<p>The level of practical skills determines whether vocational school students can perform specific jobs competently. Currently, few studies have focused on how to effectively improve vocational students’ practical skill levels. This study examined the effects of blended learning approaches on learners’ practical skill performance, self-regulation ability, interest, and behavior. This study had two objectives: first, to evaluate which learning approach is more effective in enhancing practical skill proficiency among vocational school students; second, to provide an explanatory analysis of students’ learning processes. Employing a 2 (type of operation: virtual simulation vs. hands-on activity) × 2 (video review: without vs. with) between-subject design, 130 participants were randomly assigned to one of four conditions: virtual simulation alone, virtual simulation with video review, hands-on activity alone, and hands-on activity with video review. Results indicated that blended learning approaches integrating virtual simulations or hands-on activities with video reviews more effectively enhance vocational students’ practical skills performance. Without video review, hands-on activities significantly enhanced vocational students’ practical skills performance more effectively than virtual simulations. The video review intervention enhanced learning performance in both virtual simulations and hands-on activities while eliminating the effectiveness difference between these two learning approaches. Additionally, video review acted as a scaffold that significantly promoted participants’ self-regulated learning and learning interest. Furthermore, behavioral sequence analysis revealed that video review triggered more structured reflective patterns. Vocational schools, particularly those with limited resources, may adopt blended learning approaches to cultivate students’ practical skills, especially using video review as a supplementary tool.</p>