Skip to main content
Download PDF

The mediating effects of self-directed learning ability and critical thinking ability on the relationship between learning engagement and problem-solving ability among nursing students in Southern China: a cross-sectional study

BMC Nursing volume 22, Article number: 212 (2023) Cite this article

Abstract

Background

Problem-solving ability has been identified as a core competence that nursing students should develop, and it plays a vital role in career development. Therefore, it is necessary to investigate factors related to problem-solving ability and the path relationships among those factors in the context of nursing students.

Objective

This study aims to identify the factors that affect problem-solving ability, and to investigate path relationships of self-directed learning ability, critical thinking ability, learning engagement, and problem-solving ability among nursing students.

Design

A cross-sectional study.

Settings

The Department of Nursing at a university located in Shanghai, China.

Sample

A total of 540 nursing students with a three-year education program were enrolled in the current study.

Methods

Data were collected by using a structured questionnaire, including general information, learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability of nursing students. Pearson’s correlations were used to explore the relationships between learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability. The path relationships were analyzed by constructing a structural equation model using AMOS software.

Results

Our results showed that learning engagement, self-directed learning ability, and critical thinking ability were positively associated with problem-solving ability. Furthermore, learning engagement did not influence problem-solving ability directly, but it affected problem-solving ability indirectly via self-directed learning ability and critical thinking ability among nursing students. Additionally, the total effects of self-directed learning (0.442) and critical thinking ability (0.581) were more prominent than learning engagement (0.361) on problem-solving ability.

Conclusions

To improve the problem-solving ability of nursing students, nursing educators should develop targeted strategies to enhance learning engagement, self-directed learning ability, and critical thinking ability.

Peer Review reports

Introduction

People are facing increasingly complicated health problems, and their demands for medical and health care are becoming more diversified [1]. People expect personalised and high quality health care, which requires nurses to have not only basic medical knowledge, but also specific core competencies. Problem-solving ability is one of these core competencies. Problem-solving ability involves cognitive, emotional, and behavioural activities [2], which is a process that identifies a situation as a problem, selects appropriate measures, and implements these measures to achieve the expected goals [3]. Previous studies have shown that nurses with strong problem-solving ability can deal with patients’ health problems and emergencies more effectively, and can even reduce disease recurrence and mortality [5, 6]. In other words, problem-solving ability is crucial for nurses to make clinical reasoning and decisions [4], and nurses with strong problem-solving ability are able to evaluate patients thoroughly, identify health problems immediately, and provide holistic care [5].

However, previous studies reported that nursing students’ problem-solving ability was still at a medium or low level [6,7,8]. When recently graduated nursing students enter the clinic, they lack rational thinking and decision-making ability. Moreover, it is difficult for them to use existing resources and practical methods to analyze and solve clinical problems, resulting in low efficiency in terms of nursing work, and even the emergence of negative emotions, which will have a negative effect on their career [9]. Therefore, problem-solving ability should be cultivated among nursing students immediately. And it is necessary to identify the factors related to problem-solving ability and to investigate the relationship among these factors.

The engagement was initially defined as a positive, fulfilling, and work-related mental state characterized by vitality, dedication, and absorption [10]. More recently, the scope of this concept shifted from a sole focus on work to encompass learning. Learning engagement is defined as a students’ ongoing efforts to achieve learning outcomes in the learning process, which is a multidimensional phenomenon that includes emotional engagement (i.e. enthusiasm and interest), cognitive engagement (i.e. the use of learning strategies and self-regulation), and behavioural engagement (i.e. effort, persistence, and attention) [11, 12]. Nursing students’ learning engagement is regarded as a primary component of effective teaching and a necessary prerequisite for learning [13]. Additionally, learning engagement is also a key component in nursing education, and it significantly predicts nursing students’ learning achievements and personal development [14,15,16]. Liu et al. noted that students with higher levels of emotional and behavioural engagement have stronger self-directed learning ability [17]. Accordingly, learning engagement was positively associated with self-directed learning ability. However, to the best of our knowledge, few researchers have examined the correlations between learning engagement and critical thinking ability or problem-solving ability.

