Interrelationships among educational bullying, resilience, thriving at work, medical curiosity, work adaptability,...

Bullying during clinical placements is a major challenge in nursing education, compromising interns' psychological resources and intention to remain in the profession. However, the systemic interplay among key protective resources has not been examined using a network approach.

We used network analysis to examine the interrelationships among bullying behaviors, thriving at work, medical curiosity, psychological resilience, workplace adaptability, and intention to stay among nursing students.

A cross-sectional survey design was used.

A total of 644 nursing interns from a tertiary Grade A hospital in Shandong Province, China, were included in this cross-sectional survey conducted between August and December 2025. A Gaussian graphical model was constructed to investigate associations among scores on the Bullying Behaviors in Nursing Education Environments Scale, Thriving at Work Scale, Nurse Work Adaptability Scale, Medical Curiosity Scale, Connor-Davidson Resilience Scale, and Intention to Stay Scale. Centrality indices (closeness, strength, and betweenness) and bridge centrality indices (bridge strength) were determined to identify central and bridge nodes as potential intervention targets.

"Intellectual medical curiosity (IMC)" and "work atmosphere" were positively associated with "psychological resilience" (weight = 0.32, 0.25, respectively), whereas "learning" was positively associated with "work atmosphere" (weight = 0.25). Critical central nodes included "work atmosphere" (strength = 1.30), "attack on personality," a key dimension of educational bullying (strength = 1.15), and "IMC" (strength = 1.12). Bridge nodes included "psychological resilience" (bridge strength = 0.86), "work atmosphere" (bridge strength = 0.85), and "IMC" (bridge strength = 0.82).

This study provides a novel systems-level perspective on how educational bullying, psychological resources, and learning-related factors relate to nursing interns' adaptation and retention intentions. Targeting psychological resilience, fostering a supportive clinical environment, and cultivating medical curiosity may offer strategic entry points for educational and organizational interventions to improve nursing interns' learning experiences and support workforce sustainability. However, given the use of convenience sampling, these findings should be interpreted with caution, and their generalizability remains to be further validated in multi-center studies.