Introduction: The challenges of transitioning from basic sciences to clerkships are well identified in medical education. High-fidelity simulations, which have established a track record of improving clinical reasoning and clinical skills, have been proposed as a viable approach to bridge the gap between basic sciences and clerkships. However, little is known about the results of using simulation to address the gap. Methods: In 2018, Morehouse School of Medicine enhanced the first-year cardiovascular physiology curriculum by integrating the high-fidelity simulation iStan into the cardiovascular physiology curriculum, with the purpose of early clinical exposure, cardiovascular concept mastery, and increased clinical associations. The integration included three structural design elements: (a) simulated clinical case introduction; (b) simulated clinical case development; and (c) student-led clinical case study. Results: The first-year medical (MD1) students' cardiovascular physiology learning outcomes have significantly improved compared to the last two cohorts of MD1 students, and the students' test-taking time was significantly reduced compared to the performance of the last two counterpart cohorts. Students reported increased engagement in the simulationenhanced cardiovascular physiology curriculum. Conclusion: The findings provide preliminary evidence to suggest that the structural integration of high-fidelity simulation in the cardiovascular physiology curriculum proved successful in terms of students' learning experience and learning outcomes. The three central elements of high-fidelity simulation integration can inform future endeavor as a structural solution to effectively bridge the gaps between basic science concepts and clinical reasoning by using high-fidelity simulations.