Role of academic self-efficacy in the relationship between self-directed learning readiness and problem-solving ability among nursing students

1. Introduction

Problem-solving is a core ability for students to develop professional nursing skills and perform quality care.By improving problem-solving abilities, nursing students can discover and solve patient problems using cognitive, effective, and behavioral processes.1 Today,problem-solving is believed to be an evaluation index of a student’s high-level thinking ability, and since it can help nurses design and implement effective interventions, problem-solving is a core competency of nursing students.2 Furthermore, as the economy develops,individuals are paying more attention to health care and seeking holistic care, requiring nurses to be good at solving problems. To improve nursing students’ problem-solving abilities, educators must develop pertinent teaching methods and curricula. However, researchers have previously found that nursing students in different countries had low problem-solving abilities.3,4 Therefore,to help nursing students confront the challenges they face in clinical settings, their abilities to solve problems must be improved.

According to the Organization for Economic Cooperation and Development,5 problem-solving is a process that leads an individual to recognize, formulate,and solve problems. This skill helps individuals solve problems effectively and guide the implementation of solutions. Psychologists6 believe that the ultimate goal of education is to train students to solve problems,including those related to life, society, and the environment. China’s Ministry of Health and Education (2001)stressed the need for higher medical educators to cultivate medical students’ learning ability, which can help them assess the entirety of their patients’ needs and determine timely countermeasures to solve clinical problems. In the nursing profession, problem-solving abilities affect job performance, quality of nursing care, and prognosis intervention for patients.7 Although the need for nurses who make appropriate decisions and possess strong problem-solving skills is always increasing,8 China’s traditional model for nurse education, which affects the cultivation of the students’ practical and problem-solving abilities, is not of high quality.9 Therefore, to achieve a better learning effect, educators must cultivate their students’ problem-solving abilities.

In self-directed learning (SDL), with or without the help of others, learners display great initiative to judge their own learning needs, formulate goals, evaluate learning resources, engage appropriate learning methods, and evaluate education results.10 Anyone can become a self-directed learner; however, the outcome of SDL depends on several factors, including motivation and learning attitude, self-confidence, experience,and individual characteristics,11,12 which comprise selfdirected learning readiness (SDLR). To help students convert from dependent to active learners and then become self-directed lifelong learners, the Accreditation Council for Pharmacy Education13 encouraged colleges to combine teaching and learning methods. According to previous research, nursing students’ SDLR was significantly correlated with their problem-solving ability, and problem-solving ability could be facilitated by improving the students’ SDLR.9,14 Research by Struyf et al.15 and Williams16 showed that cultivating students’ problem-solving abilities could improve their self-learning abilities. Therefore, SDL and problem-solving ability are mutually influential and stimulated. In summary, nursing educators should cultivate nursing students’ SDLR and problem-solving ability, which will help nurses effectively cope with complex working environments.17

Academic self-efficacy, which relates to an individual’s perception of his or her own capabilities,18 is an internal factor that influences a student’s SDLR ability.Additionally, it is a key factor that affects students’ learning behaviors, such as problem-solving ability and thinking.19,20 According to an individual study, self-efficacy has a positive psychological effect on an individual’s problem-solving process, which was conducive to solving problems.21

In conclusion, the ability to solve problems is a professional skill that enables nursing students to enact nursing interventions when they step into clinical work. Further, SDLR is a key factor for improving problem-solving abilities. To enhance nursing students’problem-solving abilities, educators are making many efforts to develop appropriate teaching methods, such as problem-based learning (PBL). For nurses who face a new environment and the stressful occupation of clinical work, self-confidence and self-evaluation can play an important role in their problem-solving efficacy.Nursing students should be confident when confronting various clinical problems and unpredictable situations. Therefore, academic self-efficacy can have a positive effect on nursing students’ abilities to solve problems. Today, most research investigates the relationship between problem-solving ability and SDLR or the relationship between problem-solving ability and academic self-efficacy, but researchers ignore the relationship among the three skills. This study identified the role academic self-efficacy plays in the relationship between SDLR and problem-solving ability in nursing students. From the perspective of positive psychology, this study suggests that SDLR can improve students’ abilities to solve problems by improving their academic self-efficacy. If this hypothesis is valid, nursing educators can improve their students’ SDLR and problem-solving abilities by improving their academic self-efficacy and learning enthusiasm.

