Objective To explore the application effect of sand table simulation based on the Attention-Relevance-Confidence-Satisfaction(ARCS) motivation model in the Emergency and Critical Care Nursing course. Methods The teaching design was conducted through three steps:identifying learning problems,clarifying teaching priorities and their core implementation paths;determining key motivational interventions and planning their application in sand table simulation;and designing the integration strategy of teaching content and sand table simulation based on the ARCS motivation model. By convenience sampling,86 nursing undergraduates from a university were enrolled as the participants. They were divided into an experimental group(n=41) and a control group(n=45) by lot drawing according to their classes. For specific experimental teaching content,the experimental group received sand table simulation teaching based on the ARCS motivation model,while the control group received conventional teaching methods. The two groups were compared in terms of learning engagement,theoretical and practical assessment scores,and course satisfaction. In addition,semi-structured interviews were conducted with 11 students from the experimental group to explore their gains from the sand table simulation based on the ARCS motivation model. Results Compared with the control group,the experimental group had significantly higher scores in the average item score of learning engagement,theoretical assessment results,course grades,and average item score of course satisfaction(all P<0.05). Analysis of interview data extracted four major themes:integrating theory with practice by simulating real clinical environments,facilitating knowledge transformation,improving the proficiency of clinical skills,and cultivating a positive attitude towards patient care. Conclusion Sand table simulation based on the ARCS motivation model is conducive to improving nursing undergraduates’ learning engagement and emergency and critical care nursing competence,and it is highly recognized by students.