The research, conducted between April and June 2025 at Gaziantep University, utilized three validated instruments to measure key psychological and environmental factors: the Occupational Anxiety Scale for Healthcare Students (OAS-HS), the Nurses’ Attitudes Toward Workplace Risks Scale (NATWRS), and the Safety Climate Questionnaire (SCQ). The study’s internal consistency was notably high, with Cronbach’s alpha values ranging from 0.94 to 0.97 across the three scales, indicating robust reliability in the data collected. By employing advanced statistical modeling, the researchers were able to disentangle the complex interplay between these variables, offering a nuanced view of how nursing students process the risks inherent in their training.

Participants in the study reported moderate-to-high levels of occupational anxiety, with a mean score of 69.6 and a standard deviation of 17.3. In contrast, their attitudes toward workplace risks were generally positive, averaging 144.5 with a standard deviation of 22.5. Perceptions of the clinical learning safety climate were moderately favorable, with a mean score of 71.9 and a standard deviation of 11.3. These baseline metrics provide a snapshot of the typical psychological state of nursing students in this demographic, highlighting a population that is anxious yet generally optimistic about their ability to manage workplace risks.

Demographic and academic factors also played a role in shaping these perceptions. Independent-samples t-tests and one-way ANOVA analyses revealed that occupational anxiety was significantly higher among female students, Turkish students, and those with a grade point average of 2.00 or above, with all p-values less than 0.001. Conversely, more positive attitudes toward workplace risks were observed among male students and international students, with p-values of 0.029 and 0.011, respectively. These findings suggest that gender, nationality, and academic performance are not merely background variables but active contributors to how students engage with the risks of their profession.

Perhaps most strikingly, the study found that students who reported no trust in healthcare institutions or inadequate knowledge of occupational risks exhibited higher levels of anxiety and less favorable perceptions of the safety climate, with p-values less than 0.001. This correlation underscores the importance of institutional trust and risk literacy in the nursing curriculum. When students feel that the institutions they are training in do not prioritize safety or that they lack the knowledge to identify hazards, their anxiety increases and their confidence in the learning environment diminishes.

The core of the study’s contribution lies in its path analysis, performed using AMOS 29.0 software. The model tested the direct and indirect associations among occupational anxiety, attitudes toward workplace risks, and safety climate perceptions. The results showed that more positive attitudes toward workplace risks were strongly associated with more favorable safety climate perceptions, with a standardized beta coefficient of 0.52 and a p-value less than 0.001. This relationship accounted for 27% of the variance in safety climate perceptions, indicating that risk attitudes are a substantial predictor of how safe students feel in their clinical environments.

In contrast, occupational anxiety was not significantly associated with safety climate perceptions, either directly or indirectly through attitudes toward workplace risks. The direct path from anxiety to safety climate had a beta coefficient less than 0.001 and a p-value of 0.997, indicating a lack of statistical significance. This finding is counterintuitive, as one might expect that higher anxiety would lead to a more negative perception of safety. However, the data suggest that anxiety and safety perception are distinct psychological constructs in this context, with risk attitudes serving as the primary bridge between a student’s internal state and their external environment.

The implications of these findings for nursing education are profound. If safety perceptions are driven more by risk attitudes than by anxiety, then curricular reforms should prioritize the development of risk management skills and the cultivation of a positive risk culture. This includes improving the quality and psychological safety of clinical placements, ensuring that students feel supported and empowered to identify and mitigate risks. Additionally, supporting professional motivation may help students develop the confidence and resilience needed to navigate the complexities of clinical practice.

Furthermore, the study highlights the need for targeted support for specific subgroups of nursing students. Those reporting higher anxiety or less favorable risk attitudes, such as female students or those with lower academic performance, may benefit from additional resources and mentorship. By addressing the specific needs of these students, nursing programs can create a more inclusive and supportive learning environment that promotes both student well-being and patient safety. The study’s findings also suggest that fostering trust in healthcare institutions and enhancing knowledge of occupational risks are critical components of a comprehensive approach to nursing education.

In conclusion, this study provides valuable insights into the psychological dynamics of nursing students in clinical learning environments. By demonstrating that risk attitudes, rather than anxiety, are the primary drivers of safety perceptions, the research offers a new framework for understanding and improving the clinical learning experience. As nursing programs continue to evolve in response to changing healthcare demands, integrating these findings into curricular design and placement strategies will be essential for preparing the next generation of nurses to deliver safe, high-quality care. The study underscores the importance of a holistic approach to nursing education that addresses not only the technical skills required for practice but also the psychological and cultural factors that shape a student’s experience in the clinical setting.

Subject of Research: The relationship between occupational anxiety, risk attitudes, and safety climate perceptions in nursing students

Article Title: Occupational anxiety, workplace risk attitudes, and clinical learning safety climate among nursing students: a path analysis

Article References: Kızıltan, B., Ağar, A., & Berşe, S. (2026). Occupational anxiety, workplace risk attitudes, and clinical learning safety climate among nursing students: a path analysis. Scientific Reports. https://doi.org/10.1038/s41598-026-74777-w

Image Credits: AI Generated

DOI: 10.1038/s41598-026-74777-w

Keywords: nursing students, occupational anxiety, workplace risks, safety climate, clinical learning, path analysis, healthcare education, patient safety, risk management, psychological safety, Occupational, anxiety

The research, led by Antita Kanjanakaew and colleagues at Mahidol University’s Faculty of Nursing together with nurse educators at Siriraj Hospital, emerged from a pressing global problem. Health systems worldwide face a shortage of qualified nurse-midwifery educators, the specialized faculty members who traditionally supervise students during clinical placements. When there are not enough educators to go around, students can find themselves watching from the sidelines rather than learning by doing. The buddy model was developed as a collaborative response, pairing students with experienced bedside nurse-midwives who act as day-to-day guides within authentic clinical settings, allowing experiential learning to continue even when formal educator supervision is stretched thin.

