AIM: The study compares knowledge, skills, anxiety, satisfaction and self-confidence regarding suctioning between students trained using a partial task trainer with moulage and those using a low-fidelity simulator. BACKGROUND: Moulage application in simulation has been used in nursing skills training, such as intravenous therapy, pressure ulcer and burn care, but not for suctioning. DESIGN: A randomized controlled study with pre-test, post-test design. METHODS: The study conducted in a nursing school in Turkey with 77 nursing intern students from 2020 to 2022. Students completed a two-hour theoretical course and four-hour skills training. The experimental group practiced with a task trainer with transparent lungs and moulage, while the control group used a low-fidelity simulator. RESULTS: Pretest suctioning knowledge scores were similar between experimental and control groups (10.54 ± 3.81 vs. 10.85 ± 2.96
p >
0.05). Posttest knowledge scores showed no significant difference (11.48 ± 3.47 vs. 10.35 ± 3.98
p >
0.05). On the other hand, the experimental group had higher skills scores (36.37 ± 2.69 vs. 29.17 ± 4.78
p <
0.001), greater anxiety before skill training (59.83 ± 8.96 vs. 59.72 ± 7.99
p <
0.05), evaluation (63.51 ± 9.32 vs. 58.77 ± 9.39
p <
0.05), higher satisfaction (4.69 ± 0.46 vs. 4.37 ± 0.74
p <
0.05) and self-confidence in learning (4.60 ± 0.46 vs. 4.23 ± 0.69
p <
0.05). CONCLUSIONS: Moulage significantly enhanced students' skill performance, satisfaction and self-confidence. Although knowledge scores were similar between groups, the experimental group experienced higher anxiety levels before training and evaluation, likely reflecting greater engagement and careful application of skills. These results suggest that students were engaged in learning and applied the skills more carefully. Moulage, which enhances fidelity, should be incorporated into nursing curricula to improve students' learning experiences and outcomes.