Due to the rapid technological advances in improving healthcare and living standards, nursing students need to constantly keep up to date with the latest evidence-based practice and knowledge. Self-directed learning ability is the most crucial factor in facilitating personal learning with the aim of providing efficient medical and care services to patients [18]. This ability focuses on learning needs and goals, making individuals responsible for their learning and helping individuals actively and independently seek appropriate methods to solve problems [19]. Nursing students who learn knowledge and skills on their own can effectively seek, analyze, and use the information to solve problems [20]. Previous studies have found a significant positive correlation between self-directed learning ability and problem-solving ability, and reported that self-directed learning ability could affect problem-solving ability directly among first and second-year nursing students in South Korea [13]. Similarly, a cross-sectional study conducted among junior or senior nursing students in South Korea showed that the development and implementation of appropriate self-directed learning programmes are critical for improving nursing students’ problem-solving ability [21]. Moreover, Choi et al. demonstrated that the higher independent learning scores of first-year nursing students were, the better their problem-solving and critical thinking ability would be [22]. These results indicated that self-directed learning ability played a key role in determining problem-solving ability and critical thinking ability among nursing students.

Critical thinking ability in nursing professionals is defined as the ability to think, apply, analyze, synthesize, and evaluate situations [23]. The ability refers to a complex mental process that helps nursing students make decisions and take action when facing unexpected nursing situations after recognizing, synthesizing, analyzing, and evaluating the relevant information [20, 24]. It allows individuals to raise questions logically, understand situations, and criticize solutions to problems [23]. Studies on the relationship between critical thinking ability and problem-solving ability have shown that an improvement in an individual’s critical thinking ability can lead to improvement in an individual’s problem-solving ability [25]. And Jo suggested that in order to improve the problem-solving ability of undergraduate nursing students, it is necessary to develop their critical thinking ability [26].

In summary, although previous studies have explored the importance of problem-solving ability in nursing education, as well as the association between problem-solving ability and certain other important competencies among nursing students, such as self-directed learning ability and critical thinking ability, the evidence remained insufficient, because the results that have previously been reported were inconsistent in terms of the populations studied due to populations from different regions, different education programmes, and different grades. Furthermore, according to the literature review just conducted, few studies have directly focused on the associations of learning engagement with critical thinking ability or problem-solving ability, but some studies have emphasized the association of learning engagement with self-directed learning ability, the association of problem-solving ability with self-directed learning ability and critical thinking ability Therefore, a structural equation model of problem-solving ability was hypothesized and established. This study aims to explore the structural model of the relationships between learning engagement, self-directed learning ability, critical thinking, and problem-solving ability among three-year nursing students in Southern China. And it will provide the necessary foundational data to support the design of educational programs aimed at improving the problem-solving ability of nursing students.

Methods

Materials and methods

Study design and participants

A cross-sectional survey was conducted between March and April 2022, in the Department of Nursing with a three-year education program at a university in Shanghai, China. The survey samples were selected using a convenience sampling method. First, we selected one university from a list of all universities with a department of nursing featuring a three-year education program by drawing lots. Subsequently, we chose some freshman, sophomore, and junior classes. Finally, all nursing students from the selected classes completed the structured questionnaires. Students were included if they had a normal mental status. The exclusion criteria were as follows:1) refusal to participate in this study (n = 3); 2) missing or invalid data on learning engagement, self-directed learning ability, critical thinking, and problem-solving ability variables (n = 7). A total of 540 eligible participants were recruited for the final analysis. The response rate was 98.12%.

Procedures

All research data were collected using structured questionnaires. In order to improve data collection skills and standardize data collection methods, the interviewers received specific training in advance. The project leader informed the interviewers of certain communication skills with nursing students, and explained the purpose and method of filling in the questionnaire in advance.

Measurements

College students’ learning engagement questionnaire

The 20-item learning engagement questionnaire [27]. with a Cronbach’s alpha of 0.85 was applied to assess the level of college students’ learning engagement, including behavioural engagement (6 items), cognitive engagement (7 items), and emotional engagement (7 items). Participants reported their learning engagement level by responding to items scored on a 5-point scale (1–5), which ranged from “1 = completely nonconformity” to “5 = completely conformity”, and higher scores indicated higher levels of learning engagement. The Cronbach’s alpha was 0.961 in this study.

