This retrospective study examined the effectiveness of high-fidelity simulation (HFS) in a senior maternity baccalaureate nursing program. The study specifically focused on whether students who received instruction through HFS in addition to traditional hospital-based clinical instruction achieved greater practical learning, critical thinking skills, and NCLEX performance potential. Bandura's theory of self-efficacy guided the study. Simulation students (n = 132) were found to score significantly better than nonsimulation students (n = 147) in each area. Use of HFS may foster the development of competent and clinically prepared nurses.