Objectives: To evaluate the effectiveness of an innovative teaching framework combining sandwich methodology and microteaching in improving emergency skill training outcomes among resident physicians. Methods: A randomized controlled trial was conducted involving 92 residents enrolled in standardized training programs. Participants were randomly allocated into two groups: the Experimental Group (EG, n=46), which received training via the sandwich-microteaching method in a simulated ICU, and the Control Group (CG, n=46), which received conventional teaching. Both groups underwent identical core curriculum content. Data collected included demographics (gender, age, resident year), theoretical knowledge scores, practical skill performance scores, self-assessed mastery levels, and course satisfaction. Results: Baseline characteristics showed no significant differences between groups (gender p=0.527, age p=0.394, resident year p=0.661). The EG demonstrated significantly higher theoretical scores (94.80±1.54 vs. 92.70±3.48, p<0.001) and practical skill scores (93.65±3.06 vs. 89.20±4.74, p<0.001) compared to the CG. Satisfaction rates were markedly elevated in the EG (95.65% vs. 78.26%, p=0.030). While overall self-assessed mastery distributions were similar (p=0.193), the EG reported a higher proportion of expert-level mastery (self-assessed level 10). Conclusion: This innovative teaching framework significantly improves emergency skill proficiency and learner satisfaction, while fostering clinically meaningful improvements in self-perceived expertise. The combined sandwich-microteaching approach represents a promising strategy for high-quality emergency skill training in residency programs.