Background: Student test scores in the pediatric portion were at a national percentile rank of 30, which was concerning. It was theorized that the main contributor to this dilemma was that the majority of students were not able to have a pediatric clinical experience. Objective: The purpose of this project was to determine if the addition of pediatric simulation scenarios would have an impact on student learning as evidenced by end of level test scores. Method: A convenience sample (n = 100) of first year nursing students attending a university in the western United States participated in this project. This was a mixed methods study. A quasi-experimental design was used to compare test scores of both a non-intervention group and an intervention group of students. A 5 point Likert scale questionnaire was also using post-intervention to assess for changes in perceptions of self-confidence. Results: After implementation of the pediatric focused scenarios, students' test scores increased to the 95th percentile. This 65 percentile increase is a significant change that suggests that pediatric simulation is effective in improving student exam performance. In addition, 81% of students also reported perceptions of increased levels of self-confidence after implementation of simulation scenarios. Conclusion: The findings suggest that simulation is an effective way to create alternative pediatric clinical experiences which can, in turn, increase student comprehension, test scores, and self-confidence.