Weaver, a nursing faculty and doctoral candidate, conducted an integrated review and analyzed studies published since 1998 to April 2008 on the use of high-fidelity patient simulation (HFPS) in nursing undergraduate schools. Initially screening for concepts of knowledge and confidence, the author identified the following recurrent concepts of: values, realism, stress, learner satisfaction and knowledge transfer. The review supported the benefits of HFPS for nursing students related to knowledge, value, realism, and learner satisfaction. Weaver reported mixed results in areas of student confidence, knowledge transfer, and stress. Further research is recommended in these and other areas, which would support the cost and effectiveness of HFPS.