Purpose: The purpose of this study was to identify the differences in learning flow and problem solving ability by simulation-based fundamentals of nursing practice program depending on the level of self-efficacy of nursing students. Methods: This study was a one group pre-post design. This study involved 254 second grade nursing students at T university in D city. Data were collected from October 28th to November 29th in 2013. Data were analyzed with frequency, percentage, descriptive statistics, paired t-test, ANOVA and post hoc test with using IBM SPSS WIN version 18.0. Results: There was a statistically significant increase in learning flow(F=14.328, p <.001) and problem solving ability(F=4.315, p=.014). There were significant differences on 11.12 score of learning flow and 7.20 score of problem solving ability with answer ‘Low’ by the level of self-efficacy. Conclusion: The result showed that the simulation-based fundamentals of nursing practice program improve learning flow and problem solving ability of low self-efficacy students. Therefore, it is an effective learning method.