There is a gap in the literature regarding learning outcomes linked to the use of high-fidelity simulators compared to that of traditional teaching methods.To examine the effect of using high-fidelity simulators on knowledge and skills acquisition and retention with university students.A randomized two-arm trial using two different educational approaches on 90 nursing students assigned randomly to two groups was used at two points of time.The results showed significant differences in favor of the participants in the high-fidelity simulator group on both the acquisition and retention of knowledge and skills over time. However, a significant loss of cardiopulmonary resuscitation knowledge and skills occurred at 3 months after training in both groups.The findings of this study may assist educators in integrating high-fidelity simulators in education and training. In addition, the findings may help nursing educators to arrange additional cardiopulmonary resuscitation training sessions in order to improve cardiac arrested patients' outcomes.High-fidelity simulation (HFS) provides students with interactive learning experiences in a safe controlled environment. HFS enables teachers to implement critical clinical scenarios, such as cardiac arrest, without risk to patients. Integrating the simulation training into nursing curricula will help to overcome the challenges that face many courses, specifically the shortage of clinical areas for training and the increase in numbers of nursing students.