Nursing students’ self-directed learning scale

The nursing students’ self-directed learning scale consisted of 20 items with a Cronbach’s alpha of 0.914, including learning motivation (6 items), planning and implementation (6 items), self-management (4 items), and interpersonal communication (4 items). Each item was scored on a 5-point scale (1–5), which ranged from “1 = strongly disagree” to “7 = strongly agree”, and higher scores indicated higher self-directed learning ability levels [28, 29]. The Cronbach’s alpha was 0.965 in this study.

Critical thinking disposition inventory

Nursing students’ critical thinking ability was measured using the Critical Thinking Disposition Inventory-Chinese Version (CIDI-CV) [30]. This scale was composed of 7 subscales with truth seeking (10 items), open mindedness (10 items), analyticity (10 items), systematicity (10 items), self-confidence (10 items), inquisitiveness (10 items), and maturity (10 items). Each item was scored on a 6-point scale (1–6), which ranged from “1 = strongly disagree” to “6 = strongly agree”. Higher scores on this scale indicated higher levels of critical thinking ability. The Cronbach’s alpha was 0.90 in Peng’s study. The Cronbach’s alpha was 0.947 in this study.

Social problem-solving inventory

Nursing students’ social problem-solving ability was assessed using the Chinese Version of the Social Problem-Solving Inventory (C-SPSI), which was validated based on the Social Problem-Solving Inventory Revised (SPSI-R) [31]. This scale was composed of the 5 subscales of the 25-item SPSI-R, including positive problem orientation (5 items), rational problem solving (5 items), negative problem orientation (5 items), impulsivity/carelessness style (4 items), and avoidance style (6 items). Each item was scored on a 5-point scale (1–5); the first two subscales ranged from “1 = completely nonconformity” to “5 = completely conformity”, but the last three subscales ranged from “1 = completely conformity” to “5 = completely nonconformity”. Higher scores on this scale indicated higher levels of problem-solving ability. Cronbach’s alpha was 0.817 in Siu’s study. The Cronbach’s alpha was 0.997 in this study.

Statistics analysis

Data analyses were performed using SPSS V.21.0 and AMOS V24.0 software. Data are presented as the mean ± SD, frequencies (percentage), and correlation coefficient. Pearson’s correlation was used to explore the relationships between learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability among nursing students. Hypotheses were examined by conducting a structural equation modeling analysis. The model was tested using the goodness of fit test. In this context, the most important measures are the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), the incremental fit index (IFI), the tucker-lewis coefficient (TLI), the comparative fitting index (CFI), the root mean square error of approximation (RMSEA), and the chi-square degrees of freedom (x2/df). A two-tailed P < 0.05.was regarded as statistical significance.

Results

Participants’ general information

A total of 540 participants were included in our study, and their mean age was 20.18 ± 1.29 years. Most participants were female (87.2%), only children (66.9%), and more than half of the students lived in a city. 60.6% loved nursing, and 65.9% stayed in a general learning atmosphere. More details of the participants’ characteristics were presented in Table 1.

Table 1 General information of nursing students (N = 540)
Full size table

Descriptive statistics of measured variables

The average scores of nursing students’ learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability were 71.27 ± 11.85, 71.34 ± 11.35, 269.16 ± 27.46, and 81.74 ± 8.81, respectively (shown in Table 2). The mean scores of learning engagement and self-directed learning ability were at the upper middle, indicating that the students in this study were willing to explore knowledge actively, and made efforts to achieve learning outcomes in their learning process; The mean scores of critical thinking ability and problem-solving ability were at the middle level, indicating that relevant educators need to pay more attention on improving critical thinking ability and problem-solving ability of the students in this study.

