Purpose: The global emphasis on preventing and systematically managing acute cardiac arrest necessitates improved education in cardiovascular emergencies. This study aims to provide foundational data on the effectiveness of simulation-based cardiovascular emergency management education, applying the think-aloud method for nurses. Method: A one-group pre-posttest experimental design was used from July 29 to August 15, 2022. Twenty-eight nurses participated in this study. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test with SPSS/WIN 25.0. Results: The educational intervention showed statistically significant improvements in outcomes: knowledge of cardiovascular emergency management (Z=-4.24, p<.001), confidence in cardiovascular emergency management (Z=-4.63, p<.001), clinical reasoning competence (Z=-4.16, p<.001), and self-efficacy for group work (Z=-3.47, p=.001), and selfregulation for group work (Z=-2.29, p=.022). Conclusion: This study indicates that the use of the think-aloud method in simulation-based learning can effectively enhance cardiovascular emergency management training by reducing learners’ cognitive load. Cardiovascular emergency management competencies can be strengthened through the development of diverse educational strategies and the expansion of training support.