Objective <p>The objective of this study was to compare the effects of high fidelity simulation combined with moulage and low fidelity simulation supported by visuals on nursing students’ oral assessment knowledge, skill levels, satisfaction and self-confidence.</p> Methods <p>While oral mucosal wound images were used in the simulation applications of the students in the control group, moulage was used in the intervention group.</p> Results <p>A subsequent comparison of the post-intervention skill scores of the control and intervention groups revealed that the arithmetic mean of the former was 12.40, while the arithmetic mean of the latter was 17.31. The post-intervention skill scores of the intervention group were found to be significantly higher than those of the control group (<i>p</i> &lt; 0.05). Furthermore, this study found that the simulation design scale scores of students who received training with moulage were higher than those who received training with mouth sore visuals.</p> Conclusions <p>It can be concluded that simulation with moulage is effective in developing the skills of nursing students receiving training for oral assessment and transferring what they have learned to the clinical environment.</p> The implications for practice <p>Integrating moulage into simulation-based nursing education can be an effective strategy to strengthen students’ oral assessment competencies and support the transfer of learning to clinical practice.</p> Clinical trial number <p>Not applicable.</p>