The Effects of Patient Safety Competence and Systems Thinking on Patient-centered Care among Nursing Students

Purpose: This study investigated how patient safety competence and systems thinking influence patient-centered care among 132 nursing students in Korea. Methods: A cross-sectional survey was carried out with undergraduate nursing students from first to fourth year at a university located in G city. Online data collection took place between January 3 and February 28, 2025. Data were analyzed using SPSS WIN 25.0 with descriptive statistics, ANOVA, Pearson's correlation, and multiple regression. Results: Patient-centered care differed significantly by grade, clinical practice experience, and major satisfaction. Mean scores were 3.74±0.53 for patient safety competence (knowledge 3.31±0.93, skills 3.51±0.72, attitudes 4.29±0.47), 3.84±0.62 for systems thinking, and 4.27±0.56 for patient-centered care. Patient safety attitude had the strongest correlation with patient-centered care (r=.63, p<.001), followed by systems thinking (r=.53, p<.001). Multiple regression showed patient safety attitude (β=.45, p<.001), systems thinking (β=.22, p=.007), and major satisfaction (β=.16, p=.043) significantly predicted patient-centered care, explaining 51% of the variance. Conclusion: Positive patient safety attitudes, systems thinking, and major satisfaction are essential for patient-centered care. Nursing education should integrate ethics, empathy, systems thinking, and supportive programs to enhance engagement and prepare students for safe, effective clinical practice.