Objective To explore the practice effect of online and offline blended teaching based on error management training in baccalaureate nursing students′ clinical skills teaching in the operating room. Methods A total of 87 baccalaureate nursing students were divided into a control group (n=43) and an intervention group (n=44) chronologically. The control group was taught clinical skills in the operating room adopting traditional method, while the intervention group was taught using online and offline blended teaching based on error management training. After practicing in the operating room, the theoretical and skill examination scores, and the scores of self-directed learning ability between the two groups were compared.Results In the intervention group, the skill examination score, the total score and each subscale score of self-directed learning ability were significantly higher than those in the control group (all P＜0.05). Conclusion Practice of the online and offline blended teaching based on error management training is conducive to improving baccalaureate nursing students′ clinical skills in the operating room and self-directed learning ability, so as to enhance the quality of clinical nursing teaching.