Association of learning environment and self-directed learning ability among nursing undergraduates: a cross-sectional study using canonical correlation analysis

A structural equation model of psychological capital, self-directed learning, and learned helplessness: Implications for postgraduate nursing education

BACKGROUND

Postgraduate nursing students face complex academic-clinical integration challenges that may precipitate learned helplessness and impede professional development. The mechanisms through which psychological capital and self-directed learning influence learned helplessness in nursing education remain incompletely characterized.

OBJECTIVE

This study aimed to (1) evaluate the prevalence and determinants of learned helplessness among postgraduate nursing students, and (2) analyze the mediating pathways between psychological capital and learned helplessness through self-directed learning components.

DESIGN

Multiple academic medical centers and affiliated teaching hospitals across Chinese provinces.

SETTING

Conducted across multiple universities and hospitals in various provinces of China.

PARTICIPANTS

Full-time and part-time postgraduate nursing students and clinical nurses with completed postgraduate degrees were recruited between September and October 2024.

METHODS

Validated instruments assessed psychological capital (PCQ-24), self-directed learning (SRSSDL), and learned helplessness (LHQ). Analyses included descriptive statistics, stepwise regression, and structural equation modeling with 5000-sample bootstrapping to evaluate cognitive and interpersonal mediation pathways.

RESULTS

Participants demonstrated moderate-to-high learned helplessness (41.86 ± 14.03). Multiple regression analysis identified four significant protective factors: higher levels of hope (β = -0.29), enhanced learning awareness (β = -0.20), stronger professional identity (β = 0.23), and supportive mentor communication styles (β = 0.23) (all P < 0.01). In the mediation analysis, cognitive self-directed learning accounted for 81.8 % of the psychological capital-learned helplessness relationship, while interpersonal relationships mediated 23.4 %.

CONCLUSIONS

Psychological capital significantly reduces learned helplessness through dual pathways, primarily through cognitive self-directed learning and secondarily through interpersonal relationships. Educational interventions should adopt a comprehensive approach: (1) implementing psychological capital training programs incorporating resilience workshops and reflective practices, (2) transitioning to competency-based, self-directed learning models, and (3) establishing adaptive mentorship frameworks that prioritize supportive communication styles. These evidence-based strategies could effectively mitigate learned helplessness and enhance academic success among postgraduate nursing students.

The mediating effect of advanced health assessment on the relationship between self-directed learning and clinical thinking among master of nursing specialist postgraduate students: A structural equation model

BACKGROUND

Clinical thinking is an important competency among master of nursing specialist (MNS) postgraduate students. Previous studies have demonstrated that self-directed learning (SDL) positively affects clinical thinking among MNS postgraduates. However, little is known about the mechanisms underlying the relationship between SDL and clinical thinking.

AIM

This study aimed to investigate the status of MNS postgraduates' SDL, advanced health assessment (AHA), and clinical thinking and to explore the mediating effect of AHA on the relationship between SDL and clinical thinking through a structural equation model.

DESIGN

Cross-sectional study.

SETTINGS

Participants were recruited from 7 universities in Anhui, Hubei, Hebei, and Heilongjiang provinces, China.

PARTICIPANTS

A convenience sample of 300 MNS postgraduates was recruited from May 2023 to July 2024.

METHODS

A general information questionnaire, SDL instrument, AHA scale, and clinical thinking scale were used for data collection. Data were analyzed using SPSS and AMOS software.

RESULTS

The levels of SDL, AHA, and clinical thinking among the participants were above the middle level. AHA played a partial mediated role in the relationship between SDL and clinical thinking.

CONCLUSIONS

This study provides new insights into the relationship between SDL, AHA, and clinical thinking. The results of this study indicate the effectiveness of developing AHA when conducting SDL to enhance the clinical thinking of MNS postgraduates.

Serial multiple mediation of psychological capital and self-directed learning ability in the relationship between perceived stress and professional identity among undergraduate nursing students in China: a cross-sectional questionnaire survey

BACKGROUND

Professional identity has a positive impact on the career development, job satisfaction, and job performance of undergraduate nursing students, and it is also an important foundation for their future nursing careers. Therefore, it is necessary to explore the influencing factors of professional identity and the inherent relationships between these factors.

OBJECTIVE

This study aims to investigate the serial multiple mediating effect of psychological capital and self-directed learning ability in the relationship between perceived stress and professional identity among undergraduate nursing students.

