High-fidelity simulation (HFS) is considered as a standard training in high-risk industries to provide an avenue for safe and deliberate practice. Health care professionals have been using low-fidelity simulation in education for many years to teach physical assessment and psychomotor skills. However, it is only in recent years that advanced practice nursing educators have begun to use HFS in an integrated approach to teaching cognitive skills with technical skills to augment clinical experience. The purpose of this manuscript is to describe the creation of an HFS learning experience to augment the advanced practice education of both primary care and acute care pediatric nurse practitioner students. The curricular innovations designed to foster competence using evidence-based guidelines and interventions within a simulation learning center are described. The critical role of debriefing and guided reflection is delineated. Implications for practice and significance for nursing education and practice are discussed.