Relationship between self-directed learning readiness, learning attitude, and self-efficacy of nursing undergraduates

A total of 500 undergraduate nursing students from fresh to fourth year were enrolled in. The inclusion criteria were students who were ① able to read and speak Chinese and ② physically, mentally, and cognitively able to respond to the questionnaires. A research team member provided undergraduates with information about the study. Informed consent was obtained from the students who agreed to participate in the study. A total of 500 questionnaires were distributed, and 429 surveys were included in the data analysis after excluding questionnaires with incomplete data. The recovery rate was 85.8%. The study used a convenient sampling method; a questionnaire survey was conducted on full-time undergraduate nursing students in Tianjin.

The research team adopted a self-report method based on the literature review and mainly included four parts: ① General demographic variables including gender, grade, done part-time job and Living area ② Whether the undergraduates’ first choice is apply for nursing majors or not and they have done part-time job, etc, adopt “Yes” or “No” as an answer. ③ How much they like the nursing profession and the difficulties in learning under the curriculum are measured using the Likert four-level scoring method. ④ self-study status Satisfaction adopts seven-category level options, such as very dissatisfied, dissatisfied, little bit unsatisfied, uncertain, a little satisfied, satisfied, and very satisfied.

Fisher et al.12 developed the SDLRS for nursing education. The Delphi technique with a panel of 11 nurse educator experts was used to assess the construct and content validity of a number of items perceived to reflect SDLR. In all, 201 undergraduate nursing students were involved in the administration of the questionnaire to develop the SDL. Cronbach’s a value was 0.830–0.924.The SDLR was translated and validated in China by Wang13 The SDLR including a total of 40 items with three dimensions (self-management, love of learning, and self-control) had a high reliability and validity. The total Cronbach’s a value was 0.932. A scoring method used the Likert 5-point scale. Scores from 1 to 5 indicated that they strongly disagreed to strongly agree. The higher the score, the better the self-study preparation of nursing undergraduates.

These surveys were conducted using the learning attitude questionnaire for advanced nurse students, which was compiled by the domestic scholar Zhang.14 The questionnaire consisted of four dimensions: learning interest, learning experience, personal learning habits, and understanding of nursing profession. It comprised 23 items. Likert 5-point scale was used (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). The higher the score, the better the student’s attitude toward learning. The questionnaire was of great reliability and validity; the total Cronbach’s a value was 0.927.

The academic self-efficacy questionnaire has been compiled by Liang.15 The questionnaire consisted of two subscales, learning ability self-efficacy with 11 items and learning behavior self-efficacy with 11 items. There were 22 items in total that used Likert 5-point scale (5 = strongly agree, 4 = agree, 3 = neutral, 2 = disagree, and 1 = strongly disagree). The sum of the two dimensions was the total academic self-efficacy. The higher the score, the higher the sense of efficacy; Cronbach’s a value was 0.752–0.820. In this study, the Cronbach’s a of self-efficacy questionnaire was 0.815.

The objectives of our study design were to ① find the nursing undergraduates’ differences among diverse demographic characteristics; ② find the nursing undergraduates’ SDLR current status; ③ perform correlation analysis of learning attitude, academic self-efficacy, and SDLR; ④ carry out analysis of the factors influencing on nursing undergraduates’ SDLR; and ⑤ accomplish regression analysis of influencing factors on self-study readiness of nursing undergraduates.

The collected questionnaires were manually screened and checked to reject those that are incomplete. The data were analyzed using SPSS 21.0 software for statistical analysis. To describe the sample characteristics, descriptive statistics, particularly mean, standard deviation for continuous variables, frequency, and percentage for dichotomous variables, were used. Students in different situations were assessed using the t-test or analysis of variance to see if there were significant differences in SDLRS scores; correlation analysis was used to explore the relationship between learning state, academic self-efficacy, and self-directed study readiness. To explore the influencing factors of the self-study preparation of nursing students, we took self-study preparation as the dependent variable, general information of nursing undergraduates, learning attitudes and academic self-efficacy as independent variables, a stepwise regression analysis was conducted. P < 0.05 indicates a statistically significant difference.

Of the 429 nursing students, 50 were boys and 379 were girls. The average age of the students was 21.28 ± 1.49 years. The proportions of all grades were as follows: 105 freshman nursing students, accounting for 24.5%; 105 sophomore nursing students, accounting for 24.5%; 132 junior nursing students, accounting for 30.8%; and 87 senior nursing students, accounting for 20.3%. Among the 429 nursing students, 347 (80.9%) have done part-time work before, 208 (48.5%) were from rural areas, and 222 (51.7%) did not apply nursing major as their first choice. In all, 47.1% students chose to prefer their major, while 5.4% students hated care professionals. A total of 265 cases (accounting for 61.8%) were satisfied with the current teaching style, while 1.9% expressed dissatisfaction. In all, 30.5% of the nursing students were unsatisfied with their current learning situation, while 63.2% of the nursing students had no learning difficulties.

The results showed that the SDLR score was 149.99 ± 15.73, which was at a moderate level. The results are shown in Table 1.

According to SPSS statistics, the total score of learning attitude is 73.99 ± 11.92 and the total score of academic self-efficacy is 76.26 ± 8.17. In order to further understand the relationship between learning attitude, academic self-efficacy, and the SDLR, the analysis of their correlation is shown in Table 2.

Results showed that the preparation degree of independent learning ability of nursing undergraduates is significantly correlated with three main variables including earning interest, learning experience, learning habit and nursing specialty, and it has a significant correlation with learning ability self-efficacy and learning behavior self-efficacy. Overall, there is a significant correlation between the degree of SDLR, learning attitude of nursing undergraduates, and academic self-efficacy.

