The mediating effect of nursing students' academic resilience between the clinical nursing internship environment and...

The clinical internship environment is crucial for developing nursing students' patient safety competency. While existing studies have confirmed their direct correlation, the underlying psychological mechanism remains unclear. Academic resilience, a key psychological resource for coping with clinical challenges, may serve as an important mediator, yet its specific role lacks empirical evidence. This study aims to address this gap.

To examine the mediating role of academic resilience between the clinical nursing internship environment and patient safety competency among nursing students.

From February to March 2025, we used convenience sampling to recruit nursing students from two tertiary grade-A hospitals in Kaifeng, yielding 298 valid questionnaires. We collected data using a general information questionnaire, the Clinical Nursing Internship Environment Evaluation Scale, the Patient Safety Competency Scale, and the Nursing Student Academic Resilience Scale. We performed mediation analysis using the SPSS PROCESS macro.

We obtained survey data from 298 nursing students. The total scores for the clinical nursing internship environment evaluation, patient safety competency, and nursing student academic resilience were 94.0 (91.8, 110.0), 117.0 (114.5, 138.0), and 70.0 (68.0, 78.0), respectively, all in the medium-upper range. Correlation analysis revealed significant positive correlations among the total scores of the clinical nursing internship environment, patient safety competency, and academic resilience (r = 0.933-0.960, P < 0.01). Nursing students' clinical internship environment and academic resilience can directly and positively affect their level of patient safety competence; nursing students' academic resilience partially mediates the relationship between clinical nursing internship environment and patient safety competence, with a mediating effect of 0.368 (95% CI: 0.1789-0.5108), accounting for 49.47% of the total effect.

Nursing students' academic resilience mediates the relationship between the clinical nursing internship environment and patient safety competence. Nursing managers should focus on improving nursing students' academic resilience and adaptability to the practice environment during clinical practice to optimize the clinical practice environment, improve nursing students' safety competence, and ensure patient safety.