Metacognitive processes, situational factors, and clinical decision-making in nursing education: a quantitative longitudinal study

Abstract

Objective: This study examined the longitudinal development of metacognitive skills and clinical decision-making abilities in nursing students, focusing on the interactions between metacognitive processes, situational factors, and individual differences. Methods: A longitudinal, quantitative design was employed, following 185 third-year nursing students from a major university in China over one academic year. Data were collected at six time points using the Metacognitive Awareness Inventory, Nursing Decision-Making Instrument, and custom-designed clinical scenario assessments. Latent Growth Curve Modeling, Multilevel Modeling, and Moderation Analysis were used to analyze the data. Results: Significant positive growth trajectories were observed for both metacognitive awareness (mean slope = 0.07, p