BackgroundAnxiety can negatively impact nursing students' confidence and performance during simulation-based training, leading to suboptimal learning outcomes. SampleThe study included 102 prelicensure Bachelor of Science in Nursing (BSN) students. The participants (µage = 21.72, SD = 3.14), mostly female (n = 85, 83.33%) and Caucasian (n = 67, 65.69%), were randomized into control (n = 51) and experimental (n = 51) groups. MethodParticipants in the control group prepared for simulation as they usually would, while those in the experimental group listened to 15-minutes of classical music before their simulation sessions. Anxiety, self-efficacy, and instructor-assigned performance ratings during the simulation were evaluated. ResultsThe experimental group experienced significantly lower anxiety, increased self-efficacy, and higher performance scores compared to the control group (p-values < .001 for all measures). ConclusionThese results suggest that a 15-minute music-listening intervention could effectively reduce anxiety, boost self-efficacy, and improve performance during simulation-based training.