Purpose: To explore the relationship between knowledge change, self-confidence, and satisfaction with learning concepts of growth and development across the pediatric age span using a virtual learning environment (VLE), My Virtual Child©. Design: A cross-sectional descriptive correlation design. Measurement: An author-created assessment entitled Growth and Development Assessment administered via Qualtrics assessed knowledge change from pre-test to post-test with data collected before and after the knowledge test. The NLN Student Satisfaction and Self-Confidence in Learning instrument assessed the relationship between knowledge change and satisfaction and self-confidence in learning. Intervention: The VLE My Virtual Child© was used during which participants raised a virtual child from birth to 18 years applying learned concepts of growth and development. Data Analysis: Data were analyzed using a paired t-test, correlation, and regression. Results: Data analysis demonstrated knowledge change pre- to post-test to be statistically significant (p = < 0.001). Pre-test mean = 16.66; SD 5.518 and post-test mean = 20.37; SD 2.223. The NLN Satisfaction and Self-Confidence in Learning instrument means for satisfaction items (M = 3.51-3.95) and self-confidence items (M = 3.51-4.11) indicated students were satisfied and felt confident with their learning the concepts of growth and development using the VLE, My Virtual Child©. A regression analysis demonstrated that the change in knowledge was negatively but weakly correlated with satisfaction (r = -0.030, p = 0.431) and positively but weakly correlated with self-confidence (r = 0.121, p = 0.238), and neither was statistically significant. However, satisfaction and self-confidence were highly correlated (r = 0.840) and statistically significant (p < 0.000). Age as a covariant was weakly correlated to knowledge change, satisfaction, and self-confidence (R[superscript 2] = 0.019/0.036). Conclusion: The data demonstrate participants were satisfied and felt confident in their learning using the My Virtual Child© VLE. The data further demonstrated that age had minimal impact on knowledge change, satisfaction, or self-confidence in learning concepts of growth and development using a VLE. Nursing Education Implications: This study can contribute to the literature on the efficacy of active learning strategies such as a VLE to assist nursing students in learning career-necessary concepts in a new and meaningful way. [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.]