INTRODUCTION: Nurses and ancillary staff are frequently the front-line healthcare workers that respond to in-hospital cardiac arrest patients. Successful resuscitation of patients in cardiac arrest is affected by levels of experience, exposure, setting, competency, and education. Studies have suggested that basic life support skills that include cardiopulmonary resuscitation skills are suboptimal, inconsistent, and at best retained for 3-6 months. (Halm & Crespo, 2018, p. 513). Many healthcare providers have little or no exposure to cardiac arrest patients outside of simulation training that may only occur on a biannual basis. Ineffective or lack of efficiency resulting from skill decay can be significantly reduced when incorporating more frequent high-fidelity training for cardiac arrest events. PURPOSE: The aim of this study was to evaluate the effectiveness of high-fidelity simulation training using unannounced mock cardiac arrest scenarios of health care team members responding to in-hospital cardiac arrest events. Comfort levels, knowledge, and education were surveyed to measure effectiveness. METHODS: Fourteen mock cardiac arrest scenarios were conducted in a small Midwestern rural hospital setting. The Theory of Deliberate Practice guided the simulation learning experience through real time feedback immediately after the scenario. RESULTS: The results of this study demonstrated that participation in cardiac arrest scenarios had a statistically significant positive impact among nurses and ancillary staff's education, comfort level and knowledge. CONCLUSION: Traditional biannual training is well known to not be sufficient to maintain knowledge and skills. Quality improvement initiatives in education using mock cardiac arrest scenarios on an interval or more frequent basis may provide the necessary training that prevents skill decay for a low-frequency high-fidelity event.