To evaluate the efficacy of a three-stage teaching model based on the Outcome-Based Education (OBE) concept in training resident physicians for laparoscopic hiatal hernia repair (LHHR).

A prospective randomized controlled trial was conducted, enrolling 40 resident physicians at Beijing Chaoyang Hospital Hernia and Abdominal Wall Surgery Center from June to December 2024. Sample size was estimated based on a two-sample mean comparison (α=0.05, power=80%), requiring 20 participants per group. Randomization was performed using the Fisher–Yates random number table (1983 edition) to generate 40 unique numbers (01-40), which were assigned sequentially according to enrollment; the first 20 were allocated to the traditional teaching group (n=20) and the remaining 20 to the OBE group (n=20). The traditional group received conventional training through self-directed learning and observation and the OBE group underwent a three-stage progressive training program. Outcomes were evaluated via theoretical tests, surgery completion rates, operative time, intraoperative metrics, and satisfaction surveys.

The OBE group scored significantly higher in theoretical assessments (P<0.001) and demonstrated significantly higher independent LHHR completion rates (75% vs. 30%, P=0.004) compared to the traditional group. The median operative time in the OBE group was 27.5 minutes shorter (P=0.023). No differences were observed in intraoperative blood loss or postoperative hospitalization (P>0.05). The OBE group reported superior clinical decision-making efficiency and training satisfaction (P=0.016).

The OBE-based three-stage teaching model effectively enhances resident physicians' theoretical mastery, surgical competency, and operative efficiency in LHHR. Its phased objectives and dynamic feedback mechanism establish a standardized framework for specialized surgical training, offering significant clinical implementation potential.