Background: Newly graduated nurses' communication ability often does not satisfy the needs of clinical sites. New training pedagogies are needed to help nursing students improve communication skills. This study aimed to evaluate the effects of simulation-based deliberate practice on cultivating nursing students' communication, empathy, and self-efficacy. Method: The study was a randomized controlled trial. A total of 132 first-year nursing students participated in the study at a nursing school in China. The intervention was guided by simulation-based education and deliberate practice. The Clinical Communication Ability Scale, Jefferson Scale of Empathy-Health Professionals, and General Self-Efficacy Scale were used to measure the students' outcomes. Results: After the intervention, students' scores of clinical communication ability, empathy, and self-efficacy in the experimental group all increased significantly, compared with those of the control group. Conclusion: The simulation-based deliberate practice program is a feasible teaching method targeting improvement in nursing students' communication, empathy, and self-efficacy. [ J Nurs Educ . 2019;58(12):681–689.]

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