Clinical Performance and Its Related Factors in Nursing Students: Structural Equation Model

Kim, Mi Sook

Department of Nursing
Kosin University Graduate School

Directed by Professor Sohn, Sue Kyung, RN, Ph. D.

Abstract

Recently, there is an increasing demand for patient safety and quality of care by providing nurses in healthcare environment. For the reason, nursing education focuses on students'' performance that can manage properly patient''s health problems.
This study aimed to identify the structural relationship for clinical performance and its related factors among undergraduate nursing students. Structural equation model has established based on integrated literature review and self-efficacy model proposed by Bandura (1997). Research variables comprised two exogenous (critical thinking disposition, emotional intelligence) and three endogenous variables (self-efficacy, problem solving ability, clinical performance).

Data were collected from June 23 to August 11, 2014, and collected using structured questionnaires. The study participants were 205 senior nursing students at four departments of nursing located in Busan and Gyeongnam province. Data were analyzed using descriptive statistics and Pearson''s correlation coefficients with SPSS 18.0 programs and the AMOS 18.0 programs for structural equation modeling. The results were as follows.

First, goodness-of-fit in the hypothetical model was shown like χ²=450.807 (df=268), TLI=.914, CFI=.923, RMSEA=.058, and the model is acceptable.

Second, among the 9 hypotheses in the hypothetical model, 6 hypotheses were supported. Self-efficacy and problem solving ability had a direct effect on clinical performance, and critical thinking disposition and emotional intelligence affected clinical performance, indirectly. And critical thinking disposition had a direct effect on self-efficacy and problem solving ability. Also, emotional intelligence had a direct effect on self-efficacy and problem solving ability.

In conclusion, the causal relationships among variables were identified and the strength of model established. Major factors on the clinical performance were problem solving ability and self-efficacy. And problem solving ability and self-efficacy were meaningful mediators between critical thinking disposition, emotional intelligence and clinical performance. Therefore, it is needed to develop clinical education programs to improve problem solving ability and self-efficacy for increasing nursing students'' clinical performance.


Key Words: Nursing students, Clinical performance, Self-efficacy, Critical thinking disposition, Emotional intelligence, Problem solving ability