Background: When a student has recently graduated from nursing school and passed their licensure exam, they are called a graduate nurse. The use of high-fidelity simulation can help the nursing students prepare for their professional roles. PICOT: In graduate nurses how does nursing education with high-fidelity simulation compared with nursing education with only low-fidelity simulation affect graduate nurses’ anxiety within the first year after graduation? Synthesis: Using CINAHL, PubMed, and INACSL literature search engines, only 7 articles were found, 3-Level I, 1-Level II, 3-Level III. Plan for Change: Using the ARCC-E model to guide change, high fidelity simulations are recommended for graduate nurses’ education to prepare them for the transition into the work setting and decrease anxiety.