Simulation has been shown to offer nursing students supplemental learning experiences outside of regular clinical settings. However, these learning experiences are primarily conducted with faculty serving as the patient voice, leading the scenario and prompting nursing actions. As students function within the scenario, psychomotor, cognitive, and affective learning occur within the context of the nurse's role. Little is known about whether student participation as the patient increases the self-efficacy of students' abilities to enhance their understanding of the patient's experience during a deteriorating patient simulation scenario. The purpose of the study is to examine students' self-reported evaluations of simulation sessions. Secondary data from a simulation evaluation tool will be examined with a mixed-method, descriptive, and comparative design to determine if students reported increased self-efficacy following student-led, compared to faculty-led, high-fidelity patient simulation sessions. Findings from this study will help determine the need for more innovative pedagogy to support learning outcomes.