Single-factor variance analysis of nursing undergraduates’ self-study readiness take the SDLR as the dependent variable, with gender, age, grade, part-time job, living area, the first choice to apply for collage major, attitude toward nursing professional, teaching style satisfaction, learning status satisfaction, learning difficulty as the independent variable, we conduct a single-factor variance analysis. The results show that the statistical difference between grade, living area, love the nursing profession, the teaching style satisfaction, the study satisfaction, and the class study difficulty is significant (P < 0.05) and the statistical difference among the rest of the variables is not significant (P > 0.05; Table 3).

Taking the total score of self-directed readiness as the dependent variable, the six variables of single-factor analysis and learning attitude and academic self-efficacy were used as independent variables to enter the stepwise regression equation. The standard was 0.05, and the level of elimination was 0.10. The results showed that the factors that influenced the degree of self-study readiness of nursing undergraduates were as follows: academic self-efficacy, learning attitude, liking nursing major, and learning difficulty after class. The value of F = 98.35 (P = 0.000) indicates that the regression equation is statistically significant. The cumulative variance of the four variables for autonomic learning readiness was 48.1% (Table 4).

The study of Kar et al.16 found that the independent study readiness score could indicate that the students have the good independent study ability only when they got at least 150 marks or higher. In this study, the total score of the undergraduates’ independent learning readiness degree was 149.99 ± 15.73; 25.4% of the nursing undergraduates (n = 109) got higher than 150 marks, which indicated that most of the nursing undergraduates had poor self-direct learning ability. In addition, the highest scoring dimension was self-control, while the lowest scoring dimension was self-management, which shows that the current nursing undergraduates have a good sense of responsibility and they can set the learning goal and evaluation standard independently. As far as the results of poor self-management and lack of self-learning ability are considered, they match the research results of Alharbi.17 Therefore, in the process of improving the readiness of nursing undergraduates’ self-direct learning readiness, the cultivation of self-management ability should be strengthened.

The results show that the demographic characteristics including grade, living area, love the nursing profession, the teaching style satisfaction, the study satisfaction and the class study difficulty have a statistical significant difference (P < 0.05); however, because of some options as the sample was too small in the “study satisfaction” and “teaching style” items, we should explain the results more cautiously. The statistically significant difference between the gender, whether done a part-time job, and apply nursing major as first college choice is not significant (P > 0.05). After regression analysis, this study concluded that the degree of self-study ability of nursing undergraduates has academic self-efficacy, learning attitude, prefer nursing major, learning difficulties under four factors, each factor analysis is as follows:

Academic self-efficacy can reflect the individual’s judgment and self-confidence in completing academic tasks.18 In this study, the results show that academic self-efficacy is positively correlated with the preparation degree of SDL, and the higher the self-efficacy, the more obvious the characteristics of SDL ability, such as good control of emotion, cognitive strategy, and reasonable choice. This result is consistent with the research results of Zhang et al.19. In short, the improvement of self-efficacy is beneficial to the improvement of SDL ability. According to the statistical analysis, the total academic self-efficacy of nursing undergraduates is 76.26 ± 8.17, which indicates that nursing undergraduates can make study plans, study actively, and have confidence in completing their own studies.

Back in the 1960s, De Montlibert et al.20 first defined learning attitude as the degree that consists of three dimensions of cognition, emotion, and behavioral intention. Liu and Peng21 believed that learning attitude refers to the psychological tendency of learners to respond to learning activities from three aspects of cognition, emotion, and behavior, including22 attitudes towards learning, teachers, and schools. The survey of Wang,23 Wang,24 and Malekian et al.25 all showed the learning attitude as an intrinsic factor that significantly affects students’ autonomous learning. This study also shows that the learning attitude is positively correlated with the readiness of SDL, that is, the better the learning attitude, the higher the readiness of SDL. Students with a high interest in learning can actively learn knowledge and skills, and constantly improve themselves, which is an important ability to improve independent learning. One study26 showed that university student’s independent study ability is not very positive in China at present; therefore, instructions for students to correct their study attitude are urgent and necessary. In this way, students could promote their independent self-directed study readiness, stay active, and have a high efficiency, which must benefit both their study and research.

This research showed that the study desire of nursing students is one of the factors influencing the SDLR, which is consistent with previous studies.15 However, 48.5% of nursing undergraduates’ attitude toward nursing profession had not reached the level of preference yet, which is similar to previous research results.27 Studies have shown that the higher the students’ preference for the professional knowledge of nursing, the stronger their initiative and self-confidence. The improvement of their SDLR will promote their recognition of the nursing profession.28 Before students make the choice of their major, they will consider about their interest first; their inner interest will become a subconscious to motivate their study. Therefore, in the course of training nursing undergraduates’ professional knowledge, the nursing educators can improve their SDL ability by improving their specialty identification.

In this study, learning difficulties under class have a negative impact on SDL. The traditional teaching model makes students more dependent on acquiring knowledge from teachers, while the ability to solve problems under class decreases. Leatemia et al.29 believe that the teacher-centered traditional teaching mode makes the students’ thinking limited, which is one of the factors that lead to the students’ poor SDL ability. Therefore, the teaching mode should shift from teacher centered to student centered and cultivate the ability of problem-solving of nursing students to find their own way of learning. At the same time, the nursing educators should fully understand the students’ learning characteristics and adopt the interactive teaching and Problem-Based Learning (PBL) teaching mode30 to improve their interest in learning and to cultivate the ability of nursing students to solve problems. In the class, supervision and group discussion are adopted to guide and regulate SDL and promote common progress.31, 32