Background: Simulation in a pharmacology nursing class has positive outcomes related to knowledge and confidence in undergraduate nursing education. The purpose of this study is to explore the use of simulation on knowledge, confidence, and competence in a prelicensure graduate pharmacology class. Sample: A convenience sample was comprised of graduate prelicensure nursing students (N ¼ 44) enrolled in a nursing pharmacology course. The sample was divided into an experimental (n ¼ 21) and control (n ¼ 23) group. Method: This was a quasi-experimental comparison group pre/posttest research study. The Medication Administration Competence and Confidence Scale (MACCS) and the Medication Safety Knowledge Assessment (MSKA) were used to measure student confidence, competence, and knowledge prior to and then following three low-fidelity simulation-based experiences (SBE). Results: The experimental group had a statistically significant difference in both self-reported confidence in safe medication administration and pharmacology knowledge. Conclusion: Simulation is an effective teaching method for teaching graduate prelicensure students safe medication administration.