METHODS

All participants (n = 596) were collected using an online survey between October 2023 to January 2024 through cluster sampling. Measures of perceived stress, psychological capital, self-directed learning ability, and professional identity were assessed. The serial multiple mediation of psychological capital and self-directed learning ability in the relationship between perceived stress and professional identity was examined using the SPSS PROCESS 3.4 macro by Hayes. Data analysis included descriptive analysis, independent samples t-tests, one-way ANOVA, Pearson's correlation, ordinary least-squares regression, and the bootstrap method.

RESULTS

Professional identity was negatively correlated with perceived stress (r = -0.414, p < 0.001), and was positively correlated with psychological capital (r = 0.495, p < 0.001) and self-directed learning ability (r = 0.443, p < 0.001). In the model of perceived stress → psychological capital → self-directed learning ability → professional identity, the overall mediated effect was -0.567 (95% CI: -0.707 ~ -0.443), and the mediating effect of psychological capital was -0.365 (95% CI: -0.501 ~ -0.237), accounting for 46.09% of total effect. The mediating effect of self-directed learning ability was -0.083 (95% CI: -0.150 ~ -0.028), accounting for 10.48% of total effect. The serial mediating effect of psychological capital and self-directed learning ability was -0.120 (95% CI: -0.184 ~ -0.065), accounting for 15.15% of total effect.

CONCLUSIONS

Psychological capital and self-directed learning ability serve as chain mediators between perceived stress and professional identity among undergraduate nursing students. This indicates that nursing educators can enhance the psychological capital and self-directed learning ability of nursing students to reduce the adverse effects of perceived stress on their professional identity.

Influence of perceived stress on professional identity among nursing students: a chain mediating role of self-control and self-directed learning ability

Background

A positive professional identity is key for nursing students in determining career direction and predicting future engagement in the profession. Despite its complexity and susceptibility to various influences, the factors shaping nursing students' professional identity remain poorly understood.

Objectives

This study aims to investigate how perceived stress can directly and indirectly influence professional identity among nursing students, with self-control and self-directed learning ability as mediators.

Materials and methods

A cross-sectional survey was conducted from October to December 2023, collecting data from 675 nursing students across five tertiary hospitals in Xi'an, Shaanxi Province, China. The survey captured detailed data on sociodemographic characteristics, perceived stress, self-control, self-directed learning ability, and professional identity among the participants. Descriptive analysis and correlation matrices were used to analyze participant characteristics and assess bivariate correlations. The mediation model was analyzed using the PROCESS macro for SPSS.

Results

Perceived stress showed a direct and negative influence on professional identity among nursing students; self-control was shown to play a mediating role between perceived stress and professional identity; self-directed learning ability was shown to play a mediating role between perceived stress and professional identity; and self-control and self-directed learning ability were shown to play a chain mediating role between perceived stress and professional identity.

Conclusion

Self-control and self-directed learning ability have a chain mediating role in between perceived stress and professional identity among nursing students. It suggests that nursing managers and educators can improve the self-control and self-directed learning ability of nursing students to mitigate the negative impact of perceived stress on professional identity.

The mediating role of self-directed learning ability in the impact of educational environment, learning motivation, and emotional intelligence on metacognitive awareness in nursing students

PURPOSE

This study aimed to examine the mechanisms influencing metacognitive awareness among nursing students, encompassing educational environment, learning motivation, emotional intelligence, and self-directed learning ability. These findings could be a theoretical reference for formulating metacognitive awareness intervention strategies specifically designed for nursing students.

METHOD

Through stratified sampling, 600 nursing students were recruited from two universities in China. Data collection involved five self-report instruments: the Metacognitive Awareness Inventory, Medical Education Environment Evaluation Scale, Learning Motivation Scale, Emotional Intelligence Scale, and Self-Directed Learning Ability Scale. Confirmatory factor analysis was utilized to test the measurement model, while structural equation modeling utilized multiple indices to assess model fit. Bootstrapping was conducted to analyze total, direct, and indirect effects.

RESULTS

All study variables differed significantly according to age and year level (p < 0.01). Metacognitive awareness positively correlated with the educational environment, learning motivation, emotional intelligence, and self-directed learning ability ( r = 0.493-0.729; all p < 0.01). The test of the measurement model shows good reliability and validity. The model depicting factors influencing metacognitive awareness demonstrated a good fit (χ2/df = 2.42, SRMR = 0.048, RMSEA = 0.049, CFI = 0.947, IFI = 0.935). Path analyses revealed that educational environment (EE), learning motivation (LM), and emotional intelligence (EI) directly impacted self-directed learning ability (SDLA) ( βEE = 0.189, βLM = 0.436; βEI = 0.215; all p < 0.05). Moreover, educational environment and self-directed learning ability directly influenced metacognitive awareness (βEE = 0.224, βSDLA = 0.520; all p < 0.05). Lastly, the educational environment, learning motivation, and emotional intelligence influenced metacognitive awareness by self-directed learning ability.

