Background: Clinical simulation is a popular method of educating undergraduate student nurses, however it is currently unknown, which specific simulation approach is the most effective at optimizing student learning in the context of the deteriorating patient. This study piloted a novel form of simulation called Rapid Cycle Intentional Simulation, to evaluate undergraduate nurses’ perception and performance in recognizing and responding to clinical deterioration, compared to the standard simulation approach. Methods: A two-phased, prospective, nonequivalent control group design study was implemented, recruiting a total of 138 second year undergraduate nursing students. Simulation groups were randomly assigned to the intervention or standard simulation approaches. The simulation evaluation included observations, student satisfaction and self confidence in learning scale and student knowledge test. Results: There were no significant differences in knowledge, perceived confidence, or satisfaction between standard and Rapid Cycle Intentional Simulation. Qualitative observer reflections suggest regular interruptions of Rapid Cycle Intentional Simulation, facilitated critical thinking and willingness to engage in feedback. Conclusion: Findings suggests this novel simulation approach, where the facilitator intentionally interrupts the simulation scenario to realign students through real time feedback, improved student performance, engagement, challenged learning avoidance behaviors, and increased student confidence to critique their practice.