Objective To improve critical thinking ability and test performance of baccalaureate nursing students practicing in the department of neurosurgery. Methods Two hundred baccalaureate nursing students practicing in the department of neurosurgery were divided into two groups chronologically, with 100 in each group. The control group was given traditional clinical mentoring, while their counterparts in the intervention group received mentoring by adopting modified observation-teaching-discussion pedagogy combined with microteaching. Theoretical knowledge, technical skills and critical thinking ability of the two groups were compared. Results The scores of theoretical knowledge, technical skills and critical thinking ability of nursing students in the intervention group were significantly higher than those in the control group (P<0.01 for all). Conclusion Using modified OTD pedagogy in combination with microteaching can promote theoretical knowledge, technical skills, and critical thinking ability of nursing students.