The mediating role of self-efficacy between social acuity and clinical competence among nursing students: A...

Contemporary nursing practice requires the integration of perceptual and psychological competencies alongside technical skills to ensure safe and effective care. Although situational awareness and confidence have been linked to clinical judgments, how these internal competencies are jointly associated with clinical competence remains insufficiently understood.

This study examined the relationships among social acuity, self-efficacy, and clinical competence in nursing students, and tested whether self-efficacy mediates the association between social acuity and clinical competence.

A cross-sectional survey design was employed.

The study was conducted across 15 nursing departments in South Korea.

A total of 128 third- and fourth-year nursing students with clinical practice experience participated (88.3% female; 60.2% third-year and 39.8% fourth-year students).

Validated instruments measured social acuity, self-efficacy, and clinical competence. Data were analyzed using IBM SPSS Statistics 26.0 and Hayes' PROCESS macro (Model 4). Covariates identified through univariate analyses were included in regression and bootstrapped mediation analyses (5000 resamples, 95% CI).

Students reported moderate-to-high levels of social acuity (Mean = 4.07), self-efficacy (Mean = 3.32), and clinical competence (Mean = 3.90). Correlation analyses showed positive associations among the variables. Mediation analysis indicated that self-efficacy partially mediated the relationship between social acuity and clinical competence (indirect effect = 0.064, 95% CI [0.003, 0.139]); the direct effect remained significant (β = 0.221, p = 0.006). The model explained 29.1% of the variance in clinical competence.

Social acuity and self-efficacy are significantly associated with clinical performance. By clarifying the relationships among cue recognition, self-efficacy, and competent action, this study advances understanding of how internal resources are related to clinical judgment. Nursing education should therefore move beyond technical training to deliberately cultivate perceptual sensitivity and confidence, preparing students to deliver safe, adaptive, patient-centered care in complex environments.