This theoretical article explores how mental simulation can enhance self-efficacy and stress management in emergency care, focusing on its application in nurse education. This article delves into the concept, functionality, and applications of mental simulation in nurse education, specifically addressing stress mitigation in emergency care. We offer an overview of relevant literature and research, including a specific focus on surgical skills education. The mechanisms of mental simulation, encompassing the simulation theory of action and dual code theory, are discussed, providing valuable insights into neural networks and image evocation processes. The article underscores the significant impact of stress on emergency care performance. It highlights the potential benefits of incorporating mental simulation as a stress-exposure training technique in the learning process. By adopting a Bandurian theoretical framework, the article proposes how mental simulation can contribute to the cultivation of self-efficacious nurses. Integrating mental simulation in nurse education has the potential to mitigate stress’s negative impact on emergency care. Nurses mentally rehearse and simulate scenarios, becoming familiar with demands and stressors. This practice can potentially refine skills, improve performance under pressure, and boost self-efficacy. Mental simulation replicates real-life situations, enhancing learning from a patient safety perspective. Mental simulation enhances self-efficacy and stress management in emergency care. Its integration into nurse education prepares nurses for high-stress situations. Further research should explore its diverse applications. Understanding mental simulation mechanisms can improve training programmes, potentially empowering nurses in delivering self-confident emergency care.