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High fidelity simulation within nursing education continues to gain momentum. In sub-Saharan Africa vast amounts of money are invested towards the implementation of simulation to complement nursing education. Since the use of simulation is a fairly new addition to nursing education in developing countries, contextual research is necessary to ensure meaningful implementation in educational programmes. To meet the need for such research, two researchers explored the use of high fidelity simulation in a nursing school at a higher education institution in South Africa. The aim of the article was to discuss the insights gained on what students appreciated most about the high fidelity simulation learning experiences and what aspects should be improved to make the learning experience more meaningful. Qualitative data were gathered by means of focus group interviews, a module evaluation questionnaire and the nominal group technique. The unit of analysis comprised of baccalaureate and post-registration nursing groups. From the data collected two broad categories emerged, namely students' unpreparedness and aspects that students valued in terms of simulation. Unpreparedness was related to emotional, theoretical and technical aspects of simulation. Students appreciated the authenticity and psychological safety of the simulation learning experience. To create meaningful learning experiences for students, it was recommended that a detailed orientation programme be provided. Orientation aspects should include the functions of high fidelity simulators and equipment used during simulation sessions. Students should be allowed to spend as much time as they need to familiarise themselves with the simulation environment. Educators should ensure that students understand the expected outcomes of simulation sessions and provide them with detailed information about simulation events. An agreement, whereby students and educators concur to maintain confidentiality about simulation and debriefing events should be included, since it enhances the psychological safety that students experience. It is important, through feedback, to rectify the mistakes that students make, but this should be done in a respectful manner, allowing students to share their experiences in a safe debriefing environment

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