Background: One strategy to develop nursing students’ clinical judgment are the use of high-fidelity patient simulation (HFS). The aim of the study was twofold. Firstly, the aim of this study was to describe the nursing students’ experiences while participating in HFS, and secondly to describe faculty teachers’ reflections about nursing students’ need in HFS and the related teaching challenges.

Method: Data was collected in focus group discussions and individual interviews, analyzed using thematic qualitative content analysis.

Findings: The nursing students’ experienced HFS as being thrown into an uncertain, exposure situation. This were for some, reason for reluctance. The teachers challenge was motivating and coaching the students throughout a demanding teaching situation.

Discussion: Students’ ability to perform in HFS is influenced by self-perceived efficacy, own attitudes and responsibility for one’s learning, which are a challenge for the teachers.

Conclusion: HFS methodology can be useful to identify gaps and strengths in students’ professional transition towards becoming registered nurses. Overcoming reluctance towards HFS is a mutual challenge for faculty teachers and nursing students. By entering the scenario with a positive mindset, nursing students can improve their ability to perform clinical judgments.