Relationship among clinical practice environment, creative self-efficacy, achievement motivation, and innovative behavior in nursing students: A cross-sectional study

Background: Innovation is essential to advance nursing and health care. However, few studies have focused on innovative behavior of nursing students.Objectives: The purpose of this study was to explore the mediating effects of creative self-efficacy and achievement motivation on the relationship between clinical practice environment and innovative behavior in Bachelor of Science in Nursing (BSN) students.Design: A descriptive cross-sectional study using an online questionnaire.Setting: Participants were recruited online from five practice hospitals in Henan Province, China.Participants: A total of 588 BSN students enrolled in the study. Methods: The participants completed the innovative behavior questionnaire, the clinical practice environment scale, the achievement motivation scale, and the creative self-efficacy scale online in 2022. SPSS PROCESS macro was used for data analysis. The reporting followed the STROBE checklist.Results: A total of 499 valid questionnaires were collected. A positive clinical practice environment was associated with more innovative behavior, and this relation was partially mediated by creative self-efficacy and motive to avoid failure.Conclusion: Our study complements the evidence on the mechanism of action between the clinical practice environment and innovative behavior. Our findings have important implications for nursing educators to develop education strategies to inspire nursing students to pursue innovations in school and clinical settings.