Background: Simulation-based learning is an innovative educational methodology that creates a new learning environment and represents clinical real-world situations that construct satisfaction and self-confidence for nursing students. Aim: to evaluate satisfaction and self-confidence among Technical Diploma-level nursing students through a simulated-based learning placement and explore the perceived factors of simulated learning that influenced their development of self-confidence in caring for real-life patients in clinical practice. Subjects and methods: - Research design: A sequential explanatory approach of mixed methods research design was conducted in the current study. Sample: A convenience sample of (n=39) students participated in Phase One, and then sequentially 11 volunteer students were recruited in Phase Two. Setting: The study was conducted at Gouna Technical Nursing Institute a non-profit institute in southeast Egypt. Tools: Two tools were used. Tool One: Student Satisfaction and Self-Confidence in Learning in Phase One: The survey, students were surveyed at the end of the semester using Tool Two: A structured focus group using a Nominal Group Technique of eleven volunteer students who responded to the survey were invited to participate in Phase Two. Results: The majority of studied participants had high satisfaction levels and self-confidence during the simulation experience. The produced themes are 1) patient-centered high-quality care, 2) Fidelity simulation & Supportive clinical environment, 3) Critical thinking & decision-making skills, and 4) Feedback and evaluation. Conclusion and recommendations: High satisfaction levels and self-confidence were reported among nursing students during the medical-surgical simulation experience. The study suggested fully integrating simulated-based learning in the curriculum of medical-surgical nursing.