Simulation, the use of computerized, life-sized mannequins as the patient in a clinical scenario for nursing students, is fast becoming implemented as a part of nursing school curricula across the globe. As an educational modality, simulation affords the students learning opportunities not previously available in traditional classrooms or hospital settings. This study describes and analyzes a nursing simulation session using methods of classroom discourse analysis in order to discern the nature of the interactions, and learning transactions that occur. A previously recorded nursing simulation scenario was selected and transcribed. Analysis of the discourse revealed five distinct types of interaction: teacher-nurse, teacher-student, student-student, nurse-patient, and healthcare provider-nurse. Each type of interaction was first examined as an isolated conversation. Then it was further analyzed as it actually appeared with other simultaneous, interactional sequences. The data revealed that student-student interaction was the most common type of discourse. It was during this interaction that the students collaborated with each other using peer guided participation to make clinical care decisions, and private speech to gain greater individual understanding of the nursing situation. In addition, the data revealed that guided participation was the most common method of instruction. This study represents an initial description and analysis of the discourse found in nursing simulation.