Pathways Linking Self-Directed Learning, Self-Efficacy, and Clinical Competence in Nursing Students: A Cross-Sectional Study

Abstract

Nursing education needs to support students not only in developing clinical performance but also in managing and directing their own learning. Self-directed learning (SDL) has been identified as a key factor associated with clinical competence. This study aimed to examine the mediating effect of self-efficacy on the relationship between SDL ability and clinical competence among nursing students. The study was conducted with 138 nursing students who had clinical practice experience in general hospitals. Data were collected using validated instruments measuring SDL ability, clinical competence, and self-efficacy. Data were summarized descriptively, and associations among variables were examined using Pearson correlation coefficients. The mediation effect was tested using Hayes’ PROCESS macro (Model 4) and bootstrapped confidence intervals. Among the 138 participants, 73.9% were female, 77.5% were aged 20–24 years, and 51.4% were fourth-year students. Nearly half had more than 8 weeks of clinical practice experience (47.1%), and most reported satisfaction with clinical practice (71.0%). Clinical competence showed significant positive correlations with SDL ability (r = .44, p < .001) and self-efficacy (r = .46, p < .001). Self-efficacy partially mediated the relationship between SDL ability and clinical competence, and the indirect effect was statistically significant (indirect = 0.13, 95% CI: 0.05–0.32). The model's explanatory power increased from 20% to 29% when self-efficacy was included. The results suggest that self-efficacy is an important psychological mechanism linking SDL ability to clinical competence. SDL ability had direct and indirect relationships with clinical competence, mediated by self-efficacy. Educational strategies should combine opportunities for independent learning with experiences that help students build confidence in clinical practice.