Background <p>The rapid advancement of technology and expansion of online learning environments require innovative educational methods tailored to digital contexts. Team-based learning (TBL) has shown promise in promoting engagement and collaborative problem solving; however, its long-term effectiveness in relation to online platforms, especially in emergency nursing education, remains underexplored. This study aimed to evaluate the effects of online TBL on academic self-efficacy, learning immersion, and learning interest among nursing students.</p> Methods <p>A total of 91 nursing students were randomly assigned to either an experimental group (<i>n</i> = 46), which participated in TBL via an online collaboration platform, or a control group (<i>n</i> = 45), which used traditional paper-based TBL. Data were collected at three time points—baseline (pre-test), four weeks, and eight weeks post-intervention—using validated structured questionnaires. Repeated measures analysis of variance (ANOVA) was used to analyze changes over time.</p> Results <p>No statistically significant differences were observed between the groups at baseline and after four weeks. However, at eight weeks, the experimental group showed significantly higher scores for academic self-efficacy (t = 2.09, <i>p</i> = 0.039), learning immersion (t = 2.30, <i>p</i> = 0.024), and learning interest (t = 2.85, <i>p</i> = 0.006) than the control group. These findings indicate that the benefits of digital TBL emerge over time.</p> Conclusions <p>Online TBL effectively enhances the academic self-efficacy, engagement, and motivation of nursing students. The use of digital platforms enables real-time collaboration regardless of geographic location. Future strategies should incorporate peer interaction and scaffolded tasks to promote active learning in healthcare education.</p>