Initially, interview data will be obtained from registered nurses form St Agnes HealthCare and Baltimore Washington Medical Center to inform the development of two high-alert medication administration (HAM) simulation scenarios, one for education, and one for evaluation of safety performance. After development and cognitive pretesting of the simulation scenarios by RNs, nursing students will receive both HAM simulation scenarios. Students will complete two instruments, one on the quality of the simulation design and one on the quality of the simulation debriefing. Focus groups will be conducted to assess nursing student perceptions of the learning scenarios along with the specific design elements, qualitatively. The findings of the focus group will inform revisions to the simulation scenarios. We will evaluate the potential for implementing the nursing simulations for medication administration at Howard Community College analyzing feasibility factors such as student participation, and of resources (technological and personnel).