Developing digital health literacy among nursing interns: A sequential mediation model of preceptor support, self-efficacy, and technology acceptance.

For nursing students

Study summary

This article, titled 'Developing digital health literacy among nursing interns: A sequential mediation model of preceptor support, self-efficacy, and technology acceptance,' explores a critical aspect of modern nursing education. As healthcare systems become increasingly reliant on digital technologies, it's essential for nursing students to develop strong digital health literacy (DHL). This study aims to understand how DHL is developed among undergraduate nursing interns in China during their clinical training.

The research focuses on the mechanisms that drive the development of DHL within authentic clinical learning environments. The authors hypothesize a sequential mediation model where preceptor and departmental support play a crucial role. They suggest that this support enhances nursing interns' digital self-efficacy (their belief in their ability to use digital technologies) and technology acceptance (their willingness to adopt new technologies). These psychological factors, in turn, promote clinical information-technology use – the actual application of these technologies in practice – ultimately leading to higher DHL scores.

The study employed a nationwide, multi-centre cross-sectional design. Data was collected from 1593 undergraduate nursing interns who had completed at least four months of clinical practice across eleven institutions in China. To assess various constructs like DHL, digital self-efficacy, technology acceptance, and perceived support, the researchers used validated instruments. This means they utilized questionnaires or scales that have been previously tested for reliability and validity.

The findings revealed some interesting insights into the current state of DHL among nursing interns in China. On average, participants demonstrated a moderate-to-high level of DHL (60.55 ± 8.87). However, there were variations across different subscales: privacy protection scored highest, while skills and application scored lowest. This suggests that while students might understand the importance of protecting patient data digitally, they may still be developing their practical abilities to use these technologies effectively in clinical settings.

The structural equation modelling (SEM) analysis was key to understanding the proposed sequential mechanism. SEM is a statistical technique used to test complex relationships between observed and latent variables. The results confirmed that preceptor and departmental support exerted a strong indirect effect on DHL. This means that while direct support might not immediately translate into high DHL, it works through enhancing digital self-efficacy and technology acceptance, which then lead to more frequent and effective use of clinical information-technology.

For nursing students, this study highlights the importance of developing confidence (self-efficacy) in using new technologies. It also underscores that simply providing access to technology isn't enough; a supportive learning environment from preceptors and departments is crucial for fostering DHL. Students should appraise how their own clinical experiences align with these findings – do they feel supported? Do they believe in their ability to use digital tools effectively?

When considering the source, it's important to note that this research comes from 'Nurse education today,' a reputable journal focusing on nursing education and practice. The study is based on data collected across multiple institutions in China, which provides some generalizability for understanding DHL development within similar educational contexts.

A nurse would reason from this evidence by recognizing the critical role of preceptor support and fostering digital self-efficacy in preparing students to be competent with healthcare technologies. This implies that nursing education programs should actively integrate strategies to build student confidence, encourage positive attitudes towards technology acceptance, and ensure robust clinical information-technology use during internships. By doing so, they can better prepare a digitally literate workforce capable of navigating modern healthcare systems safely and effectively.

For educators

Teaching and appraisal notes

This study investigates the development of digital health literacy (DHL) among undergraduate nursing interns in China through a sequential mediation model involving preceptor support, self-efficacy, technology acceptance, and clinical information-technology use. The research is significant as it addresses the growing need for digitally competent nurses within rapidly evolving healthcare systems.

The study employed a nationwide, multi-centre cross-sectional design, collecting data from 1593 nursing interns across eleven institutions in China who had completed at least four months of clinical practice. Validated instruments were used to measure DHL (with subscales including privacy protection and skills/application), digital self-efficacy, technology acceptance, and perceived preceptor/departmental support.

Key findings indicate a moderate-to-high overall DHL level among participants (60.55 ± 8.87). Notably, the privacy protection subscale scored highest, while the skills and application subscale was comparatively lower. This suggests that theoretical understanding of digital ethics may precede practical proficiency in using technologies.

Structural equation modelling revealed a clear sequential mechanism for DHL development: preceptor and departmental support indirectly enhanced DHL by boosting digital self-efficacy and technology acceptance, which subsequently promoted clinical information-technology use, leading to higher DHL scores. The total indirect effect of this pathway was statistically significant (0.185, p < 0.001).

The study's strengths include its large sample size across multiple institutions in China, the use of validated measurement tools, and the rigorous application of SEM to test a complex theoretical model. This provides robust evidence for the proposed sequential mediation process.

From an educational perspective, these findings underscore that fostering DHL is not merely about imparting technical skills but involves creating supportive learning environments (preceptorship) that build student confidence (self-efficacy) and positive attitudes towards technology acceptance. This ultimately translates into more effective use of clinical information-technology. For faculty, this implies the need to actively integrate strategies within clinical internships that enhance these psychological factors. Curriculum design should consider how preceptors can be trained or supported to provide optimal digital guidance, and how educational activities can systematically build self-efficacy for technology use.