# Academic Self‐Efficacy as a Mediator Between Risk for Social Media Addiction, Nomophobia, and Clinical Performance Among Nursing Internship Students: A Structural Equation Model

## TL;DR

This study shows that social media addiction and nomophobia hurt nursing interns' clinical performance, but academic self-efficacy can help reduce these negative effects.

## Contribution

The study introduces academic self-efficacy as a mediator between social media addiction, nomophobia, and clinical performance in nursing interns.

## Key findings

- Risk for social media addiction and nomophobia negatively affects clinical performance.
- Academic self-efficacy improves clinical performance and mediates the negative effects of social media addiction and nomophobia.
- 42.64% of the variance in clinical performance is explained by social media addiction, nomophobia, and academic self-efficacy.

## Abstract

To investigate the associations among risk for social media addiction (SMA), nomophobia, clinical performance, and the mediating effect of academic self‐efficacy (ASE) among these relationships.

There is a preponderance of studies about SMA and nomophobia’s negative and positive effects on nursing students’ academic performance. However, its impacts on clinical performance among nursing interns and whether ASE has a mediating effect among these relationships remain underreported.

A cross‐sectional correlational design was used, involving nursing interns, who were consecutively recruited from April to June 2025, from four nursing colleges. To collect data, three validated self‐report scales were used. Covariance‐based structural equation modeling was employed for data analyses.

Risk for SMA positively influenced nomophobia (β = 0.12, p = 0.002), while negatively affected ASE (β = −0.07, p = 0.030) and clinical performance (β = −0.04, p = 0.002). Nomophobia negatively associated with ASE (β = −0.56, p = 0.002) and clinical performance (β = −0.18, p = 0.008). ASE directly influenced clinical performance (β = 0.18, p = 0.002). The 42.64% variance of clinical performance was attributable to SMA, nomophobia, and ASE. ASE acted as a mediator between SMA and clinical performance (β = 0.08, p = 0.002) and nomophobia and clinical performance (β = 0.12, p = 0.002).

SMA and nomophobia reduced nursing interns’ clinical performance. Meanwhile, ASE improved clinical performance. ASE was a protective factor against the ill‐effects caused by SMA and nomophobia on clinical performance.

Nursing school administrators may create proactive policies in helping nursing students manage their SMA and nomophobia. Nurse managers in clinical learning environments should cultivate favorable learning experiences where students can develop ASE and master clinical skills. Nursing educators and students must elevate their knowledge regarding the negative impacts of SMA and nomophobia and at the same time how they adversely influence nursing students’ clinical performance while jeopardizing patient safety.