CONCLUSION

Metacognitive awareness in nursing students rises with age and year level. Females exhibit more potent self-directed learning abilities than males. Educational environment, motivation, and emotional intelligence indirectly influence metacognitive awareness via self-directed learning ability. This finding has enriched the ways and perspectives of metacognitive awareness training for nursing students.

The mediating role of nutritional care literacy on the relationship between self-directed learning ability and nursing competence

BACKGROUND

Nurses' nursing competence and nutritional care literacy directly affect patients' health and safety. Self-directed learning ability was pervasive throughout the entire work process of nursing work and was the basis for improving both. However, there are few studies has explored the mechanism from the perspective of nutritional care literacy. The purpose of this study was to analyze the relationship between self-directed learning ability and nursing competence, and to explore the mediating role of nutritional care literacy between self-directed learning and nursing competence among clinical nurses in China.

METHODS

A cross-sectional survey was conducted among 805 clinical nurses recruited from seven general hospitals in Hunan Province, China, between January 25 and March 6, 2022. The self-directed learning ability, nutritional care literacy and nursing competence of nurses were evaluated through investigation. A total of 799 questionnaires were received, resulting in an response rate of 99.25%.We performed an intermediary modeling to examine the mediating roles of nutritional care literacy on the relationship between self-directed learning ability and nursing competence in clinical nurses.

RESULTS

Self-directed learning ability was positively correlated with nutritional care  literacy (r=0.792, P<0.001) and nursing competence (r=0.696, P<0.001). Nutritional care literacy was positively correlated with nursing competence (r=0.658, P<0.001). Nutritional care literacy mediated the relationship between self-directed learning ability and nursing competence. The mediating effect accounted for 32.48% of the total effect and 48.10% of the direct effect .

CONCLUSIONS

This study confirmed the positive correlation between self-directed learning ability, nutritional care literacy, and nursing competence. Nutritional care  literacy played a mediating role in the relationship between self-directed learning ability and nursing competence. The findings not only provide a novel strategy for cultivating nursing professionals and improving nurse disease care abilities, but also offer a new perspective for nursing educators and managers.

The mediating role of psychological capital on the relationship between perceived stress and self-directed learning ability in nursing students

BACKGROUND

As indispensable reserves for the nursing workforce, undergraduate nursing students must possess self-directed learning abilities to consistently update their professional knowledge and adapt to the evolving demands of professional development. The acquisition of self-directed learning abilities can help undergraduate nursing students augment their theoretical knowledge and refine their clinical practice skills, thus fulfilling the demand from patients for high-quality nursing services. Hence, comprehending and investigating the factors that influence the development of self-directed learning abilities in nursing students is of paramount importance for nursing education and advancement of the nursing profession.

OBJECTIVES

This study investigated the status of and associations between perceived stress, psychological capital, and self-directed learning abilities among undergraduate nursing students. Additionally, it examines the mediating role of psychological capital in the relationship between perceived stress and self-directed learning abilities. Thus, aiming to provide nursing educators with new directions for enhancing self-directed learning abilities.

DESIGN

A cross-sectional descriptive study.

METHODS

In February and March 2023, 900 undergraduate nursing students from 10 nursing schools completed an online questionnaire. The questionnaire included measures of perceived stress, psychological capital, and self-directed learning ability. Data were analyzed using SPSS 27.0 and the PROCESS macro tool.

RESULTS

The scores for perceived stress, psychological capital, and self-directed learning ability among undergraduate nursing students were 40.07 ± 5.90, 99.89 ± 16.59, and 87.12 ± 9.20, respectively. Self-directed learning abilities were negatively correlated with perceived stress (r = -0.415, p < 0.001) and positively correlated with psychological capital (r = 0.465, p < 0.001). Perceived stress was negatively correlated with psychological capital (r = -0.630, p < 0.001). Psychological capital partially mediated the relationship between perceived stress and self-directed learning abilities among undergraduate nursing students, with a mediation effect of -0.166, accounting for 49.55% of the total effect.

CONCLUSION

This study found that undergraduate nursing students perceived high levels of stress, possessed low levels of psychological capital, and had moderate levels of self-directed learning. Perceived stress and psychological capital directly influenced undergraduate nursing students' self-directed learning abilities, and perceived stress indirectly affected self-directed learning abilities through psychological capital. Nursing managers and educators should alleviate the perceived stress of undergraduate nursing students and cultivate their positive psychological capital to enhance self-directed learning abilities.

