A class of graphs is structurally nowhere dense if it can be constructed from a nowhere dense class by a first-order transduction. Structurally nowhere dense classes vastly generalize nowhere dense classes and constitute important examples of monadically stable classes. We show that the first-order model checking problem is fixed-parameter tractable on every structurally nowhere dense class of graphs. Our result builds on a recently developed game-theoretic characterization of monadically stable graph classes. As a second key ingredient of independent interest, we provide a polynomial-time algorithm for approximating weak neighborhood covers (on general graphs). We combine the two tools into a recursive locality-based model checking algorithm. This algorithm is efficient on every monadically stable graph class admitting flip-closed sparse weak neighborhood covers, where flip-closure is a mild additional assumption. Thereby, establishing efficient first-order model checking on monadically stable classes is reduced to proving the existence of flip-closed sparse weak neighborhood covers on these classes - a purely combinatorial problem. We complete the picture by proving the existence of the desired covers for structurally nowhere dense classes: we show that every structurally nowhere dense class can be sparsified by contracting local sets of vertices, enabling us to lift the existence of covers from sparse classes.