Professional Commitment Tied to Self-Reported Clinical Competence in Perioperative Students

Students training to run operating rooms and anesthesia machines work in one of the most unforgiving corners of healthcare education. A single miscounted sponge or a delayed drug draw can matter enormously, so educators have long wanted to know what makes some students feel clinically capable while others struggle with confidence. A new cross-sectional correlational study from Rafsanjan University of Medical Sciences in Iran, published in BMC Nursing, offers a quantitative answer: the more professionally committed students are, the more competent they perceive themselves to be, even after accounting for academic performance and personal interest in their field.

The research team, led by Shiva Sadeghi Meymand of the university’s Occupational Environment Research Center, recruited undergraduate students from two allied health programs: Operating Room Technology and Anesthesia Technology. These are the technologists who prepare instruments, maintain sterile fields, assist surgeons, and manage anesthesia equipment alongside anesthesiologists. Of 180 eligible students, 150 agreed to participate, a response rate of 83.3 percent. Data collection ran from May 15, 2025 to October 22, 2025, and the study received ethics approval from the university’s committee, with all participants providing informed consent and anonymity guaranteed.

Methodologically, the study relied on three instruments. A demographic questionnaire captured background variables such as age, gender, academic term, and grade point average. Professional commitment was measured with the widely used Meyer and Allen Professional Commitment questionnaire, which scores a three-component model of commitment: affective commitment, the emotional attachment to and identification with the profession; continuance commitment, the perceived cost of leaving the field; and normative commitment, the sense of moral obligation to stay. Perceived clinical competence was assessed with a self-report questionnaire in which students rate their own abilities across domains of perioperative practice, from technical skills to communication and critical thinking.

The headline numbers are striking. Mean professional commitment was 61.3 with a standard deviation of 9.8, and mean self-reported perceived clinical competence was 168.7 with a standard deviation of 24.3. The correlation between the two totals was moderate-to-strong and positive, with a Pearson coefficient of r = 0.63 and a p-value below 0.001, meaning the probability of observing such an association by chance alone is vanishingly small. In plain terms, students who scored higher on professional commitment tended to rate their own clinical competence substantially higher as well.

But correlation between two totals can be misleading, so the team went further with multiple linear regression using the Enter method, in which all candidate predictors are forced into the model simultaneously. Before running the analysis, the researchers verified the statistical assumptions of normality, homoscedasticity, and the absence of multicollinearity, the latter typically checked with variance inflation factors. The regression revealed that three variables were independently associated with perceived clinical competence: total professional commitment, with a standardized beta of 0.48 and a 95 percent confidence interval of 0.87 to 1.51; interest in the field, with a beta of 0.22 and a confidence interval of 2.28 to 11.10; and grade point average, with a beta of 0.18 and a confidence interval of 0.69 to 5.55. All three were statistically significant, with p-values of less than 0.001, 0.003, and 0.012 respectively.

Perhaps the most consequential figure in the paper is the R-squared value of 0.493. That means professional commitment, interest in the field, and GPA together accounted for 49.3 percent of the observed variance in self-reported perceived clinical competence in this sample. In educational research, where dozens of personal, social, and institutional factors shape student confidence, explaining nearly half the variance with three variables is unusual. It suggests that the psychological investment students make in their profession is not a peripheral concern but a central driver of how capable they feel in clinical settings.

The standardized betas also tell a story about relative importance. Professional commitment, with a beta of 0.48, was by far the strongest independent predictor, roughly twice the weight of interest in the field and more than twice that of GPA. This is notable because GPA is often treated as the default proxy for student ability. The findings imply that academic grades, while relevant, do not capture the motivational core of clinical self-assessment. A student with strong grades but weak professional attachment may feel less capable in the operating room than a moderately performing student who deeply identifies with the profession.

Why might professional commitment and perceived competence travel together? The authors frame their study as hypothesis-generating, but the theoretical logic is well established in the literature on Meyer and Allen’s model. Affective commitment reflects emotional identification with the profession, which plausibly motivates students to engage more deeply with clinical learning, seek feedback, and persist through difficult rotations. Normative commitment reflects a moral sense of duty, which may drive conscientious practice. Continuance commitment reflects the perceived cost of leaving, which is a more calculative attachment. The questionnaire’s total score aggregates these components, so the association with competence could be driven by any of them, a nuance future studies could disentangle by analyzing the subscales separately.

The authors are careful about what the study can and cannot claim. Because the design is cross-sectional, the data capture a single moment in time and cannot establish whether commitment causes competence or competence fosters commitment, or whether both are shaped by a third factor such as clinical exposure or mentorship quality. Moreover, the primary variables are self-reported, so perceived clinical competence reflects students’ self-assessments rather than objective performance evaluations by instructors or supervisors. Self-assessment is a legitimate and widely studied construct, linked to self-efficacy, but it is not a direct measure of actual skill. The authors explicitly state that the findings should be interpreted as associations rather than causal effects and may inform future educational research and hypothesis generation.

Even with those caveats, the study fills a real gap. Evidence on the simultaneous relationship between professional commitment and perceived clinical competence has been limited for allied health students in high-stakes perioperative environments, where most educational research focuses on nursing and medical students. The Rafsanjan team suggests the results may inform future educational research, and the practical implication for educators is that fostering professional commitment, through early clinical exposure, mentorship, and curricula that connect coursework to the identity of the perioperative technologist, could be as important as drilling technical skills. The study received no specific grant from any funding agency, the authors declare no competing interests, and the article is published open access under a Creative Commons Attribution 4.0 license, making the full dataset of methods and results freely available to educators and researchers worldwide.

Subject of Research: The association between professional commitment and self-reported perceived clinical competence among undergraduate operating room and anesthesia technology students

Article Title: Association between professional commitment and self-reported perceived clinical competence among undergraduate operating room and anesthesia technology students: a cross-sectional correlational study

Article References: Meymand, S. S., Abolhasani, Y., Soltanmoradi, Y., Goki, M. H. S., & Hassaninejad, H. (2026). Association between professional commitment and self-reported perceived clinical competence among undergraduate operating room and anesthesia technology students: a cross-sectional correlational study. BMC Nursing. https://doi.org/10.1186/s12912-026-05504-z

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05504-z

Keywords: professional commitment, perceived clinical competence, operating room technology, anesthesia technology, allied health education, cross-sectional study, multiple linear regression, Meyer and Allen questionnaire, self-assessment, perioperative education, nursing education, Rafsanjan University of Medical Sciences