Purpose: This study developed an educational program for structured discussion-based learning, problem-based learning (PBL), and simulation for nursing students. Its effects on learning attitude, problem-solving process, and clinical competence were then analyzed. Methods: This study used a one-group pretest–posttest experimental method among 135 fourth-year nursing students taking the simulation course at a university in D city. We operated the PBL by applying the structured discussion method and simulation education based on four modules covering major diseases among adults. The data collected before and after the program were analyzed using descriptive statistics and paired t-tests. Results: The program significantly improved nursing students’ learning attitude, problem-solving process, and clinical competence. Conclusions: We verified the effects of the simulation education program for structured discussion-based learning and PBL. Further studies are needed to develop and apply simulation educational programs utilizing various devices that can improve learners’ participation and professors’ operational protocols by systematically combining them with different teaching/learning methods.