medical/surgical class. Students worked in groups of four with two students being observers and two students being nursing personnel. The scenario involved an elderly patient with a respiratory disorder who was going into respiratory distress. The exercise was completed both when the students gave the appropriate medications and completed appropriate interventions or when twenty minutes had elapsed. Immediately after participation in the scenario students completed the instruments used in the study. The two instruments used by Smith and Roehrs (2009) were developed by the National League of Nursing (NLN). The instruments were the Student Satisfaction and Self Confidence in Learning Scale and the Simulation and Design Scale. Both scales are self-report, five point Likert scales. The data was tabulated using descriptive statistical analysis, and additional correlational studies were completed using Spearman’s rho and multiple linear regression.