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Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
From creative self-efficacy to clinical decision-making confidence: A dimensional structural equation modeling
Wenyu Yue1, Yihui Lin1, Xiaoqin Ma2
1School of Nursing, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310053, China.
Background:
Graduate nursing students face cognitive and emotional demands during clinical practice, often exhibiting passive cognition and struggling with the transition from academic preparation to clinical requirements. Documented gaps between theoretical knowledge and practical application highlight the need to understand how creative self-efficacy and self-directed learning contribute to clinical decision-making confidence development.
Objective:
To investigate the mediating role of self-directed learning in the relationship between creative self-efficacy and clinical decision-making confidence among graduate nursing students.
Design:
Cross-sectional study utilizing structural equation modeling.
Setting:
Multiple Chinese medical schools and affiliated teaching hospitals.
Participants:
278 graduate nursing students.
Methods:
Validated questionnaires assessed creative self-efficacy, self-directed learning, and clinical decision-making confidence. Data analysis employed descriptive statistics, correlation analysis, stepwise regression, and structural equation modeling with bootstrap mediation analysis.
Results:
Regression analysis revealed work experience as the strongest predictor of clinical decision-making confidence (β = 0.44, p < 0.01), followed by creative self-efficacy (β = 0.21, p < 0.01). Mediation analysis demonstrated that self-directed learning significantly mediated the relationship between creative self-efficacy and clinical decision-making confidence (β = 0.095, p = 0.04). Dimensional analysis revealed learning awareness (β = 0.067, p = 0.02) and learning strategies (β = 0.057, p < 0.01) as significant mediators.
Conclusions:
Self-directed learning serves as a partial mediator (25.2 %) between creative self-efficacy and clinical decision-making confidence, with metacognitive dimensions-learning awareness and learning strategies-constituting primary pathways while behavioral and social mechanisms showed non-significant effects. Educational interventions should prioritize metacognitive skill development and strategic learning approaches to enhance clinical decision-making capabilities in graduate nursing education.
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