Background: Premature birth is a sudden event of birth below the 37th week of pregnancy. In the third trimester, that is, 27-40 weeks of gestation when the baby’s major stages of development take place, the baby receives a wonderful blood supply to its respiratory system that enables it to breathe for the first time.
 Material And Method: A Quasi- experimental Non- equivalent control group pre-test post-test design was adopted to assess the effectiveness of simulation based learning in terms of competency of nursing students. Data was collected from 114 students studying BSc. 3rd Year in M.M. College of Nursing, and M.M. Institute of Nursing, Mullana, Ambala, Haryana. Study participants were randomly allotted in experimental group (n=55) and comparison group (n=59) by using purposive sampling technique. The data was collected by using selected variables, Structured Knowledge Questionnaires, Objective Structured Clinical Examination (OSCE) and Clinical Decision Making Ability Questionnaires.
 Results: The study findings showed that majority of the nursing students (80%) were female in experimental group and (79.66%) in comparison group. The mean post-test knowledge score (26.22±5.24) of nursing students in experimental group was higher than the mean post -test knowledge score (22.46±6.54) of comparison group. The mean post-test skills score (45.40±7.45) of nursing students in experimental group was lower than the mean post -test skills score (45.51±8.36) of comparison group. The mean post-test clinical decision making ability score (17.84±2.84) of nursing students in experimental group was higher than the mean post-test clinical decision making ability score (14.39±5.47) of comparison group. The calculated ‘t’ value of post-test knowledge scores in experimental and comparison group (p=0.00*) and the calculated ‘t’ value of post-test skills scores in experimental and comparison group (p=0.94*) The calculated t value of post-test clinical decision making ability scores in experimental and comparison group(p=0.00*) was found to be statistically significant at 0.05 level of significance.
 Conclusion: The study concluded that Simulation based learning was effective in enhancing the competency in terms of knowledge, skills and clinical decision making ability regarding Preterm Newborn Care among Nursing Students.