Table 2 Level of learning engagement, self-directed learning ability, critical thinking ability and problem-solving ability among nursing students (N = 540)
Full size table

Correlation between measured variables

Table 3 showed significant positive correlations between learning engagement and self-directed learning ability (r = 0.817, P < 0.001), between learning engagement and critical thinking ability (r = 0.383, P < 0.001), between learning engagement and problem-solving ability (r = 0.326, P < 0.001), between self-directed learning ability and critical thinking ability (r = 0.527, P < 0.001), between self-directed learning ability and problem-solving ability (r = 0.442, P < 0.001), and between critical thinking ability and problem-solving ability (r = 0.652, P < 0.001).

Table 3 Correlation beween learning engagement, self-directed learning ability, critical thinking ability and problem-solving ability among nursing students (N = 540)
Full size table

Structural equation model test

The theoretical model indexes were χ2/df < 5, GFI > 0.9, AGFI > 0.9, IFI > 0.9, TLI > 0.9, CFI > 0.9, and RMSEA < 0.08 [32]. The model fitness indexes in this study were χ2/df = 2.609, GFI = 0.995, AGFI = 0.976, IFI = 0,997, TLI = 0.991, CFI = 0.997, and RMSEA = 0.055, which all met the theoretical values. Therefore, the hypothesized path model was appropriate. The fitness indices were shown in Table 4.

Table 4 Structure equation modeling fit indices
Full size table

Effects of structural equation model

The standardized direct, indirect, and total effects of the variables included in the structural equation model were provided in Table 5. Learning engagement had a direct effect on self-directed learning ability (0.817). Self-directed learning ability had a direct effect on critical thinking ability (0.527). However, learning engagement had no direct effect on critical thinking ability. Self-directed learning ability had a direct effect on problem-solving ability (0.136), and critical thinking ability had a direct effect on problem-solving ability (0.581), but learning engagement had no direct effect on problem-solving ability. In other words, self-directed learning ability (0,817*0.136 = 0.111) and critical thinking ability (0.817*0,527*0.581 = 0.250) mediated the relationship between the nursing students’ learning engagement and problem-solving ability. Although nursing students’ learning engagement did not affect their problem-solving ability directly, high levels of learning engagement improved their problem-solving ability by enhancing their self-directed learning ability and critical thinking ability. The total effect of learning engagement on problem-solving ability was 0.361 (0,817*0.136 + 0.817*0,527*0.581). The path diagram for the model was presented in Fig. 1.

Table 5 Standardized direct, indirect, and total effects of each variable in structural equation model
Full size table
Fig. 1
figure 1

The mediating effects of self-directed learning ability and critical thinking ability on the relationship between learning engagement and problem-solving ability

Full size image

Discussion

Main findings

Our results showed that learning engagement, self-directed learning ability, and critical thinking ability were significantly positively associated with the problem-solving ability of nursing students. Furthermore, learning engagement did not influence problem-solving ability directly, but it affected problem-solving ability indirectly via self-directed learning ability and critical thinking ability. Additionally, our results confirmed that the total effects of both self-directed learning ability and critical thinking ability on problem-solving ability were more prominent than that of learning engagement on problem-solving ability.

The positive association of learning engagement, self-directed learning ability, and critical thinking ability with problem-solving ability

In this study, the problem-solving ability was significantly positively related to learning engagement (r = 0.326, P < 0.001), self-directed learning ability (r = 0.442, P < 0.001), and critical thinking ability (r = 0.652, P < 0.001). These findings indicate that the higher the level of learning engagement, self-directed learning ability, and critical thinking ability of nursing students is, the higher their problem-solving ability will be. In other words, the problem-solving ability can be improved by enhancing learning engagement, self-directed learning ability, and critical thinking ability, similar to previous findings [13, 22, 33, 34]. Students with high levels of learning engagement are more likely to exhibit strong enthusiasm and desire for knowledge, and they would do their best to complete challenging tasks [35]; therefore, such students are more willing to seek problem-solving methods. Concerning the association of problem-solving ability with self-directed learning ability, our findings were consistent with that of previous studies [13, 22]. Nursing students with strong self-directed learning ability are more responsible for their learning, and can effectively seek, analyze, and use the information to solve problems [19, 20]. Fang et al. found that self-directed learning ability might be recommended as an effective way to enhance the level of problem-solving ability of Chinese baccalaureate nursing students [36]. Regarding the relationship between problem-solving ability and critical thinking ability, the results in this study were similar to Kanbay’s reports [25]. It may be that individuals with greater critical thinking have stronger confidence in solving a problem, which in turn enhances their problem-solving ability [37]. Therefore, it is necessary for educators to develop teaching methods to facilitate nursing students’ learning engagement, self-directed learning ability, and critical thinking ability for improving nursing students’ problem-solving ability.

