Context: High-fidelity simulation can provide an ideal adjunct to clinical or real-world experience by providing a realistic and safe learning environment for the practice of low-incident encounters. Objective: Given that levels of perceived self-efficacy are malleable and high-fidelity simulation can provide many positive outcomes, the purpose of this study was to determine whether participation in a high-fidelity simulated cardiovascular emergency scenario using the Laerdal SimMan in a university simulation center in the United States increased undergraduate athletic training students' self-efficacy scores. Design: Cohort design with repeated measures. Patients or Other Participants: Convenience sample of undergraduate athletic training students (n = 46) enrolled in a professional program at a National Collegiate Athletic Association Division I university in the Midwest. Intervention(s): Participation in or observation of a high-fidelity cardiopulmonary resuscitation (CPR) simulation. Main Outcome Measure(s): Self-efficacy scores before, immediately after, and 6 months after simulation. Results: There was a significant main effect for the 3 repeated measures, with the scores steadily increasing significantly from pretest (mean = 7.60, SD = 1.13) to posttest (mean = 8.04, SD = 1.22, P = 0.001), then again from immediate posttest to the 6-month posttest (mean = 8.38, SD = 1.04, P = 0.04). Scores among the participants (mean = 8.21, SD = 1.03) were not significantly higher than scores among the observers (mean = 7.85, SD = 1.40). Scores at the 6-month follow-up posttest (mean = 8.38, SD = 1.04) significantly increased from the posttest immediately after the simulation (P = 0.04). Conclusions: Participating in or observing high-fidelity CPR simulation is an effective method of providing deliberate practice opportunities for athletic training students to increase self-efficacy related to CPR techniques.