PURPOSE: This study was done to examine the effect of direct practice of newborn health assessment on nursing student's clinical competence and self-efficacy and to propose effective strategies for clinical education on newborn care. METHODS: Design was a nonequivalent control group quasi-experimental study. The direct practice program was composed of a lecture, demonstration, drill and feedback using a manikin, and repeated direct practice regarding newborn health assessment. Participants were 65 student nurses taking the pediatric nursing practicum in the nursery room at M hospital. The experimental group (n=33) participated in the direct practice program for newborn health assessment and the control group (n=32) received the traditional practice method. Nursing clinical competence was assessed by two nurse investigators and structured questionnaires were used to measure self-efficacy. RESULTS: The experimental group's clinical competence was significantly higher than that of the control group (t=-4.82, p=.000). However no significant difference was found between the two groups for self-efficacy (t=1.264, p=.211). CONCLUSION: These findings indicate that the direct practice program is effective in improving nursing student's clinical competence, but it was not effective in increasing self-efficacy. Direct practice in various clinical education settings is recommended and longitudinal effects be evaluated.