At the end of their first year at HiBu, nursing students must take and pass a preclinical exam in order to continue on to second-year clinical studies. The year before simulation was introduced at HiBu, the failure rate was relatively high for this preclinical exam. For the class of 2009, the first to experience simulation, this rate decreased by 6% and for the class of 2010 the rate was reduced by a further 10%. This may indicate that simulation increases the students’ learning outcomes.