Background: Although simulation increases competencies in end of life care, unexpected death sim-ulations are often avoided due to student stress and anxiety. This pilot study aimed to determine a protocol for studying relationships of stress, anxiety, and resilience on student learning outcomes during an unexpected death simulation.Method: A mixed methods design used demographics, resilience scores, anxiety scores, competency measurements, and one-on-one interviews to study the variables.Results: Paired samples t-test of state anxiety scores showed a statistically significant increase from the baseline measurement to immediately after the simulated death. Large negative correlations were found between baseline resilience and state anxiety scores, and between baseline resilience and trait anxiety scores. Interview responses indicated that multiple factors lead to students experiencing stress and anxiety.Conclusion: The procedures and methods were appropriate for studying the variables. Correlations between resilience and anxiety scores indicated that maximum sampling variation may be beneficial when choosing interview participants.Cite this article:Dickerson, K., Gantt, L.T. & Swanson, M. (2023, Month). Unexpected Death of a Mannequin: A Mixed Methods Pilot Study on Relationships of Stress, Anxiety, and Resilience on Learning Outcomes. Clinical Simulation in Nursing , 74, 65-71. https://doi.org/10.1016/j.ecns.2022.08.010 .(c) 2022 Published by Elsevier Inc. on behalf of International Nursing Association for Clinical Simulation and Learning.