Self-directed learning and clinical competence: The mediating role of the clinical learning environment

Abstract

Introduction: Recognizing the factors affecting clinical competence among internship nursing students is crucial. This study was aimed at determining the effects of selfdirected learning on internship nursing students’ clinical competence under the mediating role of the clinical learning environment. Methods: This cross-sectional research was performed on 300 internship nursing students selected by convenience sampling with a structural equation modeling (SEM) approach. Data were collected in one stage with three tools: the Self-Directed Learning Readiness Scale for Nursing Education, Education Environment Measure, and Clinical Competence Questionnaire. Data analysis was performed in SPSS version 21 and Smart-PLS version 3 with partial least squares-SEM. Measurement and structural model data were assessed with a significance threshold of p < 0.05. Results: A total of 20.5 % of the variance in clinical competence was explained by self-directed and clinical learning environments. Self-directed learning had a significant positive effect on clinical competence (path coefficient ¼ 0.14, 95%CI: 0.02, 0.26; p ¼ 0.027), and on the clinical learning environment (path coefficient ¼ 0.41, 95 % CI: 0.31, 0.52; p < 0.001). A relationship was observed between the clinical learning environment and clinical competence (path coefficient ¼ 0.38, 95 % CI: 0.25, 0.50; p < 0.001). The indirect effect of self-directed learning on clinical competence was positive and significant (path coefficient ¼ 0.11, 95 % CI: 0.07, 0.17; p < 0.001). Self-directed learning had a significant total effect on clinical competence (path coefficient ¼ 0.30, 95 % CI: 0.19, 0.40; p < 0.001). Conclusions: According to the results, we recommend that nursing education managers and instructors consider plans to enhance self-directed learning among nursing students and improve the clinical learning environment.