Background <p>In the context of rapid surgical technological advancement, the operating room (OR) nursing workforce faces increasing demands for specialized competency. Sub-specialty rotation training models for junior nurses, when designed with a focus on both individual ability and clinical demand orientation, can ensure comprehensive and systematic acquisition of professional skills across diverse surgical disciplines. Such models also ensure that training programs are closely aligned with the practical needs of frontline clinical medical staff, thereby enhancing both individual performance and collective healthcare outcomes.</p> Purpose <p>To evaluate the effectiveness of a competency and needs-oriented sub-specialty rotation training model for junior operating room (OR) nurses, and to provide evidence-based recommendations for improving comprehensive abilities, job competency, and professional satisfaction in perioperative nursing practice.</p> Methods <p>A quasi-experimental study with a historical control design was conducted. The control group comprised 21 junior nurses who received conventional training from July 2021 to June 2023, while the observation group comprised 23 nurses who participated in a competency and needs-oriented sub-specialty rotation training program from July 2023 to June 2025. Multiple outcomes were compared between the two groups, including comprehensive assessment scores (theoretical, skills, and clinical practice), job competency evaluations, surgeon satisfaction with intraoperative collaboration, and nurses’ self-reported work stress levels. All evaluations were conducted by blinded assessors who were not involved in the training program.</p> Results <p>The observation group demonstrated significantly higher comprehensive assessment scores, job competency ratings, and surgeon satisfaction with intraoperative collaboration compared to the control group (<i>P</i> &lt; 0.05 for all). Specifically, the observation group showed a mean theoretical assessment score of 89.89 ± 5.54 versus 85.57 ± 5.19 in the control group (<i>P</i> = 0.011). Skills assessment scores were 94.70 ± 2.20 versus 91.95 ± 3.60 (<i>P</i> = 0.004), and clinical practice scores were 94.26 ± 1.80 versus 92.36 ± 1.70 (<i>P</i> = 0.001). Additionally, the observation group reported significantly lower work stress scores (4.31 ± 0.15) than the control group (4.43 ± 0.12, <i>P</i> = 0.003). Surgeon satisfaction scores were also significantly higher in the observation group (87.42 ± 4.92) compared to the control group (83.44 ± 4.88, <i>P</i> &lt; 0.001).</p> Conclusion <p>The competency and needs-oriented sub-specialty rotation training model significantly enhances junior OR nurses’ comprehensive abilities and job competency, improves surgeon satisfaction with intraoperative collaboration, and effectively reduces nurses’ work stress. While this study demonstrates promising results, further validation through multi-center studies is warranted to confirm the model’s broader applicability in perioperative nursing education.</p>