Aim and objective. To explore undergraduate nursing students’ experiences of High Fidelity Patient Silicone Simulation. Background. Use of simulation as an educational tool is rapidly gaining popularity. Simulation provides a safe learning environment and helps overcome difficulties securing sufficient clinical placements. However, several limitations have been identified with this approach, particularly in relation to cost and authenticity. Design. Exploratory qualitative methodology informed the development of knowledge in this under-researched area. Methods. Focus group interviews were conducted with 21 nursing students and first year graduates. Participants had experienced High Fidelity Patient Silicone Simulation during the program. This involved their lecturer simulating a patient by adopting mannerisms and behaviours of a person, based on a predeveloped character and using masks and appropriate clothing to establish the visual image of a simulated patient. Thematic analysis was undertaken to identify main areas of interest to participants. Results. Two main themes are reported in this paper: ‘realism of the character’ and ‘skills of the teacher’. Characters presented to students were viewed as realistic which enabled participants to engage with the character and take the process seriously. Knowledge and skill of the teacher was used to direct student learning experience and maximise learning benefits to be gained. Conclusion. High Fidelity Patient Silicone Simulation was perceived by student participants as a highly effective teaching tool. Participants found the experience positive and believe it impacted on the quality of learning experiences. Relevance to clinical practice. Clinical experience is necessary for the development of safe and competent registered nurses. Simulation has been acknowledged as a useful adjunct to clinical experience, particularly when placements are limited. High Fidelity Patient Silicone Simulation may be used to promote realism, enhance student learning and contribute to an increase in clinical competence and confidence in nursing students.