Objective To explore the effect of hierarchical phased teaching method with nursing disease knowledge as the assessment goal in elderly patients with lung cancer in clinical nursing teaching of thoracic surgery.Methods Ninety nursing students who practiced in the Department of Thoracic Surgery Chestsurgery of the First Hospital of Jilin University from July 2021 to June 2022 were selected as the study subjects and divided into the experimental group(n=45)and the control group(n=45)by the random number table.The experimental group used hierarchical phased teaching method,and the control group used traditional teaching method.After 4 weeks of teaching,the teaching effect of the two groups of students was compared through the nursing related theoreti-cal knowledge,operation skill examination and internship satisfaction questionnaire survey of elderly patients with lung cancer and the evaluation of nursing clinical decision-making ability.Results The scores of nursing related theoretical examination and operation skill examination of elderly patients with lung cancer in the test group were higher than those in the control group(P<0.05);the in-ternship satisfaction in the test group was higher than that in the control group(P<0.05);the evaluation of nursing clinical decision-making ability of students in the two groups showed that the undergraduate students in the test group were superior to the un-dergraduate students in the control group in the evaluation of problem finding ability,goal determination ability,decision plan ability,and total score(P<0.05);compared with the evaluation of nursing clinical decision-making ability of undergraduate students in the two groups,there were no significant differences in the five dimensions(P>0.05).Conclusion In clinical nursing teaching of tho-racic surgery,the application of hierarchical phased teaching method with nursing related theoretical knowledge and operation skills of elderly patients with lung cancer as the assessment goal improves the students'theoretical knowledge level,practical operation skills and clinical nursing decision-making ability,so that students are satisfied with clinical nursing teaching.This teaching method is worth popularizing and applying in clinical nursing teaching of thoracic surgery.