Background <p>End-of-life and hospice care simulation training is an effective training method for nursing students who rarely have first-hand experience in the clinical placement environment. A systematic debriefing is crucial to maximise the effect of simulation training. This study compared the hospice-related knowledge, attitudes, and confidence of nursing students with exposure to a simulation programme with lectures on end-of-life care using a standardised patient (SIwithLE) to those with exposure to a simulation-only programme on end-of-life care using a standardised patient (SIMUL).</p> Methods <p>This quasi-experimental study was conducted at a nursing school in South Korea. Forty-nine senior nursing students participated in pre- and post-tests to measure their knowledge of hospice and palliative care, attitudes towards caring for terminally ill patients, and confidence in end-of-life care.</p> Results <p>Knowledge increase was observed not only within the group (experimental group) but also between groups and for interaction between group and time. Attitude significantly improved at post-test in both groups. Significant differences regarding confidence were observed neither within/between groups nor for interaction between group and time.</p> Conclusions <p>SIwithLE was verified to be an efficient programme for enhancing students’ knowledge of hospice and palliative care and positively changing their attitudes towards caring for terminally ill patients.</p>