The mediating effects of self-directed learning and critical thinking ability on the relationship between learning engagement and problem-solving ability

In the current study, learning engagement was not found to have a significant direct effect on critical thinking ability and problem-solving ability, but had a mediating effect on problem-solving ability through self-directed learning ability and critical thinking ability. An explanation for these findings was that learning engagement directly and positively influences self-directed learning ability. Emotional and behavioural engagement were associated with self-directed learning ability [17]. Students with high levels of emotional engagement exhibited stronger interest and confidence in learning, had a relatively correct understanding of the value of learning, and were more likely to learn actively and independently; Students with high levels of behavioural engagement were more serious and focused, and when they encountered difficulties in learning, they were more willing to ask teachers or classmates for help to solve problems. Hence, they had stronger self-directed learning ability [38]. The mediating effects highlighted the need to consider learning engagement, self-directed learning ability, and critical thinking ability in nursing students’ education when identifying factors related to problem-solving ability. Moreover, a significant finding in our study was that the total effects of self-directed learning (0.442) and critical thinking ability (0.581) were more prominent than learning engagement (0.361) on problem-solving ability among nursing students enrolled in a three-year education program. These results emphasize the need for educators to consider self-directed learning and critical thinking ability together when they focus on using learning engagement to improve problem-solving ability. Educators should adopt teaching strategies that emphasize the development of self-directed learning and critical thinking ability to improve problem-solving ability, such as flipped learning, team-based learning (TBL) and problem-based learning (PBL). Cheng et al. [39] and Qamata et al. [40] demonstrated that undergraduate nursing students’ self-directed learning ability could be significantly improved by TBL and PBL approaches. A quasi-experimental research conducted in Borujen Nursing School suggested nursing students’ critical thinking ability could be enhanced by the school training course [41].

Strengths and limitations of our study

To the best of our knowledge, the mediating effects of self-directed learning ability and critical thinking ability on the relationship between learning engagement and problem-solving ability were explored for the first time, especially in nursing students enrolled in a three-year education program in Southern China. Improving nursing students’ problem-solving ability is very necessary, because previous studies have suggested that nurses with high levels of problem-solving ability were more capable of dealing with patients’ problems [2]. However, this study has several limitations. First, the data in our analyses were based on self-reports, which could lead to biases or inaccuracies. Second, this study was a cross-sectional design, so the observed associations should not be assumed to be causal relationships. Further in-depth studies with longitudinal follow-up data are warranted to explore the cause-effect relationship. Third, this study was performed only in Shanghai, China, and the generalization of the results should be carefully promoted.

Conclusions

This study showed that self-directed learning ability and critical thinking ability affected nursing students’ problem-solving ability directly, and the association of learning engagement with problem-solving ability was influenced by the mediating effects of self-directed learning ability and critical thinking ability. Therefore, it is necessary for educators to develop improvement strategies for nursing students’ problem-solving ability in consideration of these variables.

Data Availability

As the data are shared by our team, the datasets generated and/or analysed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

References

  1. Salmerón-Manzano E, Manzano-Agugliaro F. Bibliometric Studies and Worldwide Research Trends on Global Health. Int J Environ Res Public Health. 2020;17(16):5748. https://doi.org/10.3390/ijerph17165748.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kim HR, Song Y, Lindquist R, et al. Effects of team-based learning on problem-solving, knowledge and clinical performance of korean nursing students. Nurse Educ Today. 2016;38:115–8. https://doi.org/10.1016/j.nedt.2015.12.003.

    Article  PubMed  Google Scholar 

  3. Terzioglu F. The perceived problem-solving ability of nurse managers. J Nurs Manag. 2006;14(5):340–7. https://doi.org/10.1111/j.1365-2934.2006.00551.x.

