A critical role of the professional nurse is to manage symptoms associated with cancer and its treatments. Currently, prelicensure nursing curricula lack adequate oncology content and associated opportunities for clinical application. Thus, many graduate nurses do not possess the requisite knowledge and skills required to effectively manage cancer-related symptoms upon entry to practice. The purposes of this study were to evaluate the effect of standardized patient simulation on nursing students' knowledge, confidence, and competence (objective and self-perceived) related to oncology evidence-based symptom management principles, and to determine nursing students' perceptions, satisfaction, and self-confidence with learning using standardized patient simulation in a seminar-style course. A longitudinal, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected at three time points: (T1) pre-seminar, (T2) pre-simulation, and (T3) post-simulation. A convenience sample of sixty-three senior baccalaureate nursing students in an oncology symptom management seminar participated in two standardized patient simulation scenarios. There was a significant increase in students' knowledge, confidence, and self-perceived competence over time with a large effect size. All student groups (n = 14) demonstrated objective competence in the colorectal cancer scenario and all participants, with the exception of one student group, demonstrated objective competence in the breast cancer scenario. Participants also reported positive perceptions of, a high level of satisfaction with, and self-confidence in learning with the standardized patient simulations. Qualitative themes identified included unique focus, realism, and application of knowledge. Standardized patient simulation holds promise to enhance nursing students' knowledge, confidence, and competence related to oncology evidence-based symptom management principles.

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