Purpose: This study examined the effect of the blended learning method during self-practice of transfusion therapy on nursing students’ academic achievement in transfusion therapy, confidence in performing transfusion therapy, self-directed learning ability, and satisfaction with self-practice. Methods: The study design was a non-equivalent control group pretestposttest quasi-experimental design. The participants were 75 nursing students divided into two groups: 38 in the experiment group and 37 in the control group. The blended learning method, combined with face-to-face and online learning, was applied to the experimental group’s self-practice from October 12 to 30, 2020. For the control group’s self-practice, face-to-face learning without online learning was employed. Results: The experimental group showed significantly better academic achievement than the control group. There were no significant differences in confidence in performance, self-directed learning ability, and satisfaction with self-practice between the two groups. Conclusion: This study showed that the blended learning method combined with face-to-face learning and online learning in self-practice significantly affected academic achievement. Further studies are needed to identify effective online learning methods for nursing practice.

Purpose: Simulation-based education combined with mastery learning is more effective than simulation-based education alone. This study aimed to evaluate its effectiveness with regard to both technical and non-technical skills of simulation-based mastery learning (SBML) in blood transfusion training among undergraduate nursing students. Method: A nonequivalent control group pretest-posttest design was used. Fifty-one second-year students at a college of nursing in W city, South Korea, who had not started clinical practice were selected by convenience sampling and allocated to either the experimental or control group using the zigzag method. SBML program was consisted of a diagnostic test, repeated learning and formative assessments for non-passers. All outcome variables were measured before and after completion of the program. Results: The experimental group showed significantly increased performance scores of blood transfusion as compared to the control group (z=29.50, p＜.001), with better outcomes in number of students achieving minimum passing score (χ2 =20.07, p＜.001), self-confidence (F=17.68, p＜.001), and communication skills (z=166.00, p=.003). Conclusion: This program was effective for undergraduate students to better improvement in performance, self-confidence, and communication skills, which can ensure greater safety in the transfusion. The results suggest that SBML ensures skill acquisition for clinical practice through improved performances in both technical and non-technical skills.

Purpose: The purpose of this study was to investigate the effect of debriefing learning using peer feedback after blood transfusion nursing simulation practice. Methods: This study is a mixed method research to investigate the effect of debriefing using peer feedback on learning. The subjects of this study were third-year nursing students, and 23 of them were allocated to the control group and 19 to the experimental group. The experimental treatment was performed for about three hours, and the debriefing using peer feedback was not performed with the control group. The effect of the debriefing was measured in terms of the knowledge, attitude, and confidence in the performance with regard to blood transfusion nursing. The qualitative data about cognitive learning experience during the debriefing were analyzed. The quantitative data were analyzed by a t-test, a x² test, and a paired t-test by using IBM Statistics SPSS 19.0 software. Results: The results showed that the knowledge was significantly increased in both the control group and the experimental group (paired t=-6.411, p<.001; paired t=-5.759, p<.001), that the attitude toward the blood transfusion nursing was not significantly changed in both groups (paired t=-0.639, p=.530; paired t=-0.631, p=.536), and that the confidence in the performance was significantly increased in both groups (paired t=-5.124, p<.001; paired t=-4.747, p<.001). The qualitative data analysis of the cognitive learning experience during the debriefing showed that the content was divided into four subjects: “My errors are clearly seen as I reflect on myself,” “I can understand how to say and perform,” “I could make the knowledge my own by reviewing what I have done,” and “I could have see the big picture of nursing skills.” Conclusion:. The results of this study showed that the debriefing using peer feedback after the simulation had the learning effects of repeated learning and experiential learning of specific nursing skill, indicating that it is a useful education tool in nursing education.

대상사건에서 무수혈에 의한 고관절 시술을 요구한 피해자의 요청에 응한 피고인은 피해자에 대한 인공고관절 치환술을 계속 진행하게 되면 대량출혈의 개연성을 갖고 있음을 예견할 수 있음에도 불구하고 피해자에 대한 시술행위를 중단하지 않고, 진행하였다. 그 결과 피해자의 대퇴골부 주변에 있던 혈관이 파열되었고, 그 파열된 혈관에서 3500cc 이상의 출혈이 발생하였다. 이러한 급격한 대량출혈은 일반적으로 범발성 응고장애를 야기하기 때문에, 피해자도 이런 장애로 지혈이 되지 않아 죽게 되었다. 대상사건의 사실관계가 이와 같다면, 피해자는 무수혈에 의한 수술 때문에 사망한 것이 아니지만, 피고인의 의료과실에 의한 수술로 사망한 것은 인정해야 할 것으로 보인다. 왜냐하면 피고인의 피해자에 대한 고관절수술은 처음부터 대량출혈의 가능성이 예상되었고, 수술과정에서 그런 출혈의 높은 개연성을 인식할 수 있었으며, 그렇다면 시술하지 말거나 중단했어야 함에도 피고인은 피해자에 대한 수술행위에 착수하였을 뿐만 아니라, 중단하지도 않음으로써 범발성 응고장애를 야기한 대량출혈을 일으켜 피해자를 죽게 하였기 때문이다. 따라서 피고인은 의료인으로서 요구되는 주의의무를 위반한 시술행위로 피해자를 죽게 함으로써 업무상과실치사상죄에 해당된다고 할 것이다. 한편 대상사건의 경우 피해자를 위한 인공고관절 치환술을 무수혈 방식으로 시술하는 과정에서 무수혈 방식을 요청한 피해자의 자기결정권 내지 피해자의 승낙은 업무상 과실치사죄의 위법성 조각과는 직접적 관련이 없어 보인다. 혹여 피고인의 행위가 피해자에 의한 무수혈 방식의 지속적 요청에 부합한 수술행위이며 그 결과로 피해자가 사망에 이르렀다고 하더라도, 대상사건의 경우 피해자가 인공고관절 치환술로 죽을 수 있음을 충분히 예상하고, 무수혈을 승낙한 것으로 보이지 않기 때문에, 피해자의 승낙에 의해 위법성도 조각될 수 없다.