Background: There has been considerable debate about whether it is appropriate to let the manikin die during simulation teaching. Simulations are used in high-risk industries to recreate rare and potentially catastrophic events. In healthcare, there has been a reluctance to allow scenarios to progress to a catastrophe because of the potential impact on the individual if they were to then encounter the situation in real life. In healthcare, witnessed resuscitation has an overall success rate of around 23.9 %, therefore making every simulation situation successful results in an altered perception of reality. Objective: The researchers aimed to examine whether the manikin's death during a simulation adversely affects the resuscitation self-efficacy of nursing students. Design: Quasi-experimental design. Setting: Univesity of Sunderland, United Kingdom. Participants: Students were invited to participate (n = 120) and 106 consented to take part in the study. Methods: A pre-and post-test of the nursing student's self-efficacy during a resuscitation scenario. The scenario related to a patient admitted to the emergency room with chest pain who then went into cardiac arrest. The experimental group's resuscitation was unsuccessful, and the control group's resuscitation was successful. Self-efficacy was measured using the validated Basic Resuscitation Skills Self-efficacy scale (BRS-SES). The data were analysed using a paired sample t-test. Results: Overall, both groups showed improved self-efficacy as a result of the simulation session and the death of the manikin in the experimental group did not result in a reduced level of self-efficacy related to resuscitation. Conclusion: The death of the manikin during the simulation involving resuscitation had no impact on student resuscitation self-efficacy.