Effectiveness of OBE-oriented and online-offline blended teaching versus traditional lecture-based teaching in nuclear medicine nursing education: a multicenter prospective comparative study

Nuclear medicine nursing demands high professional competence, particularly in radiation protection and radiopharmaceutical management. Traditional lecture-based teaching (LBT) fails to meet modern training needs. Outcome-Based Education (OBE) and online-offline blended teaching are promising innovative models, but head-to-head multicenter evidence comparing their effectiveness in nuclear medicine nursing education is lacking. This study aimed to compare the teaching effectiveness of OBE-oriented and online-offline blended teaching versus traditional LBT, and to clarify their applicability for different trainee types. A multicenter prospective comparative study combined with historical control was conducted from January 2023 to December 2025 across three tertiary hospitals in China. A total of 322 nursing trainees were enrolled: 109 in the OBE group, 108 in the blended teaching group, and 105 in the LBT control group. All groups received 8-week standardized nuclear medicine nursing training (40 class hours). Outcomes included professional knowledge scores, practical operation pass rates, job competency scores, and trainee satisfaction rates. Subgroup analysis was performed by trainee type (interns vs. advanced practice nurses). After training, the OBE and blended teaching groups demonstrated significantly higher professional knowledge scores, practical operation pass rates, job competency scores, and satisfaction rates compared with the LBT group (all P < 0.001), with no significant differences between the two intervention groups (all P > 0.05). Subgroup analyses suggested potential differential effects by trainee type: among interns, blended teaching yielded somewhat higher professional‑knowledge scores (91.2 ± 4.5 vs. 89.8 ± 4.8, P = 0.042) and satisfaction rates (97.1% vs. 92.6%, P = 0.038); among advanced‑practice nurses, OBE‑oriented teaching showed marginally better job‑competency (90.3 ± 3.7 vs. 87.6 ± 4.1, P = 0.029) and practical‑operation (99.0% vs. 94.3%, P = 0.045) outcomes. Formal interaction testing for teaching‑model × trainee‑type did not reach statistical significance ( P ‑interaction = 0.071). These subgroup findings should be interpreted as exploratory hypothesis‑generating observations rather than definitive evidence for differential suitability. Both OBE-oriented and online-offline blended teaching are superior to traditional LBT in nuclear medicine nursing education. Exploratory subgroup analyses hint at possible differential benefits for interns versus advanced‑practice nurses, though formal interaction testing did not confirm statistically significant effect modification. Individualized training strategies warrant further validation in larger‑scale studies before widespread adoption. Not applicable. This is a multicenter prospective comparative study: the two intervention groups (OBE and blended teaching) were randomly allocated, while the control group was a historical non‑randomized cohort; hence it is not a full randomized controlled trial.