Objective:To explore the application effect of the three-stop simulation case library of pre-examination triage skill-team cooperation in the clinical practice teaching of emergency nursing students under the guidance of Roy’s adaptation theory.Methods:Seventy-two nursing students who practiced in the emergency department of our hospital from January to December 2022 were selected. According to the establishment of the simulation case library, they were divided into the control group (36) and the observation group (36). The control group applied theory professors and individual skills training and other conventional teaching methods. The observation group applied the sub-station simulation case library for teaching and training. Compared the theoretical and operational results of the two groups of students before and after teaching, the comprehensive ability and teaching satisfaction were evaluated after teaching.Results:After the teaching, the theoretical and operational results of the two groups of nursing students were significantly improved, and the observation group was higher than that of the control group〔the theoretical results: 90.75±4.05 vs. 84.86±5.25; theoperationalresults: 94.58±3.42 vs. 89.92±5.17〕(P<0.05). The comprehensive ability of the nursing students in the observation group included first aid practice ability, condition observation ability, independent learning ability, communication and cooperation ability, emergency response ability, and clinical thinking ability. The overall satisfaction score of the nursing students in the observation group was also higher than that of the control group, and the difference was statistically significant (P<0.05).Conclusion:Guided by Roy’s adaptation theory and based on the real-world emergency route, a three-stop scenario simulation teaching of pre-examination triage-single skills-team cooperation is established to effectively improve the theoretical performance, operational skill level and clinical practice ability of emergency nursing students, which is well accepted by the majority of nursing students.