Instructors are tasked with having to prepare EMT students for work in pre-hospital, in-hospital and now more recently, mobile integrated healthcare settings. The use of simulation in the classroom helps prepare students for the workplace by exposing them to a broad variety of situations they may encounter by allowing them to apply knowledge and skills without endangering a live patient. During the simulation the students are placed in an environment set to a standardized patient scenario with a variety of sensory distractors such as props, smells, patient actors with moulage (makeup), and bystanders. The patient in the simulation responds directly to the care that is being rendered by the student(s). If the patient deteriorates the student(s) may need to adjust their care regimen. The instructor evaluates the student using a score sheet and feedback is provided immediately during a team debrief. We have found that simulation builds critical thinking, teamwork and communication skills and the students are more prepared to enter the workforce and have noticed a 20% increase in first time pass for their final skills exam.