Purpose: The purpose of this study was to examine the impact of a problem-based simulation education program on nursing student’s academic achievement, academic efficacy, and clinical performance skills. Methods: This study examined a group of nursing students using the pretest-posttest test design. Second year pediatric nursing students studying the practical subject Integrated Simulation at S University in K region were asked to complete a self-administered questionnaire before and after using a problem-based simulation education program. In addition to using SPSS/WIN 21.0 for descriptive analysis, the data was analyzed using independent t-test, repeated measures ANOVA and Pearson- correlation. Results: After completing the simulation education program, participants showed statistically higher academic achievement (t = -5.795, p < .001) and clinical performance skills (t = -3.835, p = <.001) than before. However, there was no significant difference in academic efficacy score(t=-.217, p=.829). Conclusion: The results from this study indicate that lessons with various methods and content should be developed to –evaluate both theoretical knowledge and clinical performance skills. In addition, there is a need to develop a standard evaluation.