The study evaluated a CDIO-based sequential teaching system for 40 novice nurses (9 male, 31 female, mean age 21.4 ± 0.9 years) in an emergency department. The CDIO group (n=18) was compared with a traditional teaching control group (n=22) during the 3-month program. The CDIO group scored higher in theoretical knowledge (88.17 ± 8.29 vs. 83.07 ± 3.00, p=0.005), practical skills (87.78 ± 5.74 vs. 82.32 ± 6.69, p=0.009), and emergency response (90.33 ± 3.76 vs. 85.55 ± 6.17, p=0.006). Bedside synthesis was better (94.84 ± 2.28 vs. 91.89 ± 3.33, p=0.008), all seven domains of basic competencies improved significantly, especially critical thinking (3.22 ± 0.31 vs. 2.31 ± 0.39, p<0.001). Role and breadth self-efficacy (RBSE) rose to 22.33 ± 4.09 vs. 18.14 ± 5.15 (p<0.01) and satisfaction with training at 16.06 ± 2.10 vs. 14.59 ± 1.18 (p=0.008). The sequential CDIO approach improves the theoretical knowledge, skills, competences, self-efficacy and satisfaction of nurses. It offers a workable framework for reducing transient shock and increasing clinical preparedness.