The purpose of this qualitative interview study was to examine the current pedagogical use of high-fidelity patient simulation (HFPS) by nursing and simulation faculty in the northeastern part of the United States, as reported by those faculty members. The National League of Nursing/Jeffries Theory (Jeffries, 2021) was the conceptual framework for this study. Findings in this study evidenced that the educational and professional background of faculty influenced their use of HFPS as a pedagogical tool. However, findings from this study did not determine if demographic factors of faculty influenced their use of HFPS. Course objectives were used by faculty to develop simulation objectives and subsequently directed the curricular content covered in the HFPS scenario and simulation activities. Finally, faculty designed simulation learning experiences which required students to initially show that they had met learning objectives in the course and secondly had students demonstrate their ability to practice safely and competently. Recommendation for practice include that both nursing and simulation faculty should receive training on INASCL Standards of Best Practice and the pedagogy of teaching in addition to educational and simulation theories should all be taught master's programs. Content experts that are adjunct faculty should be involved in the simulation development process. Recommendations for future research included the need to examine the effect of simulation training on faculty simulation expertise and how frequently they use HFPS. Additionally, to better understand the effect of faculty's demographic background on their use of HFPS, future research should include the demographic data of study participants. Needs assessment data should be collected throughout the academic year by nursing and simulation faculty and be presented at curriculum meetings to improve the ability of educators to use HFPS to address the curricular gaps or concerns they have previously identified in the curriculum. Local, state and virtual communities should be created to share simulation knowledge, faculty created simulation student learning experiences and scenarios. More qualitative, quantitative and survey simulation research on the use of HFPS by faculty as a pedagogical tool is also needed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]