Abstract: ObjectiveTo evaluate the application effect of online and offline mixed teaching model based on small class in surgical nursing teaching. MethodsStudents were divided into two groups (each with 54 students) .The experimental group was divided into two small classes which owned 27 students. Online and offline teaching were used in the experimental group and the control group was teached in traditional classroom teaching. Chapter test and final exam, teaching evaluation and classroom interaction between two groups were used to evaluate the teaching effect. Results The final exam scores was（83.17±6.73）in the experimental group and （80.00±4.94）in the control group, which showed to have statistically significant(P=0.006). The chapter test scores between two groups had no statistically significant (P>0.05). The score of classroom discipline, teaching content, teaching methods, teaching strategy, teaching effects, characteristics and innovations, and students‘ interaction in the experimental group were all higher than those in the control group, and the difference was statistically significant (P<0.05). ConclusionOnline and offline which based on small-class teaching can achieve the function of imparting knowledge as the traditional classroom teaching. It can also improved student recognition and participation. The teaching model is worthy of promotion in undergraduate surgical nursing teaching .

Key words: Small-class, Online and offline, Surgical nursing, Medical education