    Article  PubMed  Google Scholar 

  4. Ancel G, Problem-Solving, Training. Effects on the problem-solving skills and self-efficacy of nursing students. Euro J Edu Res. 2016;16(64):231–46. https://doi.org/10.14689/ejer.2016.64.13.

    Article  Google Scholar 

  5. Joung J, Ryu Y. The influence of humanity, problem solving ability on clinical competence in nursing students. Korean Association For Learner-Centered Curriculum And Instruction. 2019;19:193–211. https://doi.org/10.22251/jlcci.2019.19.16.193.

    Article  Google Scholar 

  6. Salehi S, Bahrami M, Hosseini SA, et al. Critical thinking and clinical decision making in nurse. Ran J Nurs Midwifery Res. 2006;12(1):13–6. https://doi.org/10.1016/S0147-9563(03)00038-4.

    Article  Google Scholar 

  7. Altun I. The perceived problem solving ability and values of student nurses and midwives. Nurse Educ Today. 2003; 23(8): 575 – 84. https://doi.org/10.1016/S0260-6917(03)00096-0.

  8. Shahbazi S, Heidari M, Sureshjani EH, et al. Effects of problem-solving skill training on emotional intelligence of nursing students: an experimental study. Educ Health Promot. 2018;7:156. https://doi.org/10.4103/jehp.jehp_50_18.

    Article  Google Scholar 

  9. Kim AY, Sim IOC, Skills P-S, Ability. Understanding of patients’ conditions, and nurse’s perception of professionalism among clinical nurses: a structural equation Model Analysis. Int J Environ Res Public Health. 2020;17(13):4896. https://doi.org/10.3390/ijerph17134896.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Schaufeli WB, Martinez IM, Pinto AM, et al. Burnout and engagement in university students-a cross-national study. J Cross-Cult Psychol. 2002;33(5):464–81. https://doi.org/10.1177/0022022102033005003.

    Article  Google Scholar 

  11. Yan ZG. English as a Foreign Language Teachers’ critical thinking ability and L2 students’ Classroom Engagement. Front Psychol. 2021;12:1–4. https://doi.org/10.3389/fpsyg.2021.773138.

    Article  Google Scholar 

  12. Coates H. The value of student engagement for higher education quality assurance. Qual High Educ. 2005;11(1):25–36. https://doi.org/10.1080/13538320500074915.

    Article  Google Scholar 

  13. Hwang Y, Oh J. The relationship between Self-Directed learning and problem-solving ability: the mediating role of academic self-efficacy and self-regulated learning among nursing students. Int J Environ Res Public Health. 2021;18(4):1738. https://doi.org/10.3390/IJERPH18041738.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Wang Y, Li MX, Zhang Q, et al. The mediating role of professional commitment between the clinical learning enviornment and learning engagement of nursing students in clinical practice: a cross-sectional study. Nurse Educ Today. 2023;121:105677. https://doi.org/10.1016/j.nedt.2022.105677.

    Article  Google Scholar 

  15. Li Q, Bake R. The different relationships between engagement and outcomes across participant subgroups in massive open online course. Comput Educ. 2018;127:41–65. https://doi.org/10.1016/j.compedu.2018.08.005.

    Article  Google Scholar 

  16. Bernard JS. Student engagement: a principle-based concept analysis. Int J Nurs Educ Scholarsh. 2015;12(1):111–21. https://doi.org/10.1515/ijnes-2014-0058.

    Article  Google Scholar 

  17. Liu XH, Guo JD. The relationship between English learning engagement and achievement under the flipped classroom model. J Hang Zhou Dian Zi University. 2018;14(5):59–64. (In Chinese).

    Google Scholar 

  18. Smedley A. The self-directed learning readiness of first year bachelor of nursing students. J Res Nurs. 2007;12(4):373–85. https://doi.org/10.1177/1744987107077532.

    Article  Google Scholar 

  19. Chen JH, Björkman A, Zou JH, et al. Self-regulated learning ability, metacognitive ability, and general self-effificacy in a sample of nursing students: a cross-sectional and correlational study. Nurse Educ Pract. 2019;37:15–21. https://doi.org/10.1016/j.nepr.2019.04.014.