To understand whether the model works, the researchers turned to the people at its center. Twenty-six nurse-midwifery students participated in online focus group discussions, while fifteen nurse-midwives took part in in-depth individual interviews. Participants were recruited through purposive sampling, a technique that deliberately selects individuals with direct experience of the phenomenon under study. The team then applied qualitative content analysis, a systematic method for identifying patterns and themes within textual data, to distill hundreds of pages of conversation into a coherent account of what the buddy model delivers, and what it demands.

Four major themes emerged from the students’ side of the relationship. The first was apprehension toward interacting with unfamiliar nurses, a reminder that stepping onto a busy maternity ward as a student is an inherently vulnerable act. Students described initial anxiety about approaching nurses they did not know, worrying about being judged or turned away. Yet this apprehension typically gave way to the second theme: hands-on learning. Once relationships formed, students reported that working alongside buddy nurses enhanced their confidence, accelerated their professional identity formation, and helped them integrate classroom theory with the messy, unpredictable realities of patient care. There is a qualitative difference, the students suggested, between reading about labor management and standing beside a woman in labor with a trusted mentor at your shoulder.

The third and fourth themes revealed the model’s internal complexity. Students described a dichotomy between two types of buddies, and correspondingly different challenges of learning from each. Some buddy nurses were engaged, generous teachers who actively created learning opportunities; others were passive, offering little direction and leaving students to fend for themselves. Busy clinical environments compounded the problem, reducing learning engagement when workloads overwhelmed even the most willing mentors. In other words, the buddy model is not a self-executing mechanism. Its educational value depends heavily on the disposition, availability, and teaching capacity of the individual nurse to whom a student is assigned.

The nurse-midwives’ perspective, captured in the individual interviews, added a second, equally textured layer. Four themes again emerged. The nurse-midwives saw the buddy nurse role as multifaceted, encompassing mentor, emotional supporter, and professional role model simultaneously. They described holding the line between teaching and care, a delicate balancing act in which patient safety must always take priority even as students need room to practice. They also spoke of growth, from self to system, suggesting that serving as buddies prompted reflection not only on their own practice but on the broader structures of the clinical environment. Finally, they identified barriers to effective teaching, including heavy workloads, the constant demands of patient safety, and limited opportunities to carve out genuine learning moments within packed shifts.

When the researchers integrated both sets of perspectives, a striking picture emerged. The buddy model, they concluded, functions as a reciprocal relational learning process rather than a simple one-way transfer of knowledge. The relationship begins with approach and engagement, as students overcome initial apprehension and nurses open their practice to observation and participation. It progresses through support and professional role modeling, as buddies demonstrate not just technical skills but the emotional and ethical dimensions of midwifery. And it culminates in shared learning and professional outcomes, with students gaining competence and confidence while nurse-midwives themselves report renewed professional growth. Learning, in this framing, is not delivered but co-constructed.

That reciprocity may explain why the model appears to support psychological safety, a concept that has attracted growing attention in health professions education. Students who feel emotionally secure are more likely to ask questions, admit uncertainty, and attempt challenging procedures, all of which are essential to developing clinical judgment. The buddy relationship, built on repeated daily contact with a consistent mentor, seems to create precisely the conditions under which such vulnerability becomes productive. The study’s authors suggest this supportive relational quality is central to the model’s perceived benefits for both experiential learning and professional development.

Yet the findings come with candid caveats. The study’s participants perceived the buddy model as valuable, but its successful implementation depended on adequate engagement of buddy nurses, manageable workloads, and sufficient clinical learning opportunities. Where any of these conditions failed, the model’s benefits eroded quickly. Passive buddies and overwhelmed wards turned a potentially rich learning relationship into a hollow formality. The authors are careful to note that their findings offer preliminary, context-specific support, drawn from a single hospital and a particular academic-practice partnership, rather than a universal prescription. Generalizing to other institutions will require further research in different settings and health systems.

Even so, the implications are significant at a moment when midwifery education faces mounting pressure. Shortages of clinical educators are not unique to Thailand; they are a structural feature of nursing and midwifery training in many countries, and they threaten the pipeline of skilled birth attendants precisely when maternal health services need reinforcement. The buddy model offers a pragmatic pathway: it mobilizes the clinical workforce already in place, transforms routine care into a teaching platform, and does so without requiring large new investments in faculty. The Bangkok study suggests the approach can work, but only if institutions treat buddy nurses as educators in their own right, protecting their time, recognizing their teaching role, and selecting for the engaged, supportive disposition that students so clearly valued. The alternative, the study quietly warns, is a buddy system in name only, in which students stand beside nurses too busy to teach and learn far less than they might.

Subject of Research: Experiences of nurse-midwifery students and nurse-midwives with the buddy model of clinical education in Thailand

Article Title: Experiences of the buddy model in midwifery clinical practice: a qualitative exploration of students and nurse-midwives

Article References: Kanjanakaew, A., Ruchob, R., Sirisomboon, R., Leetheeragul, J., Buranasak, J., Khadking, N., Hungsawanus, P., & Nuampa, S. (2026). Experiences of the buddy model in midwifery clinical practice: a qualitative exploration of students and nurse-midwives. BMC Nursing. https://doi.org/10.1186/s12912-026-05378-1

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05378-1

Keywords: buddy model, midwifery education, clinical learning, nurse-midwifery students, nurse-midwives, qualitative study, experiential learning, clinical teaching, professional identity, psychological safety, Thailand, nursing education