Empowering future nurses - exploring the relationship between higher education-related stress, academic self-efficacy and clinical education experience satisfaction among nursing students in Saudi Arabia: a cross-sectional study.
Aug 2026· Journal of Research in Nursing· pp.
17449871261462365
· 1 citation· 41 references
Medicine
TL;DR
The study underscores the significant relationship between higher education-related stress, ASE and satisfaction with clinical education and satisfaction with clinical education.
Abstract
Background
Nursing education is crucial for preparing students to navigate the complexities of healthcare.
Aim
The current study aims to investigate the relationships among higher education-related stress, academic self-efficacy (ASE) and satisfaction with clinical education experiences among nursing students to inform current policy and practice in nurse education and support in Saudi Arabia.
Methods
A descriptive, cross-sectional study was done with undergraduate nursing students at the College of Nursing at Qassim University, in Saudi Arabia. Data were collected by a socio-demographic questionnaire, the student nurse stress index (SNSI) scale, the academic nurse self-efficacy (ANSE) scale and the 'Assessment of Nursing Student Satisfaction with First Clinical Practical Education Questionnaire'.
Results
Nursing students exhibited moderate levels of SNSI (M = 70.53, SD = 17.35), ASNE (M = 52.91, SD = 8.96) and satisfaction with clinical education (M = 142.29, SD = 25.09). Furthermore, Interface Worries (includes students' worries and stress when interfacing with educators, clinical personnel, colleagues or the academic environment; 95% CI: -0.407 to -0.120) and Personal Problems (95% CI: -0.205 to -0.019) were statistically significant negative predictors of nursing students' ANSE.
Conclusion
The study underscores the significant relationship between higher education-related stress, ASE and satisfaction with clinical education.
Community health nursing (CHN) is central to primary healthcare delivery, but undergraduate nursing students may encounter educational, organizational, resource-related, and sociocultural barriers that affect their readiness for community-based practice. This study aimed to identify and quantify perceived barriers to CHN practice among nursing students in Saudi Arabia and to examine their relationships with self-reported educational preparedness and organizational support.
A quantitative cross-sectional survey was conducted among nursing students enrolled in Saudi universities. A structured online questionnaire assessed perceived CHN practice barriers, educational preparedness, and organizational support. The instruments underwent cultural adaptation, forward-backward translation, expert-panel content validation, pilot testing, and internal-consistency assessment. Descriptive statistics, non-parametric tests, correlation analyses, and exploratory multiple linear regression were used.
A total of 139 nursing students completed the survey. Participants reported minor-to-moderate overall barriers (
M
= 2.69, SD = 0.96). Resource barriers were rated highest, with shortage of equipment (
M
= 2.93, SD = 1.38) and lack of educational materials (
M
= 2.86, SD = 1.32) identified as the most salient challenges. Educational preparedness (
M
= 3.25, SD = 0.98) and organizational support (
M
= 3.46, SD = 1.03) were rated moderately positive. Small-to-moderate positive correlations were observed between barriers and educational preparedness (
r
= 0.269,
p
= 0.001) and between barriers and organizational support (
r
= 0.242,
p
= 0.004); these findings were interpreted cautiously as potentially reflecting awareness effects, conceptual overlap, or shared-method variance. The multivariable regression model was not statistically significant and explained a small proportion of variance (
R
2
= 0.089,
p
= 0.052).
Nursing students in Saudi Arabia perceived meaningful, though not severe, barriers to effective CHN practice, with resource limitations and skills gaps as primary concerns. The findings support strengthened curriculum-practice integration, expanded simulation and community-immersion experiences, improved placement resources, and targeted faculty development aligned with healthcare transformation priorities.
Objective: Empathy is a cornerstone of nursing care, yet its development is often influenced by factors outside the formal curriculum. The ability to understand and share a patient’s perspective is vital for building trust and improving care outcomes. This study aimed to explore the perception of undergraduate nursing students regarding non-academic factors influencing their development of empathy.