    Article  CAS  PubMed  Google Scholar 

  20. Kang SJ, Hong CM, Lee H. The impact of virtual simulation on critical thinking and self-directed learning ability of nursing students. Clin Simul Nurs. 2020;49(4):66–72. https://doi.org/10.1016/j.ecns.2020.05.008.

    Article  Google Scholar 

  21. Song Y, Lee Y, Lee J. Mediating effects of self-directed learning on the relationship between critical thinking and problem-solving in student nurses attending online classes: a cross-sectional descriptive study. Nurse Educ Today. 2021;109:105227. https://doi.org/10.1016/j.nedt.2021.105227.

    Article  PubMed  Google Scholar 

  22. Choi E, Lindquist R, Song Y. Effects of problem-based learning vs. traditional lecture on korean nursing students’ critical thinking, problem-solving, and self-directed learning. Nurse Educ Today. 2014;34(1):52–6. https://doi.org/10.1016/j.nedt.2013.02.012.

    Article  PubMed  Google Scholar 

  23. Yeung MMY, Yuen JWM, Chen JMT, et al. The efficacy of team-based learning in developing the generic capability of problem-solving ability and critical thinking skills in nursing education: a systematic review. Nurse Educ Today. 2022. https://doi.org/10.1016/j.nedt.2022.105704.

    Article  PubMed  Google Scholar 

  24. Papathanasiou IV, Kleisiaris CF, Fradelos EC, et al. Critical thinking: the development of an essential skill for nursing students. Acta Inf Med. 2014;22(4):283–6. https://doi.org/10.5455/aim.2014.22.283-286.

    Article  Google Scholar 

  25. Kanbay Y, Okanli A. The effect of critical thinking education on nursing students’ problem-solving skills. Contemp Nurse. 2017;53(3):313–21. https://doi.org/10.1080/10376178.2017.1339567.

    Article  PubMed  Google Scholar 

  26. Jo HH, Hwang WJ. Factors influencing on Problem solving ability of nursing students experiencing Simulation Practice. Int J Environ Res Public Health. 2022;19(18):11744.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Liao YG. A study on the Situation of College Students’ Learning Value, academic Self-efficacy, Learning Engagement and the relation between them. Fuzhou: Fujian Normal University; 2010. (in Chinese).

    Google Scholar 

  28. Cheng SF, Kuo CL, Lin KC, et al. Development and preliminary testing of a self-rating instrument to measure self-directed learning ability of nursing students. Int J Nurs Stud. 2010;47(9):1152–8. https://doi.org/10.1016/j.ijnurstu.2010.02.002.

    Article  PubMed  Google Scholar 

  29. Wu D. Study on self-directed learning ability and its influence factors among nursing undergraduates. D. Changsha: Zhongnan university,; 2014. (in Chinese).

  30. Peng MC, Wang GC, Chen JL. Validity and reliability of the chinese critical thinking Disposition Inventory (in chinese). Chin J Nurs. 2004;39(9):644–7. https://doi.org/10.3321/j.issn:0254-1769.2004.09.002.

    Article  Google Scholar 

  31. Siu AM, Shek DT. The chinese version of the social problem-solving inventory: some initial results on reliability and validity. J Clin Psychol. 2005;61(3):347–60. https://doi.org/10.1002/jclp.20023.

    Article  PubMed  Google Scholar 

  32. Wang YH, Zhang Y, Liu MH, et al. Research on the formation of humanistic care ability in nursing students: a structural equation approach. Nurse Educ Today. 2020;86:104315. https://doi.org/10.1016/j.nedt.2019.104315.

    Article  PubMed  Google Scholar 

  33. Rashid T, Asghar HM. Technology use, self-directed learning, student engagement and academic performance: examining the interrelations. Comput Hum Behav. 2006;63:604–12. https://doi.org/10.1016/j.chb.2016.05.084.

    Article  Google Scholar 

  34. Song Y, Lee Y, Lee J. Mediating effects of self-directeded learning on the relationship between critical thinking and problem-solving in student nurses attending online classes: a cross-sectional descriptive study. Nurs Educ Today. 2022;109:105227. https://doi.org/10.1016/j.nedt.2021.105227.

