Objective To evaluate the methodology and effect of network-based nurse-patient joint simulative observership in the course of Internal Medical Nursing. Methods A total of 418 undergraduate nursing students enrolled in 2018 were treated as the simulative observership group, who were subjected to a network-based nurse-patient joint simulative observership program which combined real patients and nurse-patient simulative scenarios. Another batch of 417 students enrolled in 2017 were treated as the control group, who were subjected to conventional clinical observership. Results At the completion of the observership program, there was no significant difference between the 2 groups′ academic scores (P＞0.05). The simulative observership group had higher scores in self-directed learning ability， clinical communication ability and cooperative learning ability, than before joining the observership program (P<0.05 for all); over 80.00% of the students in the former group were satisfied with the observership program they attended, and acknowledged an improvement in knowledge and skill level of internal medical nursing. Conclusion The network-based nurse-patient joint simulative observership program achieves the same effect as field observership, and improves students′ comprehensive ability, making it a good alternative.