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Enhancing nurses' clinical decision-making confidence through dual pathways of self-directed learning: A structural
Liya Wu1, Mengyu Zhang1, Juan Ye1
1Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang Province, China.
Plos One
|June 11, 2026
Summary
Emotional intelligence enhances nurses' confidence in clinical decision-making by fostering both cognitive and relational self-directed learning. These findings highlight the importance of integrating emotional intelligence and self-directed learning in nursing education.
Area of Science:
- Nursing Education
- Psychology in Healthcare
- Clinical Decision-Making
Background:
- Nurses require autonomous judgment and collaboration in complex clinical settings.
- The role of psychological and learning resources in supporting clinical decision-making confidence is not fully understood.
Purpose of the Study:
- To investigate the mediating effects of cognitive and relational self-directed learning.
- To examine the relationship between emotional intelligence and clinical decision-making confidence in registered nurses.
Main Methods:
- A cross-sectional survey study involving 1,478 registered nurses in China.
- Utilized validated scales for emotional intelligence, self-directed learning, and clinical decision-making confidence.
- Structural equation modeling with bias-corrected bootstrapping was employed to test mediation hypotheses.
Main Results:
- Emotional intelligence positively predicted both cognitive and relational self-directed learning.
- Cognitive self-directed learning significantly mediated the link between emotional intelligence and decision-making confidence (71.8% of total effect).
- Relational self-directed learning also significantly mediated this relationship (50.8% of total effect).
Conclusions:
- Both cognitive and relational self-directed learning act as crucial mediators.
- Findings advocate for integrating emotional intelligence training with self-directed learning development in nursing curricula.
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