High-fidelity burns moulage makes simulations "Come Alive".

• Professional moulage is not widely researched; however, it enhances the fidelity of simulation activities, when applying it in simulations. • Students can perceive moulage differently and their senses and emotions are triggered by moulage when the fidelity is high. • Simulation is an effective tool for training nursing students and even more so when moulage is used to increase fidelity. The simulation community knows immersive clinical simulation works, especially high-fidelity simulations that portray situations close to real-life. The question remains: what is the role of moulage in the effectiveness of this strategy? This article describes students' perceived fidelity of moulage used during a burns simulation activity. In a mixed method study, 85 nursing students completed the Moulage Authenticity Rating Scale (MARS) and responded to two open-ended questions that explored emotional fidelity. Most respondents rated the moulage burns high in fidelity. Respondents' senses of sight, touch, hearing, and smell were triggered giving way to intense emotions. However, sensory overload may have led to the students missing clinical cues. The moulage met the criteria for physical, conceptual, and emotional fidelity, contributing to students' engagement during the simulation activity. Educators could improve student engagement by enhancing the fidelity of simulation activities through moulage whilst considering the cognitive load. [ABSTRACT FROM AUTHOR]