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Purpose: The purpose of the study is to confirm the effect of ACLS program using simulations and understanding self-efficacy, practice satisfaction, learning attitude, and interest in ACLS after theory classes and simulation-based practice. Methods: A non-equivalent simulation-based practice post test design was used. The participants were 28 paramedic students. The students participated in simulation- based practice for 3 weeks and conventional instruction class for 12 weeks. Results: The students showed higher level of self-efficacy(p =.043), practice satisfaction(p <.001) and learning attitude(p =.003) compared to the conventional lecture students. Conclusion: Level of self-efficacy after simulation-based practice for ACLS was higher than that of self-efficacy after conventional instruction classes. Level of practice satisfaction was also higher. Academic achievement after simulation-based practice was higher than that in conventional instruction classes.