This research sought to evaluate the contribution of simulation to the development of a fundamental nursing skill, blood pressure measurement. Year one nursing students at UCOL, New Zealand (n = 75) and the University of Huddersfield, England (n = 55) completed questionnaires about their confidence/competence levels in blood pressure measurement at the conclusion of the simulation sessions, and again after their first clinical placement. Registered nurses who worked with those students (n = 22 UCOL, n = 21 University of Huddersfield) also completed assessments of the students' competence with both electronic and manual blood pressure during their placement. On completion of the simulation sessions 60% of the UCOL students considered themselves competent or confident/competent in blood pressure measurement compared with just 16% of those at the University of Huddersfield. Reports of registered nurse supervision of students undertaking blood pressure measurement on clinical placement varied, but it was clear that students often undertook blood pressure measurement without a registered nurse in attendance to check technique, or the accuracy of their recording.