# Clinical decision-making competencies and work readiness in senior nursing students: a path analysis study

## TL;DR

This study explores how senior nursing students in Turkey develop clinical decision-making and work readiness skills, and what factors influence these abilities.

## Contribution

The study identifies specific factors influencing clinical decision-making and work readiness in senior nursing students using path analysis.

## Key findings

- Senior nursing students showed moderate clinical decision-making competence and moderate-to-high work readiness.
- Organizational Intelligence had the strongest positive association with clinical decision-making subdimensions.
- Personal Work Characteristics showed negative associations with clinical decision-making.

## Abstract

Clinical decision-making and work readiness are essential competencies that support nursing students’ transition into professional practice. Understanding the factors that are associated with these competencies is critical for designing effective educational strategies and planning future internship programs.

This study aimed to assess the clinical decision-making competencies and work readiness levels of senior nursing students and to examine the factors associated with these competencies using path analysis.

The study included 219 senior nursing students enrolled in a nursing program in Turkey. Data were collected using a Sociodemographic Data Form, the Clinical Decision-Making in Nursing Scale (CDMNS), and the Work Readiness Scale (WRS). Statistical analyses included descriptive statistics, t-tests, ANOVA, and path analysis modeling performed using SPSS and AMOS.

The mean age was 22.4 ± 2.3 years and 74% were female. The majority (78.5%) had completed two terms of internship. Students reported moderate clinical decision-making competence (CDMNS mean = 3.34 ± 0.43) and moderate-to-high work readiness (WRS mean = 6.10 ± 1.44). Female students and those who had voluntarily chosen nursing reported higher CDMNS scores. Consistent use of scientific evidence, confidence in patient-safety decisions, tolerance of ambiguity, and generating alternative solutions were associated with higher scores. In the path model, Organizational Intelligence showed the strongest positive associations with all CDMNS subdimensions (β = 0.37–0.67), while Personal Work Characteristics showed negative associations (β = −0.14 to − 0.35).

Senior nursing students exhibited moderate levels of clinical decision-making competence and work readiness. Personal motivation, evidence-based practice, creative problem-solving, and organizational skills were associated with clinical decision-making competence and work readiness. Strengthening structured internship programs and promoting innovative thinking may further enhance students’ readiness for professional practice.

Not applicable.