The shortage of clinical sites can be a particular problem for rural nursing programs. One remedy to the shortage of clinical sites is to incorporate simulation into nursing curricula. The purpose of this study was to offer high-fidelity simulation opportunities to students in a rural baccalaureate nursing education program. Students' satisfaction with the simulation experiences and self-confidence levels were measured using the Student Satisfaction and Self-Confidence in Learning tool (NLN, 2018). Scores indicated a high level of satisfaction with the simulations and a high level of self confidence post-simulation. The outcomes support the formal integration of a simulation program into the curriculum of the rural nursing program. Simulation can help overcome barriers to clinical access found in rural nursing programs.