Background <p>Simulation-based learning (SBL) provides realistic clinical scenarios within a safe and controlled environment, allowing students to develop clinical skills without posing risks to patient safety. However, heightened anxiety surrounding performance assessments may hinder nursing students’ learning outcomes, with potential gender-based differences. Identifying factors associated with student satisfaction in SBL is crucial to optimize learning experience and improve educational strategies.</p> Objectives <p>This study aimed to identify factors associated with satisfaction in SBL, and to examine the interaction between psychological safety and gender on satisfaction among nursing students.</p> Methods <p>This cross-sectional study collected data from nursing students after simulation-based assessments. Based on the NLN/Jeffries Simulation Framework, multiple linear regression was employed to analyze the relationships between satisfaction in SBL and variables such as demographics, psychological safety, and simulation design features.</p> Results <p>Among 243 nursing students in this study, 85.2% were female. In simulation-based assessments, female students were more sensitive to interpersonal risks in the simulation environment, whereas male students were more affected by high-fidelity design features. Higher psychological safety and better simulation design features were significantly associated with satisfaction in SBL. No significant interaction effect between psychological safety and gender was found.</p> Conclusions <p>This study expands on prior research by providing empirical evidence of gender-specific responses to psychological safety and simulation design in SBL. The findings suggest the need for gender-sensitive approaches in SBL. This study might help guide educators and researchers develop effective simulation-based curriculums and provide foundational evidence for a professional development plan.</p> Clinical trial number <p>Not applicable</p>