2. Methods

2.1 Design and study sample

In addition, previous research33,34 showed that the impact of academic self-efficacy on individual development varied, and it was related to the individual’s perception of their capabilities, such as thinking, goal-setting,and the ability to cope with difficulties, all of which can improve students’ SDLR and problem-solving ability. With increased academic self-efficacy, students will have confidence in themselves. They learn how to set goals, solve problems, and bring a positive attitude to their studies.Therefore, nursing educators face a common challenge of determining how to improve academic self-efficacy by increasing student confidence and how to foster the students’ capabilities to be successful in school.

2.2 Instruments

A demographic questionnaire was designed to collect a range of information, including age, gender, grade, and national origin, as well as whether the participant was an only child. Students were asked five questions: did they have experience working in a part-time job; did they choose nursing as their first profession; did they enjoy nursing; did they feel satisfied with their learning; and did they have difficulty learning.

The Self-Directed Learning Readiness Scale(SDLRS) for nursing students was used to measure the level of SDLR. This instrument was developed by Fisher et al.22 and translated into Chinese by Wang.9 It consisted of 40 items in three subscales: self-management(13 items), the desire to learn (12 items), and self-control (15 items). This was a five-point Likert scale, ranging from 5 (strongly agree) to 1 (strongly disagree), with a higher score representing a higher level of SDLR. The total Cronbach’s a coefficient of the SDLRS was 0.932,which indicated good reliability.

The Chinese version of the Social Problem-Solving Inventory (C-SPSI), which was translated by Wang,9 was used to evaluate the problem-solving ability of nursing students. This scale consisted of 25 items in five subscales: rational problem-solving (RPS), positive problem orientation (PPO), negative problem orientation(NPO), avoidance style (AS), and impulsivity/carelessness style (ICS). A five-point Likert scale was used to measure responses. Prior research concluded that the C-SPSI could measure the level of problem-solving ability in nursing students. For example, Huang and Li23 and Li and Xu20 found that Cronbach’s a coefficients for the C-SPSI were 0.840 and 0.871, respectively. In this study, the total Cronbach’s a coefficient for the C-SPSI was 0.774.

The final component of this study was academic self-efficacy. Using a questionnaire designed by Liang,24 the nursing students’ level of academic selfefficacy was tested. The questionnaire included 22 items in two subscales. The sum of the two dimensions was the total score of the respondent’s academic selfefficacy, with a higher score indicating a higher level of academic self-efficacy. This method has high reliability and validity and has been widely used in the evaluation of college students’ academic self-efficacy. For example, using an academic self-efficacy questionnaire, Guoet al.25 analyzed college students’ academic self-efficacy and its influencing factors. Additionally,researchers used an academic self-efficacy questionnaire26 to test the level of academic self-efficacy among nursing students. In this study, Cronbach’s a coefficient was 0.815.

2.企业档案的保管方法进一步提高。企业电子档案的保管、维护与传统的方式截然不同，其数字化特性决定了保管的复杂性和安全维护的难度。不同载体档案的保管方法有许多相同的方面，防火、防光、防尘、防虫、防潮、防盗是它们的共性。各种载体的档案材料都易燃，库房一定要有防火措施，库房内严禁烟火，不得铺设没有防静电功能的地毯。库房内电源、电线要经常检查，库房附近不得堆放易燃品。要有防光措施，特别是纸张档案，太阳光中的紫外线尤为强烈，可使纸张强度降低，字迹退色。库房不要设在潮湿的地下室，也不要设在楼房最顶层。要保持库房内清洁，防止灰尘污染。要保持库房内适宜的温度、湿度，库内应配备温、湿度测定仪和温湿度调节装置。

2.3 Data collection

●五原县天吉泰镇复丰五社千亩盐碱治理示范园区刘斌福，弃耕20多年的重度盐碱地经过硅谷功能肥治理，葵花出苗达到80%以上，当年亩产达到近400斤。

2.4 Ethical considerations

This study was approved by Tianjin University of Traditional Chinese Medicine’s Research Ethics Committee. Students who voluntarily participated were informed about the purpose of the study. Researchers also ensured that respondents’ school records were unaffected, and they experienced no negative consequences for their participation in the study.

