Purpose: This study aimed to develop an emergency department (ED) in a virtual reality space using ZEPETO, an augmented reality avatar service, and to verify the effect of applying the metaverse-based emergency nursing simulation (MENS) in the developed virtual ED. Methods: This study used a one-group pre-post experimental design to verify the effect of the MENS performed in the developed space. An ED was created in a virtual space using ZEPETO's Studio Build-it program. The MENS used a three-phase design: scenario development (120 minutes), simulation in ZEPETO (70 minutes), and debriefing (30 minutes). The MENS in ZEPETO was performed from September to October 2022 for 57 nursing students, and a pre-post questionnaire was conducted. Results: There was no significant improvement in the participants’ communication (t=?1.09, p=.281), problem-solving process (t=?1.65, p=.105), and learning self-efficacy (t=?1.38, p=.172) after MENS. However, among the sub-factors of communication, “connectioning” (t=?2.22, p=.030) and rapport building (t=?2.27, p=.027) were significantly improved. After MENS, applying the solution, a sub-factor of the problem-solving process, showed an increase (t=?2.31, p=.025). Conclusion: Various programs based on the metaverse will have to be designed and...