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From Simulation to Sustainability: The Mediating Role of Clinical Self-Efficacy Among Undergraduate Healthcare
Waleed El-Sayed Mohammed Hemaida1, Ekram Mohammed Gomaa Geenedy2, Mohamed Sayed Abdellatif3
1Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Wadi Addawasir 11991, Saudi Arabia.
Abstract:
Despite growing recognition that nurses must be equipped with sustainability competencies to address climate-related health challenges, the psychological mechanisms through which nursing education fosters sustainability attitudes are not yet fully understood. This study examined the mediating role of clinical performance self-efficacy in the relationship between simulation-based learning quality and sustainability attitudes among undergraduate nursing students. A cross-sectional correlational design was employed with a main sample of 679 nursing students from four Egyptian universities. Data were collected using the CHEST, SECP Scale, and SANS_2. Mediation analysis used Hayes' PROCESS macro with 5000 bootstrap resamples. Simulation-based learning quality significantly predicted both self-efficacy (β* = 0.772) and sustainability attitudes (β* = 0.613). Self-efficacy partially mediated this relationship, accounting for 68.34% of the total effect (indirect β* = 0.419, Boot 95% CI [0.343, 0.494]). Nursing educators should design simulation curricula that deliberately cultivate self-efficacy while embedding sustainability content, producing clinically competent and environmentally responsible graduates.
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