Purpose: In this study, we developed an integrated simulation practicum and investigated the effectiveness of the practicum for senior nursing students. Methods: Sixty-seven senior nursing students from a university were enrolled in this study and assigned into two groups: experimental (n = 31) and control (n = 36). We developed and applied a 60-hour integrated simulation practicum that spans a 3-week period. The control group performed a traditional clinical practicum. The outcome measures were critical thinking disposition, clinical competence, and practicum satisfaction and the data were analyzed using the SPSS 23.0 software. Results: After the intervention, both experimental and control groups showed significant improvement in critical thinking disposition (p = .017) and clinical competence (p < .001) compared to those of the baseline. Regarding practicum satisfaction, the experimental group showed significantly higher satisfaction than the control group (p = .003). Conclusion: The integrated simulation practicum was an effective program that improved critical thinking, clinical competence, and practicum satisfaction in senior nursing students. To effectively improve critical thinking and acquire clinical competence, which are essential for prospective nurses, nursing students should be exposed more to simulation practicum that reflect environments similar to actual clinical settings for various patients with complex health problems.