PURPOSE: This study was conducted to examine the effects of simulation education integrated with problem based learning (SIM-PBL) on clinical competency and self-efficacy in post operation nursing care for children. METHODS: This study was a quasi-experimental design. Thirty six students in the third year of a 4-year baccalaureate nursing program were recruited conveniently and assigned to the control or intervention groups using time difference. Students were all in a pediatric nursing clinical practicum. The control group received the regular clinical practicum in a hospital setting. For the intervention group, a SIM-PBL education replaced 150 minutes of their clinical practicum. RESULTS: The intervention group showed greater improvement in two areas of clinical competency compared with the control group; physical assessment (t=3.019, p=.005) and post operation advice (t=2.428, p=.021). However, no statistically significant differences in improvement in any areas of self-efficacy were found between two groups. CONCLUSION: The results indicate that the SIM-PBL education is effective in improving some areas of clinical competence, but not self-efficacy in post operation nursing care for children. Further study is needed to develop SIM-PBL programs for various clinical topics and evaluate the effectiveness on the learning outcomes.