Background: Medical devices are incorporating information technology into complex user interfaces, increasing the need for training and testing. However, the actual devices are costly to purchase and maintain. Method: Participants in this study programmed a simulated and actual smart medication infusion pump and completed a user satisfaction survey. The number of features accessed successfully and the number of errors made during interface programming with the simulator and pump were compared. Results: Differences between the pump and simulator show where the simulator needs to be refined to increase fidelity. Conclusions: Simulating devices provides a low-cost platform for nursing education and for device and interface development. © 2013 International Nursing Association for Clinical Simulation and Learning.