To evaluate the effectiveness of the 7E teaching model based on real clinical cases in nursing students' clinical rounds. Nursing rounds, as an integral component of clinical teaching, are designed to reinforce professional knowledge, foster critical thinking and enhance practical skills. However, the traditional teacher-centered approach often results in passive learning and low efficiency. Therefore, it is crucial to explore methods that engage students, promote active learning and cultivate clinical reasoning and practical abilities. Quasi-experimental study. Fifty nursing students who participated in clinical internships from July 2022 to April 2023 were assigned to the control group, receiving traditional rounds. An additional 52 students, who interned at the same hospital from July 2023 to April 2024, formed the experimental group and received rounds based on the 7E model using real clinical cases. Critical thinking, self-efficacy and clinical practice abilities were compared between the two groups. Clinical practice was assessed using the Nursing-Mini-CEX scale, covering eight dimensions: nursing interview, physical examination, nursing diagnosis, nursing interventions, health consultation, humanistic care, organizational effectiveness and overall evaluation. Data were analyzed using SPSS 27.0 software with t-tests and chi-square tests. After the intervention, the experimental group demonstrated significantly higher critical thinking, self-efficacy and clinical practice abilities compared with the control group (P < 0.05). The 7E teaching model based on real clinical cases is more effective than the traditional round approach, significantly enhancing nursing students' critical thinking, self-efficacy and clinical practice abilities.