Purpose: This study aims to improve nursing students’ competency through evidence-based nursing simulation education. Simulations included blood transfusion care for cancer patients, pneumothorax post-op care, and blood pressure control for hypertension care. Moreover, the study investigated the effects of simulations on anxiety, self-confidence, and student satisfaction with the learning experience. Method: Participants completed a survey on student satisfaction, self-confidence, and anxiety. A prospective, one-group, pre- and post-test design of 135 fourth-grade nursing students was used. A simulation scenario was developed according to the design. It consisted of pre-briefing, practice, serial tests, and debriefing. A simulation of three scenarios comprised blood transfusion care for cancer patients, pneumothorax post-op care, and blood pressure control for hypertension care. Twenty hours of evidence-based nursing simulation practicum consisting of three scenarios dealing with major adult diseases was conducted. Result: Students showed significant improvements over time in self-confidence (t=4.67, p<.001), student satisfaction (t=3.94, p<.001), and anxiety (t=-4.63, p<.001) after the evidence-based nursing simulation. Conclusion: Simulation of evidence-based education may be a useful and effective learning strategy. Nursing educators can design evidence-based simulation programs to improve educational effectiveness.