# Innovating transfusion training: a BOPPPS-based blended learning model to enhance nursing interns’ specialized competency

## TL;DR

A new blended learning model based on the BOPPPS framework improves nursing interns' theoretical knowledge and self-directed learning in transfusion skills training.

## Contribution

A BOPPPS-based blended learning model is proposed to address gaps in traditional nursing transfusion training.

## Key findings

- The experimental group showed significantly higher theoretical knowledge and self-directed learning scores.
- Thematic analysis revealed perceived learning benefits and competence improvements among participants.
- No significant difference was found in transfusion operational skills between the groups.

## Abstract

Traditional clinical internship training for nursing interns’ transfusion skills is commonly characterized by unstructured design and insufficient personalized guidance, which leads to inconsistent learning outcomes and inadequate self-directed learning abilities. High-stakes clinical procedures such as transfusion lack standardized, targeted training in the conventional rotational internship system, creating persistent educational gaps for nursing interns.

A quasi-experimental study was conducted between October and December 2024 among 78 nursing interns. Participants were allocated to a control group (n = 38) receiving traditional transfusion skills training, or an experimental group (n = 40) receiving blended specialty training based on the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary (BOPPPS) framework. Outcome measures encompassed theoretical knowledge, transfusion operational skills, and self-directed learning (SDL) abilities, assessed using validated questionnaires (Cronbach’s α > 0.7) and standardized objective structured skill evaluations. Semi-structured interviews were performed among the experimental group and analyzed via thematic analysis. Quantitative data with normal distribution were analyzed using independent-samples t-tests, with a significance level defined as p < 0.05.

The experimental group exhibited significantly higher scores in theoretical knowledge (68.91 ± 10.53 vs. 60.47 ± 17.03, p = 0.010) and SDL abilities (105.88 ± 7.30 vs. 94.84 ± 8.17, p < 0.001) compared with the control group. No statistically significant between-group difference was detected in transfusion operational skills (experimental group: 90.35 ± 2.02; control group: 89.71 ± 1.94; p = 0.160). Thematic analysis of interview data identified three core themes: recognized deficiencies in clinical specialty practice, recommendations for training model optimization, and perceived learning benefits and competence improvements.

The BOPPPS-based blended specialty training model effectively ameliorates key shortcomings in traditional nursing internship education by significantly enhancing nursing interns’ theoretical mastery of transfusion and self-directed learning capabilities. The high engagement and learning motivation observed in this study support the model as a structured, replicable, and complementary educational strategy for the conventional rotational internship. Integrating this standardized training model can help address the lack of formalized procedural skill training for high-risk clinical practices, thereby promoting consistent and high-quality clinical competency development among nursing interns.