Purpose: This study was conducted to compare blended practicum with clinical and lab combined e-learning between cooperative and individual group on learning outcomes. Method: A total of 63 junior Nursing students were recruited from C University in G city from May, 2012 to June, 2012. Ten hours lab practicum for two weeks was provided for both two groups during the period of adult nursing practicum. Prior to blended practicum, e-learning was conducted. For cooperative group, two hours off line team learning with a tutor for eight weeks was provided, in other hands, for individual group, any off line team learning was not provided and self study on line was not evaluated by the tutor. Results: The result of ANCOVA showed that critical thinking and self directed learning were significantly improved in the individual group compared to the cooperative group (F=-18.15, p<.001; F=28.12, p<.001). In other hands, clinical competence was significantly higher in the cooperative group than in the individual group (F=16.61, p<.001). Conclusion: Through development of self-leaning facilitating online contents, the blended practicum combined e-learning could be effective in critical thinking, self-directed learning and clinical competence. Further studies about e-learning strategies of off-line learning are still needed.