Background Didactic clinical skills training employing low fidelity simulation has been the traditional approach to teaching undergraduate nursing students the insertion of an indwelling urinary catheter. This approach, however, does not adequately prepare students for the intricacies and complexity of this procedure in the real world, which is associated with high rates of infection secondary to procedural contamination. Objectives To explore students' confidence levels in developing clinical psychomotor skills associated with the insertion of an indwelling urinary catheter in a high-fidelity simulation using Mask-Ed. Methods A mixed methods study was conducted involving final year Bachelor of Nursing students. Preproceduraland postprocedural confidence was rated by students using a 5-point Likert scale. A focus group consisting of eleven students was conducted to further explore student's experience of engaging with a Mask-Ed character and the procedural experience from a learning perspective. Results The findings indicated that students increased their procedure confidence when engaging with the Mask-Ed simulation (P=0.025). The ability to maintain procedural asepsis and ability to accurately identify the correct anatomical structures related to indwelling urinary catheter insertion were found to be related (r s =0.71, P<0.05). Three primary themes were identified: caring of a person, intimate care and communication. Conclusion Psychomotor skills related to communication, support and maintaining procedural asepsis were areas that required further clinical development, which are not concurrently integrated into the simulation approach using manikin based simulation. Mask-Ed provided a unique learning opportunity to replicate a clinically and anatomically realistic experience.