© Lippincott Williams & Wilkins. Clinical simulation within nursing programs is a hallmark teaching strategy. With faculty challenged to design effective simulations for large groups of students, students are often divided into an active or passive role group. This study examined the anxiety levels experienced by students in the two roles. Results indicated that trait anxiety was similar in both groups before and after the simulation; however, there was a significant decrease in state anxiety ratings in the active role group following the simulation. The finding that students in the active role group experienced reduced state anxiety can theoretically facilitate learning.