Saudi nursing interns reported negative clinical learning experiences, including inadequate supervision and insufficient learning opportunities during their internship year. The Saudi nursing workforce reached 94,021 employed Saudi nurses in 2023. Saudi Vision 2030 aims to improve healthcare quality by increasing the number of qualified Saudi healthcare trainees and enhancing the quality of training. Providing high-quality clinical learning experiences during the internship year is essential to strengthening clinical competence and promoting attractive nursing careers in Saudi Arabia.This study examined (1) the association between clinical learning environment (CLE) domains (personalization, involvement, task orientation, innovation, individualization) and student interns’ satisfaction and self-efficacy, and (2) the association between preceptors’ facilitation of learning, instructors’ facilitation of learning, learning opportunities, and student interns’ self-efficacy and clinical competence domains (nursing professional behavior, general performance, core nursing skills, and advanced nursing skills) at the end of the internship year in Saudi Arabia.A quantitative, cross-sectional design was employed. A convenience sample of 400 student interns was recruited from four universities, five hospitals, and the Ministry of Health hospitals in Saudi Arabia between October 2024 and April 2025. All instruments were translated into Arabic and pilot tested with 36 student interns from the target population in Saudi Arabia, demonstrating excellent reliability. Data analyses were conducted using reliability analysis (Cronbach’s alpha), descriptive statistics, Pearson correlations, independent samples t-tests, one-way ANOVA, hierarchical multiple regression, and mediation analysis using Hayes’ PROCESS Model 4.The sample of 400 student interns had a mean age of 23.1 years, was majority female (78.8%), single (87.5%), attended public universities (88.5%), and completed an internship at Ministry of Health hospitals (53.3%). Nearly half (46.0%) had a GPA ≥ 4.0, and 39.3% had completed their full internship year. Hospital type, university type, GPA, and internship significantly influenced perceptions of clinical learning environment, facilitation of learning, self-efficacy, satisfaction, and clinical competence. Age, gender, and marital status were not significant.Student interns reported negative perceptions of clinical learning environment domains (personalization, involvement, task orientation, innovation, individualization) (M = 2.29–2.47) while reporting high satisfaction (M = 2.98) and self-efficacy (M = 2.57). All CLE domains were significantly and positively correlated with satisfaction (r = .615–.719, p < .001) and self-efficacy (r = .692–.813, p < .001). Personalization (individual attention to students’ personal well-being) was the strongest predictor of satisfaction (β = .372, p < .001), and individualization (learning adapted to each student’s individual needs) was the strongest predictor of self-efficacy (β = .317, p < .001). Self-efficacy partially mediated the relationship between all five CLE domains and satisfaction, indicating that CLE influences satisfaction both directly and indirectly through self-efficacy.Student interns reported negative perceptions of facilitation of learning by preceptors, instructors, and learning opportunities (M = 2.96–2.99), high self-efficacy (M = 2.57), high clinical competence in professional behavior (M = 3.06), and low clinical competence in general performance, core nursing skills, and advanced nursing skills. All facilitation of learning was significantly and positively correlated with self-efficacy (r = .837–.845, p < .001) and clinical competence (r = .791–.838, p < .001). Instructors’ facilitation of learning (bridging theory to clinical practice) was the strongest predictor across all clinical competence domains (β = .499–.755, p < .001), while preceptors’ facilitation of learning (hands-on supervision by hospital staff) was not a significant predictor. Learning opportunities (i.e., the availability of hands-on clinical experiences) significantly predicted professional behavior, general performance, and advanced nursing skills. Self-efficacy partially mediated the relationship between all facilitation of learning and clinical competence, indicating that facilitation of learning influences clinical competence both directly and indirectly through self-efficacy.This study highlights the critical role of the clinical learning environment and facilitation of learning in shaping Saudi nursing interns’ satisfaction, self-efficacy, and clinical competence. Nursing programs and healthcare organizations should collaborate to (1) align internship objectives with learning outcomes, (2) implement formal training and certification programs for preceptors and instructors, and (3) expand simulation-based learning to address limited hands-on practice opportunities. These findings directly support the goals of Saudi Vision 2030 to improve healthcare quality and increase the number of qualified Saudi nurses.
Tahani Mohammed Maashi (Thu,) studied this question.