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Self-efficacy as a mediator in the relationship between clinical learning environment and core nursing competence of intern nursing students: a multicentre cross-sectional study

Yunxia Pu, Hong-Mei Xie, Lan Fu, Xiaoxia Zhang, T. Long, Xiaotian Su, Xiao-Juan Feng, Xian-Qiong Feng

BMJ Open, 2025

13 citations

Abstract

Objective The aim of this study was to examine the relationships between Chinese intern nursing students’ self-efficacy, the clinical learning environment, and core nursing competence. In addition, self-efficacy was investigated as a mediator in the association between the clinical learning environment and core nursing competence. Design This study used a cross-sectional, descriptive research design. Setting 15 nursing colleges and universities in China were the setting for the study. Participants The participants were 552 nursing student interns. Primary and secondary outcome measures The participants completed measures of general self-efficacy and nursing student core competencies. Results Participants’ mean scores indicated they were satisfied with the clinical learning environment (123.02±19.62), their self-efficacy was at a medium-high level (29.71±5.25), and their core competence was at the upper intermediate level (148.73±22.63). Core nursing competence was positively correlated with self-efficacy and the clinical learning environment (r=0.597, p<0.001; r=0.549, p<0.001). The clinical learning environment (β=0.362, p<0.001), duration of clinical practice (β=0.131, p<0.001) and self-efficacy (β=0.406, p<0.001) were identified as significant predictors of core nursing competence. Self-efficacy partially mediated the association between perception of the clinical learning environment and core competence level, accounting for 45.88% of the overall effect. Conclusions…

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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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