1977; Megel etal., 2012; Omar, 2016). Several studies indicated that the self-confidence and the clinical skills of the undergraduate nursing is improved after participating in high-fidelity simulations (Leigh, 2008; Kuznar, 2007; Lasater, 2007; Reilly & Spratt, 2007; Bearnson & Wiker, 2005). A descriptive study carried out by Khalaila (2013) explored the effectiveness of simulations in reducing anxiety and promoting selfconfidence, caring ability, and satisfaction with simulation of a 61 second-year nursing students at their first clinical practice. Data were collected at 2 time points T1 before the first clinical and simulations practice, and T2 four months later. The result implied that the student’s anxiety scores decreased after participating in the study. Another study done by Megel etal. (2012) further supported that HFS could reduce the pediatric nursing students anxiety and increase their confidence before going to the clinical areas and doing their hospitalized child assessment for the first time. This study employed a quasi- mixed methods research design using a sample of accelerated and traditional BSN pediatric nursing student. Three survey instruments including self-confidence, and satisfaction with the learning and State anxiety (STAI). The results indicated that anxiety scores were significantly lower in the intervention group. Jefferies & Rizzolo (2006) conducted a multi-site, multi-methods study. The objectives of the research were to examine design and implement simulation as a teaching modality and also to assess the learning outcomes using simulation. The participants were 403 baccalaureate and associate degree nursing students. The data were collected using several questionnaires such as Simulation Design Scale (SDS), Self-Confidence in Learning, Self-Perceived Judgment Performance Scale and the Educational Practices in Simulation Scale (EPSS). Results showed that the students who used high-fidelity patient simulator had a better sense of reality and more opportunities to problem solve and make decisions than did the paper/pencil case study simulation. The researchers concluded that involvement of the students in simulation provided them with an opportunity to apply knowledge in a safe non-threatening environment. Another study by MacDowall (2006) examined the perceived confidence of 23 medical students regarding their comptences in some psychomotor nursing skills using simulationmedical students’ perceived confidence regarding their competence in a variety of psychomotor skills using HPS. The results indicated significant increase in the student’s confidence level after participated in simulation experience. McLaughlin, Moutray, & Muldoon, (2008) recruited 96 senior Bachelor of Science in nursing (BSN) students enrolled in the pediatric nursing course to participate in their study. Students participated in the clinical scenario as a part of their clinical time. The student completed the socio-demographic, knowledge survey, self confidence in nursing survey pretest Lambton, O’Neill, Dudum (2008) enrolled 60 baccalaureate nursing in their study. Three open-ended questions were asked. A 10-question evaluation form using a 4-point scale was given to the students, along with Journal of Education and Practice www.iiste.org ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.8, No.11, 2017 97 an opportunity to reflect on their experience in journals. The authors reported high means in the domains of skill acquisition, communication techniques, and overall confidence in the ability to perform in a similar clinical challenge. Students who participate in simulated experience conveys their satisfaction with simulated clinical experience. Omar (2016) conducted a descriptive study to explore the satisfaction and self-confidence of a 117 bachelor of science in nursing (BSN) students after clinical simulation experience using a self-reported questionnaire. Results indicated an increase in overall satisfaction and confidence scores after clinical simulation experience. Cantrell, Meakim, & Cash, 2008 was also conducted a study to evaluate the learning experience of three pediatric simulations. Students found the simulations well designed and realistic. Student’s satisfaction and self-confidence in learning scores were high. These results indicate that students in the pediatric courses valued well designed simulation learning experiences. Little literature has been published to date on the use of simulation-based learning in pediatric nursing in Saudi Arabia. There are several initiatives intended for improving the quality of health services and the quality of nursing education in the country of Saudi Arabia, such as establishment of quality assurance and implementation of internationally recognized accreditation standards. The question arises about if baccalaureate nursing programs are preparing nurses for the new health care perspectives. The aim of this study was to evaluate the effect of using a simulation based scenarios on the pediatric nursing students’ students’ knowledge, self-efficacy, satisfaction, and confidence. This study used Bandura’s Social Cognitive Learning Theory (1977) as a theoretical framework. Methods Study design: A descriptive one group pre-test/post-test design was employed to answer the following research questions 1. What are the difference in the pediatric student’s self-efficacy