Simulation games can be used in nursing education to promote problem solving or to impart information. Most games focus upon one of the two areas: cognitive knowledge or affective knowledge. We call these types of games content games and process games, respectively. Simulation games of both types are used in nursing education. Since simulation gaming in nursing education is a relatively new teaching strategy much of its use has been haphazard. In order for a simulation game to be an effective teaching strategy; there must be a "fit" between the game and the instructional objectives. The game operator should analyze the components of each game used prior to playing the game, so he will be able to use the game appropriately. One disadvantage of gaming is that there is a risk of experiencing untoward reactions in the gaming experience. For this reason, the operator should support all the participants throughout the game. Finally, the game operator should assess the effectiveness of the gaming process through the debriefing session and through research. To extend our knowledge of the effects of simulation games, game operators can research the effect of simulation gaming on student motivation, cognitive learning, and affective learning.