Abstract
Background: Negative attitudes toward individuals with opioid use disorder (OUD) are common among healthcare providers, including nursing students. While simulation education can reduce stigma, evidence-based simulations incorporating diverse perspectives of individuals with OUD, including LGBTQ+ individuals, rural residents, older adults, and those experiencing human trafficking, are needed. Methods: This qualitative descriptive study explored the impact of six high-fidelity simulations, co created with input from the recovery community, on 60 nursing students' attitudes toward caring for diverse individuals with OUD. Simulation debriefings were analyzed for evolving perspectives. Results: Initial reflections revealed themes of "Limited knowledge of OUD" and "Out of my comfort zone." Postdebriefing themes included "recognizing stigma," "treating the person-not the disorder," "importance of caring behavior," and "building connections." Beyond attitudinal shifts, debriefings elicited personal reflection with some students connecting the simulations to family or friend OUD experiences with new meaningfulness. Trauma informed debriefings helped students process emotions triggered by these reflections. Conclusion: Community-informed simulations are transformative in nursing education. By addressing knowledge gaps, challenging biases, and fostering empathy, they promote stigma-free, person-centered OUD care. (c) 2025 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.