Status Of Nursing Students’ Competence And Correlation Analysis With Professional Identity And Efficacy In Internship Period

Aims:To investigate the status of nursing students’ competence during the internship,and analyze the correlation of competence with professional identity and self-efficacy.Methods:This was a non-experimental study with a full cross-sectional survey,using convenience combined with snowball sampling method.An electronic questionnaire survey was conducted among 887 internship nursing students mainly from Shandong,Zhejiang,Beijing from November to December 2020 through Wenjuanxing,a platform providing functions equivalent to Amazon Mechanical Turk.The survey tools included the following:1.Self-designed general information questionnaire,including gender,age,internship,hospital level,internship duration and other information.2.Nursing Students Competence Instrument,developed by Lin et al in 2017 and localized by domestic scholars Yang et al in 2019.The scale includes 27 items with 4 dimensions,including integrating care ability(10 items),leading humanity concerns(6 items),advancing career talents(7 items)and dealing with tension(4 items).Likert 10 grading method were adopted with a total score of 270.The higher the score indicating the better of the competence.3.The questionnaires of professional identity,which was developed by Hao,confirming 17 items loaded on five factors including professional self-image(6 items),benefit of retention and risk of turnover(4 items),social comparison and self-reflection(3 items),independence of career choice(2 items)social modeling(2 items).Likert 5 scoring method was used for scoring,the full score was 85 points,where the higher of the score means the stronger of the professional identity.4.General self-efficacy,using General Self-Efficacy Scale developed by German psychologist Schwarzer,translated and revised by domestic scholar Wang Caikang.There are 10 items in the scale.Likert 4-level scoring method was adopted,with a full score of 40.The higher the score,the better the self-efficacy.Data analyses were performed using the SPSS22.0 and AMOS22.0.Two independent samples t-test,analysis of variance and chi-square analysis were used to analyze the difference between nursing students with different characteristics in scale scores according to data types.Pearson correlation analysis was used to verify the correlation between professional identity self-efficacy and competence.Multivariate linear regression analysis was used to explore the influence of general information,professional identity and self-efficacy on competence of nursing students.Structural equation model(SEM)was used to analyze the correlation between professional identity self-efficacy and competence.Results:1.General information of nursing studentsThe average age of 887 nursing students was(20.66±1.10)years old(19-24),and the average internship duration was(5.11±1.04)months.There were 152 males and 735 females.The general information of the nursing students was consistent with that of the nursing students during the data collection period.2.Nursing students’ score of completion ability,professional identity and self-efficacyThe total complete ability score of 887 nursing students was(220.44±41.44),the scoring rate was 81.6%.In terms of dimension scores,the scoring rate ranked from high to low was:dealing with tension(82.7%),advancing career talents(82.5%),leading humanity concerns(82.3%)and including integrating care ability(80.2%).The total score of professional identity of nursing students was(70.03± 11.33),in terms of dimension scores,the scoring rate ranked from high to low was:social modeling(4.41 ±0.71),social comparison and self-reflection(4.23±0.71),professional self-image(4.19±0.80),benefit of retention and risk of turnover(4.07±0.83)and independence of career choice(3.55±0.76).The score of self-efficacy was(31.25±6.67)3.Difference of competence of nursing students with different characteristicsNursing students with different situation including gender,age,education level,student cadre or not,the reasons for studying nursing,whether exposing to nursing and patients communication,humanistic care and career development courses had differences in the scores of completion ability(P<0.05).4.The correlation of completion ability with professional identity and self-efficacy in nursing studentsPearson correlation analysis revealed that the correlation coefficients for the total score of completion ability with the total score of professional identity and self-efficacy of nursing students were up to 0.623 and 0.692 respectively(P<0.01).In terms of specific dimensions,the total score and all dimensions of competence were correlated with all dimensions and total score of professional identity except the autonomy of career choice,and the correlation coefficients were greater than 0.5(P<0.01).5.The effects of professional identity and self-efficacy on the competence of nursing studentsMultiple linear regression analysis revealed that professional identity,self-efficacy,registered residence location and whether received career development course or training was the influential factors of competence(P<0.05),accounting for 53%of the total variation studied.6.The analysis of structural equation model of competence with professional identity and self-efficacyAmos analysis revealed that completion ability was affected by professional identity(β=0.31,P<0.01)and self-efficacy(β=0.48,P<0.01),and professional identity could influence self-efficacy(β=0.70,P<0.01).The fitting results of the model were as follows:x2/df=46.78/25=1.97、GFI=1.00、AGFI=0.98、IFI=1.00、CFI=1.00、RMSEA=0.03,which indicated that the model was well fitted with the actual data.In terms of effect analysis,Bootstrap 5000 samples were used to analyze whether the mediating effect of self-efficacy between professional identity and competence was statistically significant.The results revealed that the 95%confidence interval of bias correction of indirect effect of professional identity on completion ability was(2.012,3.017),and the 95%confidence interval of percentile was(2.091,3.009),neither of which included 0,indicating that professional identity could indirectly affect competence by affecting self-efficacy.Self-efficacy played a partly mediating role between professional identity and completion ability.The indirect effect accounted for 52.0%and the direct effect accounted for 48%.Conclusions:1.The professional identity,self-efficacy and competence of nursing students are in their average level,which needs to be further improved.Meanwhile,the level of competence,professional identity and self-efficacy of internship nursing students with different characteristics is different.2.Competency is positively correlated with professional identity and self-efficacy Competence is affected by professional identity and self-efficacy among nursing students in internship3.Professional identity has the directly affect the competence among nursing students,and it also has the indirect effect on competence through self-efficacy.Self-efficacy plays a mediating role between professional identity and competence.