Objective <p>To evaluate the comparative effectiveness of video-based peer feedback (VPF) versus video-based expert feedback (VEF) in fundamental skill acquisition among residents.</p> Methods <p>In this randomized controlled trial, 33 surgical residents were allocated to either VPF (<i>n</i> = 17) or VEF (<i>n</i> = 16) groups. Both groups completed training in three fundamental skills: (1) wound dressing change with suture removal, (2) indwelling urinary catheterization, and (3) simple interrupted suture. Following training, performance was assessed via objective structured clinical examination (OSCE).</p> Results <p>Both groups demonstrated significant improvement across all skills (<i>P</i> &lt; 0.05). Comparative analysis revealed superior performance by the VPF group in wound dressing change with suture removal (<i>P</i> &lt; 0.05), while no significant intergroup differences were observed for catheterization or suturing (<i>P</i> &gt; 0.05). Notably, among Professional Master of Medicine candidates, VPF showed significant advantages in both wound care and catheterization (<i>P</i> &lt; 0.05).</p> Conclusion <p>VPF demonstrates comparable efficacy to VEF for all fundamental skills, with superior outcomes for specific procedures and learner subgroup. These findings position VPF as both a viable alternative and potentially preferred methodology for targeted applications in surgical residency training.</p>