OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia in clinical practice making proficient diagnosis and treatment vital to patient outcomes. The increased incidence of new-onset symptomatic rapid atrial fibrillation (NOSRAF) necessitates consistent provider training. This practice improvement project created a simulation-based training (SBT) program to prepare prehospital health care providers for responding to NOSRAF. METHODS: A pre/post design was used to evaluate SBT for prehospital health care providers during biannual training. A protocol-based checklist, knowledge questionnaire, and the Simulation Effectiveness Tool-Modified (SET-M) were used to collect data on protocol fidelity, knowledge, and simulation effectiveness, respectively. RESULTS: SBT improved NOSRAF protocol compliance; however, the SET-M survey data revealed no change in provider confidence. Further studies focused on SBT for the prehospital health care provider are warranted. CONCLUSION: SBT can improve prehospital health care provider preparedness in caring for patients with NOSRAF. Further studies are needed to better represent the influence of simulation-based learning in the prehospital health care provider population and to identify knowledge deterioration time frames.