Development of safe nursing practice in entry-level nursing students requires special consideration from nurse educators. The paucity of data supporting high-fidelity patient simulation effectiveness in this population informed the development of a quasi-experimental, quantitative study of the relationship between simulation and student self-confidence and clinical competence. Moreover, the study reports a novel approach to measuring self-confidence and competence of entry-level nursing students. Fifty-three baccalaureate students, enrolled in either a traditional or simulation-enhanced laboratory, participated during their first clinical rotation. Student self-confidence and faculty perception of student clinical competence were measured using selected scale items of the Lasater Clinical Judgment Rubric. The results indicated an overall improvement in self-confidence and competence across the semester, however, simulation did not significantly enhance these caring attributes. The study highlights the need for further examination of teaching strategies developed to promote the transfer of self-confidence and competence from the laboratory to the clinical setting.