Purpose: This study was conducted to investigate the effects of simulation-based education using high-fidelity simulator and standardized patient in nursing care for children with fever on nursing students. Methods: A total of 166 senior nursing students who completed pediatric nursing practicum courses participated in this study. The single group study design with pretest and posttest was used. The simulation education was provided for 200mins including orientation, simulation preparation, simulation practicum, and debriefing. Pre and post surveys were performed using questionnaires on clinical performance competency, communication skills, critical thinking disposition and self-confidence. Results: The mean scores of clinical performance competency (t=-2.56, p<.05), communication skills (t=-6.39, p<.001), critical thinking disposition (t=-3.43, p<.001), and self-confidence (t=-3.72, p<.001) in posttest were significantly higher than those in pretest. Also, clinical performance competency in nursing care for children with fever has significant relationships with communication skills, critical thinking disposition and self-confidence. Conclusion: The results indicate that simulation-based education using high-fidelity simulator and standardized patient is an effective strategy for improving clinical performance competency, communication skills, critical thinking disposition and self-confidence in nursing students. Further study is needed to verify the effects.