2.5 Data analysis

近年来，现代石产业、石文化作为新兴产业和主流文化的兴起，受到各级政府的高度关注，开始制定了相关的政策、措施，石产业、石文化迎来了发展的春天。

农民是从事农业生产的主体人员，因此农民的自身素质对于设施农业的发展有直接影响。农民对于机械的使用认识程度不高，是影响设施农业发展的重要原因之一。所以，可以向农民开展“如何致富”、“如何增加粮食产量”为主题的指导课程，通过课程向农民讲解设施农业机械化的重要性，提高农民对机械的使用意识和市场竞争意识，向农民明确使用机械设施会减少人力劳动的投入、提高生产效率、科学的种植能够提高农作物的产量、能够提高农民的经济效益。农民对于设施农业有正确的认识，才能积极使用设施农业机械设备，进而推动我国设施农业的发展水平。

3. Results

3.1 Participant demographic characteristics

Participants’ ages were between 17 and 25 years (mean:21.3 years). Nursing student participants included 379 females (88.3%) and 50 males (11.7%). Five hundred students from different grades participated: 105 freshmen (24.5%), 105 sophomores (24.5%), 132 juniors(30.8%), and 87 seniors (20.3%). Most students(65.7%) were satisfied with their school’s teaching methods. More than half of the students (67.1%) had no difficulty with learning and reported that they were satisfied with their major (53.14%). Most participants came from the village (48.5%), and the remainder were from the town (27.5%) and city (24%). The results are shown in Table 1.

Table 1. Demographic characteristics of the participants (n=429)

Characteristics n (%)Gender Male 50 (11.7)Female 379 (88.3)Grade 1 105 (24.5)2 105 (24.5)3 132 (30.8)4 87 (20.3)Living location City 103 (24.0)Town 118 (27.5)Village 208 (48.5)Satisfaction with major Very much 19 (4.4)Prefer 202 (47.0)No feeling 185 (43.1)Hate 23 (5.4)Satisfaction with teaching methods Satisfied 17 (3.9)Relatively satisfied 265 (61.8)Uncertain 80 (18.6)Less satisfied 59 (13.8)Very dissatisfied 8 (1.9)Learning difficulties No difficulties 288 (67.1)Have little 130 (30.3)Have more 11 (2.6)

3.2 Scores of and correlations among variables

The total scores for SDLR and academic self-efficacy were 149.98 (standard deviation [SD] = 15.73) and 76.26(SD=8.16), respectively, which were at the medium-tohigh level. Further, problem-solving ability was at a low level, with a score of 85.14 (SD=10.08).

SDLR was remarkable when correlated with academic self-efficacy and problem-solving ability. Academic self-efficacy was significantly correlated with problemsolving ability. The four dimensions of problem-solving ability were related to the other variables, except ICS(Table 2).

3.3 Mediating effect of academic self-efficacy on the relationship between SDLR and problem-solving ability

The authors gratefully thank the supervisors and the 429 nursing students who participated in this study.

Table 2. Pearson correlation coefficients of the variables (N = 429)

Notes: SM: self-management; DL: the desire to learn; SC: self-control; SDLR: self-directed learning readiness; NPO: negative problem orientation; RPS:rational problem-solving; PPO: positive problem orientation; AS: avoidance style; ICS: impulsivity/carelessness style; PSA: problem-solving ability; ASE:ability self-efficacy; BSE: behavioral self-efficacy.＊P ＜ 0.001.