Materials and Methods: A quantitative approach with a cross-sectional descriptive design was adopted. Convenience sampling was used to collect data from 200 undergraduate nursing students (across first, third, fifth, and eighth semesters) from four selected nursing colleges in Ernakulam. Data were collected using a socio-demographic data sheet and the Perceived Non-Academic Influences on Empathy Scale (PNAIES). The Cronbach’s score is 0.8 for the present tool.
Results: The majority of undergraduate nursing students (76%) reported that non-academic factors had a moderate influence, 12.5% of students reported strong influence, and 11.5% reported low influence on their empathy development. Family and upbringing factors were perceived to have the highest influence (50.4%), while technology and media exposure were perceived to have the least influence (24.8%).
Conclusion: The findings highlight that personal background, specifically family and upbringing, plays a more significant role in shaping a student’s empathetic capacity than modern environmental factors like technology. Peer dynamics and clinical exposure are also vital in fostering compassionate professional behavior. Nursing education should acknowledge these diverse personal backgrounds to better support students' professional development and therapeutic relationships.
A. J. V, Usha Marath, Mereena Shibu et al.· Journal of Nursing Research,...· 0 citations
Background Supervisory support during clinical placements is central to nursing students’ professional development. Professional self-efficacy, students’ confidence in performing clinical tasks, is increasingly recognised as a key outcome associated with transition to practice and workforce retention. In Saudi Arabia, Vision 2030 healthcare reforms have intensified demand for qualified nurses, making the quality of clinical supervision a strategic priority. This study examined the relationships among supervisory support, professional self-efficacy, and nursing student satisfaction at King Saud University-affiliated hospitals. Methods This descriptive cross-sectional study was conducted among 145 nursing students (second-, third-, and fourth-year bachelor’s degree students) at three King Saud University-affiliated teaching hospitals in Riyadh, Saudi Arabia. Participants were selected using stratified random sampling based on year of study. Data were collected using four validated instruments: a sociodemographic questionnaire, the Supervisory Support Scale (9 items; Cronbach’s α = 0.90), the Nursing Student Satisfaction Scale (6 items; α = 0.88), and an adapted Professional Self-Efficacy Scale (12 items; α = 0.90). Descriptive statistics summarised the three key study variables (supervisory support, professional self-efficacy, and student satisfaction) alongside sociodemographic characteristics. Pearson correlation coefficients assessed the strength and direction of linear associations among continuous study variables. Formal mediation analysis was conducted using the PROCESS macro (Model 4) with 5,000 bias-corrected bootstrap resampling iterations. Results Of 175 students approached and meeting eligibility criteria, 145 returned valid questionnaires (response rate = 82.9%). The sample was predominantly female (60.7%) and in the age range of 20–22 years (66.9%). Students reported high levels of supervisory support (mean = 4.10 ± 0.53 out of 5), satisfaction with clinical placements (mean = 4.11 ± 0.52), and professional self-efficacy (mean = 4.06 ± 0.56). Supervisory support was strongly correlated with satisfaction (r = 0.68, p < 0.001) and professional self-efficacy (r = 0.57, p < 0.001); professional self-efficacy was positively correlated with satisfaction (r = 0.49, p < 0.001Statistical mediation analysis revealed that professional self-efficacy partially mediated the supervisory support–satisfaction relationship: the indirect association (ab = 0.13, 95% CI [0.07, 0.19]) was statistically significant and accounted for approximately 19% of the total association. In regression analysis, supervisory support remained significantly associated with satisfaction (β = 0.43, p < 0.001) even after accounting for professional self-efficacy, consistent with partial statistical mediation. Conclusions Supervisory support was significantly and positively associated with nursing students’ satisfaction and professional self-efficacy. These findings, grounded in social cognitive theory, suggest that high-quality supervision may enhance clinical learning outcomes both directly and through strengthening students’ professional confidence. Standardising supervisory practices, investing in supervisor training, and creating structured feedback mechanisms are priorities for improving nursing education in Saudi Arabia and advancing national nursing workforce goals under Vision 2030.
