<p>In professional education, cultivating students’ abilities in communication, cooperation, reflection, and problem solving is a crucial objective. Taking nursing student training as an example, cooperative learning involves collectively discussing the evaluation and management of first aid cases. This aims to help students comprehend their roles and responsibilities throughout the first aid process. The Situation-Cooperation-Conversation-Sensemaking (SCCS) mode is a commonly adopted training procedure. However, due to concerns about patient safety, it cannot provide authentic first aid situations, thus limiting its effectiveness in terms of developing students’ task handling and problem-solving abilities. Moreover, in the conventional SCCS (C-SCCS) mode, it is also challenging to examine the behaviors of high and low achievers to examine the effectiveness of the learning mode from a different angle. To address these issues, the present study proposed a metaverse-enabled SCCS (M-SCCS) learning approach which guided students in cooperative learning to solve real-life cases in a virtual environment. In this study, we conducted triangulation of its effectiveness by comparing students’ performance and perceptions, and exploring the relationship between these factors and their behavioral patterns. A total of 98 junior nursing students from two pediatric first aid training classes at a technological university participated in the study. One class, comprising 50 students, served as the experimental group which adopted the M-SCCS learning approach; the other, with 48 students, served as the control group which adopted the C-SCCS learning approach. This study aimed to compare differences between the two groups’ learning achievement, learning behaviors of high and low achievers, and their perceptions. The results revealed that the M-SCCS enhanced students’ learning achievement and positive learning behaviors in pediatric first aid compared to the C-SCCS learning approach.</p>