Objective To explore the effects of implementing a teaching and examination linkage model based on Constructivism theory for the course of Internal Medical Nursing. Methods Two classes of students enrolled in 2020 were randomly divided into an experimental group (n=60) and a control group (n=60).The control group received traditional education for the course of Internal Medical Nursing, while the experimental group was subjected to a teaching and examination linkage model based on Constructivism theory for the same course.This model integrated an anchored CBL (Case-Based Learning) scenarios library, random selection of teaching scenarios, and group-based scaffolded independent proposition.At the end of the semester, the critical thinking skills, self-directed learning ability, and performance in the final written exam were compared between the two groups. Results The scores of critical thinking ability, self-directed learning ability, case analysis questions, additional questions and final written exam in the experimental group were significantly higher than those in the control group (all P＜0.05). Conclusion The teaching and examination linkage model based on Constructivism theory can effectively cultivate students′ critical thinking ability and self-directed learning ability, and improve the learning outcomes.