Simulation technology in healthcare education is continuously evolving but little is known about the effects of high fidelity simulation on student knowledge and skill retention or motivation. The purpose of this quantitative study was to use quasi-experimental design in a randomized controlled trial that compared the retention of knowledge and skills, and educational motivation in two groups of healthcare professions students enrolled in an Advanced Cardiovascular Life Support (ACLS) course at Penn Hershey Clinical Simulation Center. Healthcare profession students at the Penn Hershey Medical Center were randomized into high fidelity simulation training and traditional low fidelity training for their mandatory ACLS course that included a written and skills exam. A comparison of ACLS test scores was made between the fidelity groups. A quantitative survey was also used to measure the students' change in motivation in ACLS training when measured pre- and post course. The survey measured student motivation based on their "self-efficacy", the students' "benefit" from taking the course and the utility of the course in future courses and careers. A power analysis using G*Power was used to determine a sufficient sample size using an alpha of 0.05, a power of 0.80 and an effective size of p = 0.5. A two tailed t-test determined that 126 participants would be an effective for this research. A total of 132 participants were recruited and completed both the exam and survey portions of the study (n = 71) representing low fidelity and (n = 61) representing high fidelity. The results showed that the low fidelity group retained more knowledge than the high fidelity group as reflected in the independent t-test p = 0.03. Motivation remained higher in the low fidelity group as seen by the mean scores for each motivation construct. The implications of this study are that the use of high fidelity manikins in ACLS courses may not result in better knowledge and skill retention. Retention of ACLS knowledge was achieved with low fidelity simulation. [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://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]