Order Item 1 2 3 4 5 6 7 8 9 10 11 12 13 1 SM 1 2 DL 0.537＊ 1 3 SC 0.616＊ 0.673＊ 1 4 Total SDLR 0.849＊ 0.838＊ 0.890＊ 1 5 NPO 0.210＊ 0.163＊ 0.219＊ 0.232＊ 1 6 RPS 0.285＊ 0.393＊ 0.413＊ 0.420＊ −0.370＊ 1 7 PPO 0.365＊ 0.502＊ 0.528＊ 0.537＊ 0.118＊ −0.58＊ 1 8 AS 0.294＊ 0.313＊ −0.280＊ 0.346＊ 0.530＊ 0.125＊ 0.266＊ 1 9 ICS 0.000 0.063 −0.024 0.012 0.270＊ 0.004 0.010 0.379＊ 1 10 Total PSA 0.376＊ 0.452＊ 0.451＊ 0.493＊ 0.660＊ 0.481＊ 0.592＊ 0.808＊ 0.520＊ 1 11 ASE 0.507＊ 0.431＊ 0.540＊ 0.576＊ 0.201＊ 0.353＊ 0.422＊ 0.173＊ −0.067 0.339＊ 1 12 BSE 0.557＊ 0.490＊ 0.509＊ 0.606＊ 0.291＊ 0.308＊ 0.432＊ 0.379＊ 0.134＊ 0.499＊ 0.621＊ 1 13 Total academic self-efficacy 0.591＊ 0.512＊ 0.582＊ 0.657＊ 0.274＊ 0.366＊ 0.474＊ 0.308＊ 0.039 0.467＊ 0.898＊ 0.903＊ 1

Table 3. Mediating effect of academic self-efficacy on the relationship between self-directed learning readiness and problem-solving ability(N = 429)

Note: ＊P ＜ 0.001.

Dependent variableIndependent variable tßR2Adjusted R2 Academic self-efficacy Self-directed learning readiness 17.990＊ 0.657 0.431 0.430 Problem-solving ability Academic self-efficacy 10.900＊ 0.467 0.218 0.216 Problem-solving ability Self-directed learning readiness 11.720＊ 0.493 0.243 0.242 Problem-solving ability Self-directed learning readiness 6.027＊ 0.329 0.279 0.276 Academic self-efficacy 4.598＊ 0.251

Figure 1. Mediating effect of academic self-efficacy on the relationship between self-directed learning readiness and problem-solving ability.

4. Discussion

The results of our research were consistent with the results from other studies and showed that SDLR was significantly positively correlated with problem-solving ability, indicating that higher levels of SDLR in nursing students leads to better problem-solving ability.9,17 Further, academic self-efficacy had a remarkable positive correlation with SDLR and problem-solving ability.In their research, Wang et al.28 and Zhang and Liu29 showed that when the level of a student’s academic self-efficacy increased, the level of the student’s SDLR and the ability to solve problems also increased. This study suggested that academic self-efficacy was a partial mediator in the relationship between SDLR and problem-solving ability among nursing students.

SPSS version 21.0 (IBM Corporation, Armonk, NY,USA) was used to analyze the data. Demographic characteristics of the study participants were summarized using descriptive statistics. Correlations among SDLR, academic self-efficacy, and problem-solving ability were analyzed by Pearson’s correlation coefficient. The linear regression method was used to analyze the mediating effect of academic self-efficacy on the relationship between SDLR and problemsolving ability. To establish a valid mediation model,three requirements must be satisfied in three steps:the mediator (academic self-efficacy) must predict the independent variable (SDLR) in Step 1; the independent variable (SDLR) must be a predictor of the dependent variable (problem-solving ability) in Step 2;and the dependent variable (problem-solving ability)must predict the mediator (academic self-efficacy) in Step 3. Partial mediation will be considered if there is a significant relationship between the independent and dependent variables in Step 3.27

抛光液中3 mL/L FAOA与6 mL/L AEO复配时，CMP后铜晶圆表面的缺陷为420个，明显少于7 mL/L FAOA与6 mL/L AEO复配时的825个。

村口的老樟树就这样每天早上看着麻糍用双手双脚推着独轮车带着小羽出村，每天傍晚看着小羽一人进村。麻糍一般是晚上八点左右才会回来，那个时候的天空不是已经黑得像被泼了墨，就是星星点点的图画了。

