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The dialectical dynamic dual-main teaching theory, based on He Kekang’s dual-main teaching model, emphasizes the dynamic adjustment of teacher and student roles to enhance learning. This study applies this theory to in-service training for neonatal nurses and aims to empower students and optimize training by integrating teacher–student competition mechanisms. This study aims to evaluate the effectiveness of the dialectical dynamic dual-main teaching model in training new neonatal nurses and to provide a reference for improving in-service nursing education. Nurses were divided into two groups based on their year of entry using a historical control design. The study included 46 new nurses who received first-year training in the neonatal department of a single hospital between July 1, 2018, and June 30, 2022. They were divided into two groups: a control group (those who received traditional training between 2018 and 2019) and an experimental group (those who received training using the dialectical dynamic dual-main teaching model between 2020 and 2021). Evaluation was conducted using theoretical, practical, and comprehensive nursing assessment scores, and results were obtained using the nurse core competency scale. There were no significant differences between the two groups of new nurses in terms of age ( P = 0.772), gender ( P = 0.151), educational level ( P = 0.936), and standardized training experience ( P = 0.084). The significance level for hypothesis testing was set at α = 0.05. Except for the first month’s theoretical scores ( P = 0.139, Cohen’s d = −0.447), the experimental group had significantly higher scores on theoretical, practical, and comprehensive nursing assessments at all time points compared with the control group ( P < 0.05). The overall competency (25.98 ± 4.14, P = 0.018, Cohen’s d = −0.709), management (3.45 ± 0.55, P = 0.002, Cohen’s d = −0.965), communication (3.39 ± 0.53, P = 0.012, Cohen’s d = −0.764), teaching (3.30 ± 0.40, P = 0.001, Cohen’s d = −1.049), and comprehensive knowledge ability (3.36 ± 0.69, P = 0.010, Cohen’s d = −0.766), and critical thinking ability (3.09 ± 0.61 vs. 2.67 ± 0.56, P = 0.018, Cohen’s d = −0.731) scores of the experimental group were significantly higher than those of the control group. These findings suggest that the dialectical dynamic dual-main teaching theory significantly improves training outcomes for newly hired nurses. The dialectical dynamic dual-main teaching model significantly improved the training of new neonatal nurses and enhanced their theoretical, practical, and comprehensive nursing assessment scores as well as their core competencies. This approach was effective and warrants further research. • The Dual-Main Model enhances theoretical, practical, and comprehensive assessment scores of new neonatal nurses. • The model leads to substantial improvements in new nurses' core competencies: management, communication, and teaching proficiency. • Dynamic role adjustments between teachers and students effectively optimize in-service training for neonatal nurses. • The research offers valuable insights for improving in-service nursing education through innovative teaching approaches. • This teaching model shows promise for broader implementation in clinical nurse training programs.
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