The purpose of this study was to assess the effect of a simulation nursing education program in terms of clinical reasoning, problem-solving process, self-efficacy, and clinical competency using the Outcome-Present State-Test (OPT) model in nursing students. The participants comprised 45 undergraduate nursing students recruited from two universities in Korea. The number of nursing students assigned to the experimental group and control group were 25 and 20, respectively. For a period of two weeks, the experimental group received a simulation nursing education program using the OPT model, while the control group received a traditional clinical practicum. The data were analyzed using prior homogeneity tests (Fisher’s exact test and paired t-test); ANCOVA was performed to investigate the differences in dependent variables between the two groups. There was a significant improvement in clinical reasoning (F = 10.59, p = 0.002), problem-solving process (F = 30.92, p < 0.001), and self-efficacy (F = 36.03, p < 0.001) in the experimental group as compared to the control group (F = 10.59, p = 0.002). Moreover, the experimental group showed significantly higher scores in clinical competency than the control group (F = 11.07, p = 0.002). This study demonstrates that the simulation nursing education program using the OPT model for undergraduate students is very effective in promoting clinical reasoning, problem-solving processes, self-efficacy, and clinical competency.
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