Yuan Yuan, Tang Haoyu, Ni Fei, Xu Xia, Peng Yu
General Practice, the First Affiliated Hospital of Army Medical University, Chongqing, China.
Department of Nursing, the First Affiliated Hospital of Army Medical University, Chongqing, China.
Nurse Educ Today. 2025 Apr;147:106598. doi: 10.1016/j.nedt.2025.106598. Epub 2025 Jan 29.
Nursing interns' patient safety attitudes and professionalism is important for safety and quality of care. Clinical internship is a core component of nurse education, and the clinical learning environment is considered a crucial factor in nursing interns' patient safety attitude and professionalism.
To evaluate the patient safety attitude and professionalism of nursing interns, and explore latent influencing mechanism of clinical learning environment on it based on the Social Cognitive Theory (SCT) theory.
A cross-sectional study.
A convenience sample of 402 nursing interns from 5 general hospitals in southwest China was surveyed between May-July 2023. Data on general information, clinical learning environment, safety attitudes and professionalism, and professional identity of nursing interns were collected. Regression analysis was used to analyze the factors influencing nursing interns' patient safety attitudes and professionalism in the clinical learning environment. The relationship between the clinical learning environment, professional identity, patient safety attitudes and professionalism were examined using Pearson correlation analysis and SPSS PROCESS macro (model 4).
Overall, the participants reported a higher than a moderate level of patient safety attitudes and professionalism (4.11 ± 0.57), while the domain of professionalism need to be improved. Teaching atmosphere of ward (β = 0.185, p = 0.006) and role of general manager in the department (β = 0.390, p = 0.001) were the two key factors for patient safety attitudes and professionalism of nursing interns. The effect of clinical learning environment on the safety attitudes and professionalism was partially mediated by professional identity (β = 0.066, P < 0.05).
Hospital administrators need to provide nursing interns a clinical learning environment with positive teaching atmosphere and a model role of general manager to increase their professional identity, and ultimately enhance their patient safety attitudes and intentions to safety-related behavior.
护理实习生的患者安全态度和专业素养对护理安全和质量至关重要。临床实习是护士教育的核心组成部分，临床学习环境被认为是影响护理实习生患者安全态度和专业素养的关键因素。
评估护理实习生的患者安全态度和专业素养，并基于社会认知理论（SCT）探讨临床学习环境对其潜在的影响机制。
横断面研究。
2023年5月至7月期间，对来自中国西南部5家综合医院的402名护理实习生进行了便利抽样调查。收集了护理实习生的一般信息、临床学习环境、安全态度和专业素养以及职业认同的数据。采用回归分析来分析临床学习环境中影响护理实习生患者安全态度和专业素养的因素。使用Pearson相关分析和SPSS PROCESS宏程序（模型4）检验临床学习环境、职业认同、患者安全态度和专业素养之间的关系。
总体而言，参与者报告的患者安全态度和专业素养水平高于中等水平（4.11±0.57），而专业素养领域有待提高。病房教学氛围（β=0.185，p=0.006）和科室护士长角色（β=0.390，p=0.001）是护理实习生患者安全态度和专业素养的两个关键因素。临床学习环境对安全态度和专业素养的影响部分通过职业认同介导（β=0.066，P<0.05）。
医院管理者需要为护理实习生提供一个具有积极教学氛围和护士长榜样作用的临床学习环境，以增强他们的职业认同，最终提高他们的患者安全态度和与安全相关行为的意愿。
