Rapid technological advances in the last 20 years have led to the exponential adoption of simulation-based learning in nursing education.

Simulation-based learning is designed to engage, challenge and enrich the learner's knowledge base and skill set. It presents the opportunity to experience a variety of clinical scenarios, both common and uncommon, in a safe environment allowing repeated skills training and facilitating the transfer of classroom-knowledge to real situations.Research demonstrates that simulation can improve student engagement and learning and is being increasingly used as an educational strategy for nursing students. This prospective randomized controlled study that was undertaken with the following goals:

1. to investigate the effectiveness of simulation-based training in a large sample of perioperative nurses, measured as nurses' learning progress in the simulation environment;
2. to determine whether the learning acquired through this training is transferable to recognizing real surgical instruments; and
3. to evaluate whether simulation-based learning is retained at least one week.

Inclusion Criteria:

• Perioperative nurse
• Employed at Queen Elizabeth II Health Sciences Center

Exclusion Criteria:

-Unable to provide informed consent