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This study investigated the influence of emotion regulation strategies (cognitive reappraisal and expressive suppression) on nursing students' performance in high-fidelity simulation (HFS) settings. Data from 98 students revealed that cognitive reappraisal positively affected simulation design satisfaction (SDS) and performance, while expressive suppression negatively influenced both. Importantly, SDS was a significant mediator in the relationship between cognitive reappraisal and simulation performance. The findings underscore the critical role of emotion regulation in HFS and emphasize the need to integrate emotion regulation training into nursing education. By considering emotion regulation and SDS, educators can create more effective learning environments that contribute to better student performance for clinical practice. This study highlights the intersection of emotion regulation and learning outcomes in nursing education.