    Article  Google Scholar 

  35. Wu H, Zheng J, Li S, et al. Does academic interest play a more important role in medical sciences than in other disciplines? A nationwide cross-sectional study in China. BMC Med Educ. 2019;19(1):301. https://doi.org/10.1186/s12909-019-1737-1.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Fang J, Luo Y, Li Y, et al. mSocial problem-solving in chinese baccalaureate nursing students. J Evid Based Med. 2016;9(4):181–7. https://doi.org/10.1111/jebm.12232.

    Article  PubMed  Google Scholar 

  37. Han Y, Park Y. Effects of self-leadership and job involvement on clinical competence in general hospital nurses. J Korean Acad Nurs Adm. 2013;19(4):462–9. https://doi.org/10.11111/jkana.2013.19.4.462.

    Article  Google Scholar 

  38. Liu Q, Zhen L. The Influence of Self-efficacy on College Students’ English Autonomous learning: The Mediating Effect of Learning Engagement. J Southwest Jiaotong University. 2021; 22(6):71–81.https://kns.cnki.net/kcms/detail/51.1586.C.20211111.1359.018.html.

  39. Cheng CY, Liou SR, Hsu TH, et al. Preparing nursing students to be competent for future professional practice: applying the teambased learning-teaching strategy. J Prof Nurs. 2014;30(4):347–56.

    Article  PubMed  Google Scholar 

  40. Qamata-Mitshali N. Self-directed learning readiness is independent of teaching and learning approach in undergraduate nursing education. Nurse Educ Today. 2018;43(5):277–81.

    Article  Google Scholar 

  41. Ahmady S, Shahbazi S. Impact of social problem-solving training on critical thinking and decision making of nursing students. BMC Nurs. 2020;19(1):1–8. https://doi.org/10.1186/s12912-020-00487-x.

    Article  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the staff of Shanghai Lida University for their kind assistance in data collection and other people who assisted us throughout the study.

Funding

This study was funded by the Shanghai Young Teachers Training Program in 2019 (Z20002-19-06), the Shanghai “Chenguang Plan” Program in 2019 (2007030003), and the 12th Batch of Special Funds of Shanghai Municipal Government (Z30001-19-08), and the scientific research project of Shanghai Lida University in 2022 (AKY-2022-01-10).

Author information

Author notes

  1. Lingling Huang and Xuanhua Li contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Lida University, Shanghai, 201609, China

    Lingling Huang, Xuanhua Li, Ming Lei, Yanru Niu & Rong Li

  2. Department of Nursing, School of Medical, Huanghe Science and Technology College, Zhengzhou, 450000, China

    Ya Meng

  3. Department of Nursing, School of Nursing, Philippine Women’s University, Manila, Philippines

    Ya Meng

  4. Shanghai General Hospital, Shanghai, 200080, China

    Shanshan Wang

Authors
  1. Lingling Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xuanhua Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ya Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yanru Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shanshan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Data curation: LingLing Huang, Ming Lei, Yanru Niu; Formal analysis: LingLing Huang; Funding acquisition: LingLing Huang; Methodology: LingLing Huang; Software: LingLing Huang, Shanshan Wang, Ya Meng, and Rong Li; Writing–original draft: LingLing Huang and Xuanhua Li; Writing–review & editing, Lingling Huang, Xuanhuan Li, and Rong Li.

Corresponding author

Correspondence to Rong Li.

Ethics declarations

Ethica approval and consent to participate

The use of data was performed in accordance with relevant guidelines and regulations. This study was approved by the Ethics Committee of Shanghai Lida University (SLDU 2022-1). Each subject received written information about the aim of the study. If they decided to participate, a written informed consent was obtained.

Consent for publication

Not application.

Competing Interest

The authors declare no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, L., Li, X., Meng, Y. et al. The mediating effects of self-directed learning ability and critical thinking ability on the relationship between learning engagement and problem-solving ability among nursing students in Southern China: a cross-sectional study. BMC Nurs 22, 212 (2023). https://doi.org/10.1186/s12912-023-01280-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12912-023-01280-2

Keywords

BMC Nursing

ISSN: 1472-6955

Contact us