This study reviewed the use of simulation-based learning (SBL) to teach nursing in 2016 in a nursing course for certification in emergency care. This study also examined learning support, which served as a scaffold for on-campus practice in 2017. Nursing notes following SBL in 2016 were assessed with a rubric used in practical training, and the average score was low (68％). Thus, case-based learning (CBL) was implemented in 2017 prior to SBL, and feedback was provided after CBL and SBL. The score was 10.20±2.20 points in 2016 and 14.10±1.52 points in 2017. The course design in 2017 resulted in more effective learning than that in 2016. In 2016, a heavy extraneous load (cognitive load theory) was imposed, but, the course design in 2017 decreased the extraneous load, allowing students to take on the germane load. Students presumably built a schema using pre-existing knowledge from classroom lectures in their long-term memory.