Nursing education requires a three-dimensional view of knowledge, which consists of scientific, practical and ethical knowledge [26]. Nursing students learn practical skills through both theoretical and practical instruction and skill training. Ethical reflection over clinical situations is also of great importance, because caring for human beings is not value neutral [27]. During preclinical skill training, students must work with all three knowledge domains. Kiat et al [12] conclude in their study that simulation is an enjoyable way to learn while at the same time theory and practice are combined, but that it requires that learning tools are used properly. The students in our study also indicated that the simulation was instructive and that they were able to test their skills more than normally. They also reported that they were aware of what they did in a different way. This corresponds to the results seen in a study by Baxter et al [28]. In a study by Wotton et al [25], third-year nursing students practiced simulation with an advanced manikin, a SimMan 3G. The results from this study showed that over 90% of students were satisfied with working with the high-fidelity simulation manikin and the various scenarios that this manikin provided. In Kiat et al [12], who evaluated second-year nursing students, simulation was found to be a good learning method. It was also seen that self-confidence increased when students were able to make mistakes without harming an actual patient. The students in our study indicated that they learn from their mistakes.