与此同时，技术进步、空间结构、交通拥堵对物流业能耗增长起到抑制作用，尤其技术进步在考察期内对物流业能耗增长始终起到抑制作用，这说明提高物流业技术进步，降低能耗强度，对北京物流业能耗下降至关重要。空间结构虽然总体对物流业能耗增长起到了抑制作用，但在大多数年份依然起到了促进作用，所以进一步提高城市的紧凑结构，合理布局城市功能，对缓解物流业能耗压力也具有显著的作用。有趣的是，交通拥堵在考察期内多数年份对物流业能耗增长起到了抑制作用，这可能与近年来北京市采取的机动车限号以及加大道路交通建设有关。

However, in China, the majority of teaching strategies are teacher-centered, which provides students with little opportunity to discover, explore, or solve problems in continuing education programs.31 This study demonstrated that Chinese nursing students’ SDLR was at a medium-to-high level, but their problem-solving ability was at a low level, which was consistent with previous findings.4,9,32 The ability to solve problems is particularly important for nursing students, especially in their clinical work, when they must plan and implement appropriate nursing interventions for their patients. Therefore, it is imperative for nursing educators to pay more attention to improving nursing students’ problem-solving abilities.

From November to December 2016, we collected data among nursing students in Tianjin. With an 85.8%response rate, 429 questionnaires were returned, all of which were adapted for analysis.

A cross-sectional design was used to identify the mediating effect of academic self-efficacy in the relationship between nursing students’ SDLR and problem-solving ability. Convenience sampling was used to select participants from a nursing school in Tianjin, China. With a total of 500 respondents, undergraduate nursing students in all grades participated in this survey.

Academic self-efficacy partly mediates SDLR and problem-solving ability. This finding shows that nursing students with SDLR are likely to have a higher ability to solve problems. Furthermore, positive psychological effects, such as self-confidence, were conducive to solving problems.

SDLR is a major priority for the development of professional health education. Medical schools should not hesitate to cultivate nursing professionals’SDL ability, such that students’ knowledge and skills can exceed beyond graduation, and they can form the habit of observation, thinking, and solving problems in study and life. To encourage students to engage in the process of SDL, Alotaibi30 recommended that nursing educators pay attention to students’ independence, especially during times of knowledge exploration and the evolution of technology. In turn, this ability will enhance their problem-solving abilities and academic performance.

Convenience sampling was used to extract the samples. We recruited students only from Tianjin, China,which may not be representative of all nursing students.Further research will be needed to expand the study sample and recruit students from different regions.Another limitation was that we used a Likert scale to conduct a quantitative analysis of nursing students’responses. Without a qualitative analysis, the effect of the evaluation was limited.

5. Conclusions

Problem-solving is considered an evaluation index of high-level thinking ability, and it is a core competency of nursing students.35 Problem-solving can also influence nurses when making decisions related to their patients’outcomes in the clinic. Therefore, to achieve a better learning effect, educators must cultivate nursing students’ problem-solving ability.

The findings of this study suggest that academic self-efficacy partly mediates SDLR and problem-solving ability. From the perspective of psychological cognition,nursing educators can enhance students’ SDLR and problem-solving ability by improving their learning confidence and attitude. This study provides a basic understanding of the role of academic self-efficacy in the relationship between SDLR and problem-solving ability among nursing students.

Acknowledgments

The results of the mediating effect of academic selfefficacy on the relationship between SDLR and problem-solving ability are shown in Table 3 and Figure 1.In Step 1, SDLR had a significant effect on academic self-efficacy (F=323.634, P=0.000). In Step 2, academic self-efficacy had a significant effect on problem-solving ability (F=118.84, P=0.000). In Step 3, when adding academic self-efficacy to the regression model in Step 2,the standardized coefficient decreased from 0.493 to 0.251, and the variance of SDLR explained by problemsolving increased from 24.3% to 27.9%. Academic selfefficacy predicted problem-solving ability. Moreover, theSobel test indicated a partial mediating effect of academic self-efficacy on the relationship between SDLR and problem-solving ability.

在农业食品系统的演变下，拉美地区经历了超市迅速崛起、跨国化和巩固整合。与20世纪90年代初的低市场占有率相反，如今超市已越来越多地占据拉美国家的农业食品经济，引起了供应链的深刻转换。

Conflicts of interest

All contributing authors declare no conflicts of interest.

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