The rise of simulation in nursing education programs is due to technological advancements and limitations in the number of clinical placements available for students. Building off the National Council of State Boards of Nursing's National Simulation Study, this evaluative follow-up study sought to update the current simulation landscape in prelicensure programs, compare results between 2017 and 2010, and determine the impact of the National Simulation Study and and National Council of State Boards of Nursing's National Simulation Guidelines. Results of a survey sent to all prelicensure nursing education programs in the U.S. indicate high-fidelity simulation use in undergraduate courses increased substantially during the 7-year period, and computer-based simulation use decreased for all courses except for psychiatric/mental health nursing. Most nursing programs substitute simulation for clinical hours using a 1:1 ratio of simulation to clinical hours. The National Simulation Study and the Simulation Guidelines have a definite impact on how simulation is being employed. Knowledge of the study and guidelines seem widespread, and half of the programs indicated they adopted at least some of the simulation guidelines. Boards of nursing should remain vigilant and ensure that debriefing is occurring and that faculty receive formal training in programming the mannequins and running the scenarios.