Purpose: This study examined the effectiveness of an integrated nursing simulation practicum in enhancing readiness for practice and self-confidence in clinical decision-making among nursing students. Methods: A quasi-experimental design with a nonequivalent control group and preand post-test measurements was employed. The participants were 51 fourth-year nursing students enrolled in a simulation practicum. The integrated simulation program comprised six scenarios covering adults, women’s health, and pediatric nursing, totaling 30 instructional hours. Data were analyzed using SPSS version 26.0, with paired and independent t-tests, Fisher’s exact test, and the Mann-Whitney U test. Results: The experimental group showed significant improvements in readiness for practice (t=-3.55, p=.002) and self-confidence in clinical decision-making (t=-7.40, p<.001) compared to pre-intervention scores. A statistically significant difference in readiness for practice was observed between the experimental and control groups (p=.048). However, the difference in self-confidence in clinical decision-making between the groups was not statistically significant. Conclusion: Nursing education should equip nursing students to effectively transition into clinical practice as new graduate nurses. The integrated simulation practicum can be considered an effective strategy for enhancing nursing students’ readiness for practice.