Abstract Aim To identify elements in scenario‐based simulation associated with nursing students' satisfaction with the simulation activity and self‐confidence in managing the simulated patient situation. The study will provide insight to improve the use of simulation as a learning strategy. Design A cross‐sectional study. Method The Student Satisfaction and Self‐Confidence in Learning scale was used as the outcome measure to identify associations with elements of the Simulation Design Scale and the Educational Practices Questionnaire scale after scenario‐based simulation using patient simulators. First‐year nursing students at a university college in Norway (N = 202) were invited to participate and (N = 187) responded to the questionnaires. Results The mean scores for self‐confidence and satisfaction were 4.16 and 4.57, respectively. In the final multiple linear regression analysis, active learning was associated with satisfaction with the simulation activity, while clear objectives and active learning were associated with self‐confidence in managing the simulated patient situation.