This randomized controlled study aims to determine the effect of simulation on the cardiac auscultation competence of nursing students. The main questions it aims to answer are:

• Simulation is effective in developing the cardiac auscultation competence of nursing students.
• The psychoacoustic approach is effective in developing the cardiac auscultation competence of nursing students.

One week after the 2-hour theoretical lecture, all three groups will be taken simultaneously to a 3-hour laboratory practice for cardiac auscultation. An instructor will lead each group to ensure coordination. The psychoacoustic approach group will listen to normal heart sounds (S1, S2), abnormal heart sounds (S3, S4) and murmur sounds from the audio file uploaded to their mobile phones in the laboratory environment through headphones for 500 repetitions each. The simulation group will practice auscultation of heart sounds in a one-to-one and repetitive manner, working with a high reality simulator. Trainers will act as facilitators during the cardiac auscultation practice of the students in the intervention groups. The control group will continue with the standard education.

Inclusion Criteria:

- First-time registration in the course.

Exclusion Criteria:

• Non-native speakers of the country's native language.
• Previous graduation from any health-related university.