Thurayya Eid, Faihan F. Alshaibany, Abdulaziz M. Alodhailah et al.· PLoS ONE· 0 citations
Nursing students demonstrated a developing but not yet fully clinically competent and readiness for professional practice which mirrors the theoretical foundational competence with strength in communication and should address the emotional unpreparedness and the used of medical equipment and technologies.
Rosemarie D Vista, Najd Hamed Alenzi, Samia Ali Alanzi et al.· Journal of Frontiers in Mult...· 0 citations
Information regarding job satisfaction of nursing officers helps in identifying areas for keeping them motivated, leading to better patient care and satisfaction. This study aimed to determine the level of job satisfaction amongst nursing professionals in a tertiary care teaching hospital and identify areas for improvement. A cross-sectional and descriptive study was conducted among the nursing professionals at All India Institute of Medical Sciences, New Delhi from July 2016 to June 2017. Study participants included all the nursing officers (approximately 3,000) working in the institute. A pre-validated 24-item questionnaire using a seven-point Likert scale broadly covered seven domains of job satisfaction. A pilot study was conducted on 100 participants, and Cronbach’s alpha was calculated to be .78. The questionnaires were posted to the study participants in their respective work areas in sealed envelopes. The overall score for job satisfaction was 4.56 ± 0.70. The domain-wise job satisfaction of the nursing staff in decreasing order was: work interaction with co-workers, communication, relationship with supervisor, career development, patient care, administration and nursing education. Overall, the job satisfaction levels of nursing administrators were higher across all domains as compared to bedside nurses. Qualitatively, 32.3% of the responders expressed that the shortage of staff was a major problem in delivering their best effort. Overall, job satisfaction among nursing personnel working in a public hospital is low, except for two domains related to co-workers and communication. Training of the nursing officers and relationships with supervisors are the areas that need immediate attention, as they reported as having the lowest satisfaction scores among the nursing officers.
Mansoor Hussain, Mohammad Kausar, V. Siddharth et al.· Journal of Health Management· 0 citations
Background: Clinical posting is a fundamental component of nursing education, providing students with opportunities to apply theoretical knowledge and develop essential clinical competencies. However, students’ attitudes toward clinical posting may be influenced by institutional, individual, and environmental factors. This study examined the determinants of nursing students’ attitudes towards clinical posting at Delta State University, Abraka, Nigeria, using Social Influence Theory as a conceptual framework.
Methods: A descriptive cross-sectional quantitative study was conducted among nursing students in the Department of Nursing Science, Delta State University, Abraka. A stratified random sampling technique was used to select 156 nursing students in 300–500 levels who had participated in at least two clinical postings. Data were collected using a structured questionnaire and analyzed using descriptive statistics and chi-square tests in SPSS version 23.
Results: Findings revealed that 83.3% of respondents demonstrated positive attitudes towards clinical posting, acknowledging its importance in skill acquisition and professional development. Institutional factors such as staff behaviour, availability of resources, adequate supervision, and quality of facilities significantly influenced students’ attitudes. Chi-square analysis showed statistically significant relationships between institutional factors (χ² = 4.00, p = 0.045), individual factors (χ² = 4.50, p = 0.033), environmental factors (χ² = 3.91, p = 0.048), and students’ attitudes towards clinical posting.
Conclusion: Nursing students generally exhibited positive attitudes towards clinical posting. Institutional, individual, and environmental factors significantly influenced these attitudes. Strengthening clinical supervision, improving learning environments, and promoting supportive staff–student interactions may enhance students’ clinical learning experiences and professional development.
A. Onyenwenyi, Goodness Ogheneochuko Ayovo-E, E.E. Onakpoya et al.· Emerging Frontiers in Transl...· 0 citations