Nursing students, and many practicing nurses, lack self-efficacy and competence in providing quality end-of-life care. Nursing programs are frequently unable to provide opportunities to participate in end-of-life nursing care in the traditional clinical setting, despite evidence that experiential learning enhances student attitudes about death and increases self-efficacy and competency levels. The authors describe a simulated clinical experience using high-fidelity patient simulation in an undergraduate nursing elective to facilitate application of theory content to a clinical end-of-life scenario. Themes identified in participant evaluations, including impact of family presence, value of realism (fidelity), and self-efficacy, are explored.