Background <p>With the global population aging, there is an urgent need for nurses competent in providing end-of-life (EOL) care for older adults. Traditional nursing curricula often fail to adequately prepare students for the complexities of palliative care, creating a significant competency gap. Simulated Clinical Immersion (SCI) presents an innovative pedagogical strategy to address this deficit by offering students realistic, hands-on learning experiences.</p> Methods <p>This study employed a quasi-experimental pre-test/post-test design with 128 fourth-year nursing students conducted from September to December 2024. Participants were systematically sampled and assigned to either an intervention group, which received high-fidelity SCI with structured debriefing, or a control group, which received traditional lectures. Data on EOL care knowledge, clinical self-efficacy, and perceived simulation effectiveness were collected using validated instruments and analyzed with t-tests and chi-square tests.</p> Results <p>The SCI group demonstrated statistically significant improvements in both EOL care knowledge (mean change Δ = 6.20, p&lt;.001) and clinical self-efficacy (mean change Δ = 4.19, p&lt;.001). Furthermore, their perceived simulation effectiveness scores increased dramatically (mean change Δ = 12.30, p&lt;.001). In stark contrast, the control group showed no significant changes in any measured outcome. Large effect sizes were observed for all outcomes in the intervention group, highlighting the substantial impact of the SCI.</p> Conclusion <p>Simulated Clinical Immersion is a significantly more effective educational strategy than traditional lecture-based instruction for preparing nursing students to provide EOL care to older adults. The integration of high-fidelity simulation is strongly recommended in nursing curricula to foster the essential knowledge, confidence, and competence required for compassionate and holistic palliative care.</p>