Critical thinking, communication, decision-making confidence, and practicum stress among nursing students in maternal nursing practicum: A structural equation model

IF 3.6 2区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Nurse Education Today Pub Date : 2025-06-20 DOI:10.1016/j.nedt.2025.106815

Yu-Yun Hsu , Tram Thi Bich Nguyen , Ching-Hsueh Yeh , Shiow-Meei Tsai , Yi-Chien Tsai

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引用次数: 0

Abstract

Background

A nursing practicum course plays a vital role in enhancing the clinical competence of nursing students. Core competencies such as critical thinking, communication, and clinical decision-making are essential for professional nursing practice. Maternal nursing practicums possess unique characteristics that can contribute to increased practicum-related stress. However, there is limited evidence-based research examining the relationships between practicum stress and key aspects of nursing competence, including critical thinking, communication skills, and confidence in clinical decision-making among nursing students.

Aim

This study aimed to investigate the interrelationships among critical thinking, communication, and clinical decision-making confidence and examined the impact of practicum stress on these competencies among undergraduate nursing students.

Design

A cross-sectional correlational design.

Settings

Participants were recruited from four universities in Taiwan.

Participants

A convenience sample of 219 undergraduate nursing students who had completed a maternal nursing practicum was recruited from October 2021 to April 2022.

Methods

Students were surveyed using validated scales to measure their practicum stress, critical thinking, communication, and clinical decision-making confidence during maternal nursing practicum. Covariance-based structural equation modeling (CB-SEM) was used to analyze data and examine the interrelationships among these variables. All statistical analyses were conducted using SPSS and AMOS.

Results

The participants included undergraduate nursing students (mean age: 21.4 years, 84 % female). Practicum stress had significant negative direct effects on critical thinking and communication. Critical thinking influenced communication. Additionally, communication mediated the effects of stress and critical thinking on decision-making confidence. The model fit indices for an emerging were strong: χ2/df = 1.71, SRMR = 0.05, RMSEA = 0.06, GFI = 0.91, TLI = 0.96, CFI = 0.97.

Conclusions

Practicum stress reduces critical thinking and communication abilities, influencing decision-making confidence in nursing students during maternal practicums. Strategies to reduce stress and strengthen critical thinking and communication skills are essential to support nursing students' clinical decision-making competency.

查看原文本刊更多论文

护生批判性思维、沟通、决策自信与实习压力：一个结构方程模型

背景护理实习课程对提高护理专业学生的临床能力起着至关重要的作用。核心能力，如批判性思维，沟通和临床决策是必不可少的专业护理实践。产妇护理实习具有独特的特点，可以有助于增加实习相关的压力。然而，关于实习压力与护理能力关键方面（包括批判性思维、沟通技巧和临床决策信心）之间关系的循证研究有限。目的探讨本科护生批判性思维、沟通能力和临床决策信心的相互关系，并探讨实习压力对这些能力的影响。设计横断面相关设计。参与者来自台湾的四所大学。研究人员从2021年10月至2022年4月招募了219名完成了孕产妇护理实习的本科护理学生作为方便样本。方法采用有效的量表对学生进行问卷调查，测量实习压力、批判性思维、沟通能力和临床决策信心。基于协方差的结构方程模型（CB-SEM）用于分析数据并检验这些变量之间的相互关系。所有统计分析均采用SPSS和AMOS进行。结果研究对象为本科护生，平均年龄21.4岁，女性占84%。实习压力对批判性思维和沟通有显著的负向直接影响。批判性思维影响沟通。此外，沟通在压力和批判性思维对决策信心的影响中起中介作用。新兴市场的模型拟合指数较强：χ2/df = 1.71, SRMR = 0.05, RMSEA = 0.06, GFI = 0.91, TLI = 0.96, CFI = 0.97。结论实习压力降低了护生在产妇实习期间的批判性思维和沟通能力，影响了护生的决策信心。减轻压力，加强批判性思维和沟通技巧的策略是支持护理学生临床决策能力的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nurse Education Today 医学-护理

CiteScore

6.90

自引率

12.80%

发文量

349

审稿时长

58 days

期刊介绍： Nurse Education Today is the leading international journal providing a forum for the publication of high quality original research, review and debate in the discussion of nursing, midwifery and interprofessional health care education, publishing papers which contribute to the advancement of educational theory and pedagogy that support the evidence-based practice for educationalists worldwide. The journal stimulates and values critical scholarly debate on issues that have strategic relevance for leaders of health care education. The journal publishes the highest quality scholarly contributions reflecting the diversity of people, health and education systems worldwide, by publishing research that employs rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of education and systems globally. The journal will publish papers that show depth, rigour, originality and high standards of presentation, in particular, work that is original, analytical and constructively critical of both previous work and current initiatives. Authors are invited to submit original research, systematic and scholarly reviews, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing and related health care education, and which will meet and develop the journal''s high academic and ethical standards.