To investigate whether an enhanced blended learning approach can effectively address the surgical procedural competence gap in medical students entering clinical practice.

A randomized controlled trial was conducted with 63 third-year undergraduate medical students from Nanjing University School of Medicine. The intervention group engaged in an integrated online-offline curriculum delivered through triad learning groups, while the control group received conventional in-person training. Outcomes were assessed through objective structured clinical examinations (OSCE) and a comprehensive satisfaction survey after a 3-month intervention period.

The study was conducted at Nanjing University School of Medicine, Nanjing, China.

Third-year undergraduate medical students.

The blended learning cohort demonstrated significantly higher overall performance in technical skill assessments (p < 0.05), with notable advantages in surgical gown/glove donning technique, incision creation and wound closure, wound dressing management and suture removal, and intestinal anastomosis procedures. No significant intergroup difference was observed in surgical hand scrub proficiency (p = 0.095). While overall course satisfaction levels were comparable between groups, blended learning participants reported significantly greater confidence in skill retention (p = 0.03) and perceived clinical relevance of acquired competencies (p = 0.01).

The enhanced blended learning model significantly improves surgical skill acquisition compared to traditional teaching methods, particularly when implemented through small-group collaborative learning structures. This approach maintains comparable learner satisfaction while better preparing students for the clinical application of surgical techniques. The study provides evidence for the effectiveness of the enhanced blended learning model in medical education.