This randomized-controlled pilot study investigated the effects that Virtual Gaming Simulation (VGS) with enhanced gaming elements had on student enjoyment, satisfaction and confidence levels among undergraduate, pre-licensure nursing students. Students enrolled in an accelerated nursing program were randomly assigned to participate in Virtual Gaming Simulation (VGS) activities with branching scenarios. Students (n= 23) were randomized into a control group that included VGS but no enhanced gaming elements or an experimental group that received enhanced gaming elements including a storyline and plot, sound effects, and a progress bar within the VGS. Results demonstrated that participants in the experimental group had statistically significantly higher satisfaction and self-confidence levels, however difference in enjoyment levels did not reach statistical significance between groups. Findings from this study suggest that enhanced gaming elements within VGS are valuable additions for enhancing student satisfaction and self-confidence and warrant further investigation.