Exploration of CDIO-Based Training Mode with A Sequential Teaching Approach for Emergency Department Novice Nurses

Chen LinQianqian JinXiu HuangDejun Liao^*

• The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

Objective: To evaluate a CDIO-based sequential tutorial system for emergency-department (ED) novice nurses. Methods: Forty novice nurses (9 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 three-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. Results: 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. Conclusion: 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.