AimThis study aimed to compare the critical thinking and clinical decision-making levels of first-year nursing students studying at two different universities that provide synchronous and asynchronous online distance education. MethodsThis research was applied as a pretest-posttest, quasi-experimental design. The study was conducted with the students taking the course Fundamentals of Nursing at two nursing schools that provided undergraduate education in the west of Turkey (School A and B) between May and June 2020. Seventy-one first-year students from School A and 56 first-year students from School B participated in the study. The Student Descriptive Information Form, Critical Thinking Disposition Scale, and Clinical Decision-Making Scale were used for collecting data. ResultsThe study revealed that online distance education methods did not create a difference in the first-year nursing students' critical thinking and clinical decision-making levels. However, a positive significant relationship was found between critical thinking level and clinical decision-making. ConclusionIn this study, it was concluded that synchronous and asynchronous online distance education was not superior to each other in terms of critical thinking and clinical decision-making levels of first-year nursing students. Based on the results of the research, critical thinking and new research can be done on how to make effective practices in improving the level of thinking and clinical decision-making. Thus, different research results can be compared and it can be decided how to make more effective practices related to distance education practice.