# Exploration of CDIO-based training mode with a sequential teaching approach for emergency department novice nurses

## TL;DR

A new training method for emergency department nurses improves their skills, knowledge, and confidence compared to traditional training.

## Contribution

A CDIO-based sequential tutorial system is shown to enhance training outcomes for novice emergency nurses.

## Key findings

- The CDIO group outperformed traditional training in theoretical knowledge, practical skills, and emergency response.
- The CDIO method significantly improved core competencies and self-efficacy in novice nurses.
- Training satisfaction was higher in the CDIO group, indicating a better learning experience.

## Abstract

To evaluate a CDIO-based sequential tutorial system for emergency-department (ED) novice nurses.

Forty novice nurses (nine male, 31 female; mean age 21.4 ± 0.9 years; predominantly bachelor’s degree holders) rotating in the ED were allocated by time period to either a CDIO group (n = 18, September 2022 to June 2023) or a traditional-tutorial group (n = 22, September 2021 to June 2022) for a 3-month program. Both groups received equal training hours. Outcomes were theoretical exam, practical-skills exam, emergency-response simulation, bedside synthesis, Core-Competence Scale, Role-Breadth Self-Efficacy (RBSE), and training satisfaction.

Compared with controls, the CDIO group achieved higher mean ± SD scores in theoretical knowledge (88.17 ± 4.99 vs. 82.91 ± 5.88, t = 3.007, p = 0.005), demonstrating enhanced understanding of emergency disease theory. Practical skills improved significantly (87.78 ± 5.74 vs. 82.32 ± 6.69, t = 2.734, p = 0.009), indicating better procedural competency. Emergency response performance was superior (90.33 ± 3.76 vs. 85.55 ± 6.17, t = 2.886, p = 0.006), reflecting improved crisis management. Bedside synthesis scores were higher (94.84 ± 2.28 vs. 91.89 ± 3.33, t = 2.800, p = 0.008), suggesting enhanced clinical integration. All seven core-competence domains showed significant improvement, with critical thinking showing the largest gain (3.22 ± 0.31 vs. 2.31 ± 0.39, p < 0.001). Post-training RBSE increased markedly to 22.33 ± 4.09 vs. 18.14 ± 5.15 (p < 0.01), indicating greater confidence in expanded role performance. Training satisfaction was higher (16.06 ± 2.10 vs. 14.59 ± 1.18, p = 0.008), reflecting positive learner experience.

A CDIO-sequential tutorial significantly improves ED novice nurses’ theoretical knowledge, operational skills, core competence, self-efficacy, and learning satisfaction. This structured approach offers a feasible and effective framework for standardized ED nurse training, with important implications for reducing transition shock and enhancing clinical preparedness in emergency care settings.