Professional Identity and Its Influencing Factors Among Nursing Interns: The Mediating Role of Career Adaptability Between Social Support and Professional Identity
This study of 407 nursing interns reveals that professional identity is at a moderate level and is positively influenced by social support and career adaptability, with the latter partially mediating the relationship between social support and professional identity.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Every profession has a moment when a student stops thinking of themselves as a learner and starts feeling like a member of the tribe. For nurses, this shift happens during their internship, a critical time when they move from the classroom into the high-stakes reality of a hospital ward. It is a period where they must decide if they truly belong to their chosen field. This sense of belonging, known as professional identity, is not just a feeling; it is the psychological foundation that determines whether a new nurse will stay in the job or leave. When nurses leave, hospitals face shortages that can delay care and increase risks for patients. Understanding what helps a student nurse feel confident and committed during this fragile transition is a question that matters to everyone who relies on the healthcare system.
Researchers have long known that people do not develop these feelings in a vacuum. Two main forces shape how a student sees their future career: the support they receive from others, such as family and mentors, and their own internal ability to handle change and new challenges. The first force, social support, is the network of encouragement and help a person gets from their community. The second, career adaptability, is the personal toolkit of skills that allows someone to navigate career changes, solve problems, and stay focused on their goals. While it is obvious that having support helps, and that being adaptable helps, scientists have been trying to understand exactly how these two forces work together. Does support simply make a person feel better, or does it actually build the internal strength needed to stick with a difficult career path?
A team of researchers in China set out to answer this question by studying 407 nursing interns at a large hospital in Quanzhou. They wanted to see how these young students felt about their profession and to map out the specific connections between the support they received, their ability to adapt, and their sense of identity. The researchers gathered data using a series of detailed questionnaires. These surveys asked the students about their background, how much support they felt from their families and peers, how stressed they were, how resilient they felt in the face of difficulty, and how well they believed they could handle the demands of their future career. They also asked the students to rate their own sense of belonging to the nursing profession.
The results revealed a clear picture of the current state of these young nurses. On average, the interns reported a moderately high level of professional identity, with a score of 61.74 out of a possible 85. This suggests that while most students feel a sense of connection to their profession, nearly three-quarters of them are still in a middle ground where their commitment is not yet fully solidified. The study found that the students who felt the most supported by their parents and who had chosen nursing because of their own personal interest, rather than because they were told to do so, tended to have the strongest sense of professional identity. Conversely, those who felt high levels of stress or who had been assigned to the major without their own input showed weaker feelings of belonging.
The most significant discovery of the study was how the different factors influenced one another. The researchers found that social support and career adaptability were the two strongest positive drivers of professional identity. However, the relationship between them was more complex than a simple cause-and-effect. The data showed that social support acts as a powerful external resource that directly boosts a student's confidence. But it also works indirectly. When a student receives strong support from family and mentors, it helps build their internal career adaptability—their confidence and ability to handle the ups and downs of the job. This increased adaptability, in turn, strengthens their professional identity.
In fact, the study calculated that this indirect path, where support builds adaptability which then builds identity, accounted for a substantial portion of the total effect. It means that while having a supportive network is good in itself, its greatest power may lie in how it equips the student with the internal tools to navigate their career. The researchers also noted that the reasons a student chose nursing mattered deeply. Those who entered the field out of genuine interest had much higher identity scores than those who were pushed into it by parents or teachers. This suggests that external support works best when it aligns with the student's own internal motivation.
The study concludes that to help nursing students stay in the profession, hospitals and schools should focus on two things: providing a robust network of support and actively helping students develop their adaptability skills. By strengthening the external support system, educators can indirectly boost the internal resilience of their students, creating a stronger sense of belonging that will help them survive the challenges of their early career. The findings offer a clear roadmap for training programs, suggesting that the key to retaining the next generation of nurses lies not just in teaching them medical skills, but in nurturing the psychological resources that allow them to see themselves as true members of the nursing community.
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