PURPOSE: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. METHODS: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. RESULTS: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were 37.82+/-6.03. 3.61+/-0.38, 3.61+/-0.33, and 3.73+/-0.32, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. CONCLUSION: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.