职业认同在护理专业学位硕士研究生临床学习环境与临床实践能力间的中介效应OA

Objective To investigate the current status of professional identity,clinical learning environment,and clinical practice competence among master of nursing specialist(MNS)postgraduates in China,to explore the mediating effect of professional identity between clinical learning environment and clinical practice competence,and to provide evidence for nursing educators to refine clinical practice training programs for MNS postgraduates in higher medical institutions.Methods With convenience sampling,207 full-time MNS postgraduates were selected.Questionnaire surveys were conducted using a General Information Questionnaire,Clinical Learning Environment Evaluation Scale,Nursing Professional Identity Scale,and Clinical Practice Competency Questionnaire.Spearman's correla-tion analysis was used to assess the relationships between variables,while Bootstrap methods to examine the mediating role of professional identity between clinical learning environment and clinical practice competence.Results The total score for clinical practice compe-tence among MNS postgraduate students was 210.03±27.29,the total score for the clinical learning environment was 139.39±20.43,and the total score for professional identity was 115.54±17.23.Spearman's analysis revealed significantly positive correlations of clinical prac-tice competence with both clinical learning environment(r=0.854,P<0.05)and professional identity(r=0.876,P<0.05).Professional iden-tity also had a significantly positive correlation with clinical learning environment(r=0.882,P<0.05).Mediation effects were tested using Bootstrap method,and results revealed that professional identity fully mediated the relationship between clinical learning environment and clinical practice competence.The total effect of clinical learning environment on clinical practice competence was 0.892(95%CI:0.841～0.932,P<0.05),with an indirect effect via professional identity of 0.610(95%CI:0.394～0.890,P<0.05),while the direct effect of clinical learning environment on clinical practice competence was 0.282(95%CI:-0.029～0.526,P>0.05).Conclusion Clinical practice competence of MNS postgraduates is at an upper-middle level.Both clinical learning environment and professional identity posi-tively influence clinical practice competence.Clinical learning environment enhances clinical practice competence of MNS post-graduates through professional identity,thereby promoting the high-level and professional development of MNS postgraduates.