Association between Problem-Solving Skills and Knowledge of the Nursing Process and Standardized Nursing Languages among Undergraduate Nursing Students

Abstract

Introduction. Problem-solving skills and the use of Standardized Nursing Languages (SNLs) are essential for clinical reasoning in nursing education, yet their relationship has been insufficiently explored. This study aimed to describe nursing students’ characteristics alongside their problem-solving skills, compare these across program years, and identify predictors of their knowledge of the nursing process and SNLs, with a specific focus on problem solving. Methods. A prospective observational study was conducted in 2024–2025 among undergraduate nursing students in a public university in Italy. Data were collected through an online survey including a knowledge test on SNLs, the Positions on Nursing Diagnosis scale, and the Problem-Solving Inventory (PSI). Descriptive statistics, ANOVA, correlation analyses, and multiple linear regression were performed. Results. A total of 352 students participated (87.5% female; mean age 22.79). Knowledge levels did not significantly differ across academic years. Higher knowledge was associated with better academic performance, stronger intention to use nursing diagnoses, and higher PSI-Self-Assurance, while larger class size and male sex were negatively associated with knowledge. Regression analysis identified PSI-Self-Assurance, intention to use nursing diagnoses, class size, and sex as significant predictors (R² = 0.11). Discussion. Knowledge of the nursing process and SNLs appears to be more strongly influenced by motivational and cognitive factors than by academic progression alone. Confidence in problem-solving and intentional engagement with nursing diagnoses emerge as key elements in supporting diagnostic reasoning.