Self-directed learning readiness and learning achievements of a flipped classroom model approach in research methods class: A quasi-experimental study

AIM

This study sought to assess how the flipped classroom model of instruction affected self-directed learning readiness and learning outcomes among Nigerian nursing students enrolled in a research method class.

BACKGROUND

Although the effectiveness of the flipped classroom model of instruction has been thoroughly and scientifically investigated in several fields, its potential to promote self-directed learning readiness and learning outcomes in a research method class has not yet been investigated.

DESIGN

A quasi-experimental design was employed. To achieve the study's objectives, two experiments were conducted: a pre-test and a post-test.

METHODS

Participants were 64 400-level nursing undergraduates purposively recruited from two government-owned universities in Southeast Nigeria. The experimental group received a flipped classroom model of teaching methods, while the control group received traditional teaching methods (TTM) from April - July 2021. A validated self-directed learning readiness scale and multiple-choice questions derived from a research method course were used to gather data. A structured questionnaire was used to collect demographic data. Descriptive statistics of frequencies, percentages, means and standard deviations were applied to the collected data. A one-factor independent measure analysis of covariance (ANCOVA) and an independent sample t-test was employed to compare the pre-and post-test results of FCM and TTM students.

RESULTS

Pre-test results from self-directed learning readiness showed overall scores of 3.99 ± 0.39 and 3.95 ± 0.35 for the traditional teaching method and flipped classroom model, respectively, while post-test results showed overall scores of 3.84 ± 077 for the traditional teaching method and 4.01 ± 0.81 for flipped classroom model. The difference in mean scores between the pre-and post-tests was statistically significant (p=0.030). Pre- (p=.001) and post- (p =.025) learning outcomes for the flipped classroom model were significantly higher than those for the traditional teaching method.

CONCLUSION

The flipped classroom model of instruction had a positive impact on nursing students' readiness for self-directed learning and learning outcomes in the research course. Since the method demonstrated statistically significant benefits in both the development of self-learning abilities and learning achievements, the need to improve learning experiences through the flipped learning method should be promoted.

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review

BACKGROUND

The COVID-19 pandemic radically changed nursing education.

PURPOSE

To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces.

METHOD

Eligible articles were reviewed using the Joanna Briggs framework.

RESULTS

The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects.

CONCLUSIONS

The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study

INTRODUCTION

Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China.

OBJECTIVES

This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors.

DESIGN

This was a cross-sectional descriptive study.

SETTINGS AND PARTICIPANTS

The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %).

METHODS

Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors.

RESULTS

The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (β = 0.261, P < 0.01), scholarship (β = -0.231, P < 0.01), work intention (β = -0.135, P < 0.05), and self-efficacy (β = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001).

CONCLUSIONS

Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.

The state of clinical education and factors affecting effective clinical education: the point of view of nursing and midwifery students

BACKGROUND

Clinical education is the basis of education in medical sciences. Clinical education, as the essence of education in nursing and midwifery, promotes social health, improves health care, and reduces mortality. Considering the position of nursing and midwifery, investigating the views of students in this field can be an effective step in improving clinical education. Therefore, the present study was conducted to investigate the status of clinical education and the factors affecting effective clinical education from the point of view of nursing and midwifery students.

METHODS

A descriptive-analytical study was conducted among nursing and midwifery students at Qazvin University of Medical Sciences in 2022-2023. Using available sampling, 242 students were included in the study. Students were included in the study if they completed at least one unit of in-person internship. Refusing to continue the study for any reason and having a practical nurse certificate were the criteria for exclusion from the study. The data collection tools included a demographic information questionnaire, a questionnaire to assess the status of clinical education, and a questionnaire on factors affecting effective clinical education. The data were analysed with descriptive and inferential statistics and SPSS 20 software.

RESULTS

The mean age of the participants in this study was 21.66 ± 2.25. A total of 180 (74.4%) of the participants were women, and the rest were men. The results showed that the general condition of clinical education is at an average level (103.16 ± 19.21). It was also found that the clinical education status of midwifery students was better than that of nursing students, and this difference was significant (p = 0.003). Among the fields of clinical education, the highest score belonging to the field of objectives and planning was reported on the average level (34.39 ± 6.66). Among the factors affecting effective clinical education, the highest score was given to the field of personal characteristics of the student (33.97 ± 5.99). The results showed that there is a significant relationship between the grades of the general state of clinical education with the academic semester (p = 0.001) and interest in the field of study (p < 0.040).

CONCLUSIONS

Based on the findings of the present study, clinical education is at an average level. Among the factors affecting effective clinical training, the field of personal characteristics of the student is more effective in clinical training. Providing educational facilities according to the number of students, using modern teaching methods, and determining and communicating the duties of professors and students can help to improve clinical education.