Professional Relationship Development Through Nursing Care Delivery System Training in Nursing Education
Abstract
Background. However, a significant "theory-practice gap" persists, where nursing students often struggle to apply relational skills in complex clinical environments, potentially leading to medical errors and suboptimal care.
Purpose. This study aims to evaluate the effectiveness of Nursing Care Delivery System (NCDS) training in enhancing these professional relationships among nursing students.
Method. A quantitative approach with a quasi-experimental one-group pretest-posttest design was conducted on 60 nursing students selected via total sampling.
Results. The findings revealed a statistically significant improvement in relational scores (t = -7.010, p = 0.000) with an average increase of 19.63% (N-Gain = 0.1964). Despite this positive shift, the results suggest that the training’s impact was not yet uniform across all participants.
Conclusion. This study’s novelty lies in transforming the NCDS model from a technical task management tool into a holistic relational framework that integrates social dynamics and clinical roles.
Full text article
References
Abujaber, A. A. (2024). Bridging the generational gap between nurses and nurse managers: A qualitative study from Qatar. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02296-y
Al-Hammouri, F. (2024). Quality of nursing care: Predictors of patient satisfaction in a national sample. Nursing Open, 11(8). https://doi.org/10.1002/nop2.2252
Almadani, N. (2024). Nurse Interns’ Perception of Clinical Preparation and Readiness for Clinical Internship Experiences. Journal of Nursing Management, 2024(Query date: 2026-04-03 14:51:03). https://doi.org/10.1155/2024/6682600
Almeida, A. S. (2024). Nursing Interventions to Empower Family Caregivers to Manage the Risk of Falling in Older Adults: A Scoping Review. International Journal of Environmental Research and Public Health, 21(3). https://doi.org/10.3390/ijerph21030246
Al-Noumani, H. (2024). Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study. Nurse Education Today, 133(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nedt.2023.106044
Amin, S. M. (2025). Bridging virtual and real learning: The role of digital literacy and metaverse perspectives in enhancing academic motivation in nursing education. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03681-x
Ar?burnu, Ö. (2024). Nursing students’ perceptions and experiences in pressure injury risk assessment: A qualitative study. Nurse Education in Practice, 79(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nepr.2024.104039
Avilés, L. (2024). Person-centred care and online pedagogy in nursing education: A discussion paper. Nurse Education in Practice, 78(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nepr.2024.103998
Cardwell, R. (2024). Being effective and supervising for thesis success in nursing coursework master degrees: A qualitative descriptive study. Journal of Advanced Nursing, 80(12), 5050–5063. https://doi.org/10.1111/jan.16164
Chang, L. C. (2025). Registered Nurses’ Attitudes Towards ChatGPT and Self-Directed Learning: A Cross-Sectional Study. Journal of Advanced Nursing, 81(7), 3811–3820. https://doi.org/10.1111/jan.16519
Christidis, N. (2024). Preparation of dental and nursing professionals within Swedish higher education: Navigating to confidence in literacies and professional knowledge. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-024-06439-2
Cubelo, F. (2024). Policy Reform on the Qualification Pathway of Internationally Educated Nurses in Greenland and Its Relationship With the Danish System: A Qualitative Discourse Analysis. Policy Politics and Nursing Practice, 25(3), 172–181. https://doi.org/10.1177/15271544241245975
Dias, J. M. (2024). Nursing students’ stressors and coping strategies during their first clinical training: A qualitative study in the United Arab Emirates. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01962-5
Dissanayake, D. M. A. P. (2024). Challenges of integrating patient safety into nursing curricula: An integrative literature review. Journal of Patient Safety and Risk Management, 29(1), 8–35. https://doi.org/10.1177/25160435231222808
Emino?lu, A. (2024). Assessment of the relationship between executive Nurses’ leadership Self-Efficacy and medical artificial intelligence readiness. International Journal of Medical Informatics, 184(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.ijmedinf.2024.105386
Estrada-Araoz, E. G. (2024). Psychological distress and sleep quality: A cross-sectional study in university students. Gaceta Medica De Caracas, 132(1), 23–29. https://doi.org/10.47307/GMC.2024.132.1.3
Farfán-Zúñiga, X. (2024). Reflections of nursing students on the care of the person’s dignity at the end of life: A qualitative study. Nurse Education Today, 133(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nedt.2023.106067
Fernández-Araque, A. (2024). Assessment of nurses’ level of knowledge of the management of chronic wounds. Nurse Education Today, 134(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nedt.2023.106084
Fouladi, E. (2024). Predicting Missed Nursing Care Based on Moral Sensitivity and Care-Related Factors. Journal of Nursing and Midwifery Sciences, 11(2). https://doi.org/10.5812/jnms-143728
Galletta, M. (2024). Cognitive Flexibility and Professional Identity in Nursing Students: The Modeling Role. Journal of Nursing Education, 63(11), 764–772. https://doi.org/10.3928/01484834-20240628-01
Garcia, D. (2024). Nursing students’ personality (Temperament and Character), burnout symptoms, and health and well-being. International Journal of Nursing Studies Advances, 6(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.ijnsa.2024.100206
Gershater, M. A. (2024). Nurse assistants’ perception of caring for older persons who are dying in their own home: An interview study. BMC Palliative Care, 23(1). https://doi.org/10.1186/s12904-024-01399-2
Güler, K. G. (2024). Nature-friendly hands: The relationship between nursing students’ climate change anxiety, intolerance of uncertainty, and anxiety about the future. Public Health Nursing, 41(6), 1491–1502. https://doi.org/10.1111/phn.13388
Hammad, B. M. (2024). Clinical Learning Environment: Perceptions of Palestinian Nursing Students. Inquiry United States, 61(Query date: 2026-04-03 14:51:03). https://doi.org/10.1177/00469580241273101
Jaastad, T. A. (2025). Nursing students’ movement toward becoming a professional caring nurse. Nursing Ethics, 32(1), 125–140. https://doi.org/10.1177/09697330241238343
Jantzen, D. (2024). Promoting moral imagination in nursing education: Imagining and performing. Nursing Philosophy, 25(1). https://doi.org/10.1111/nup.12427
Jiang, D. (2024). New Nurse Turnover Intention and Related Factors in Japan and China: Focusing on Nursing Practice Environment and Burnout. Journal of Nursing Research, 32(5). https://doi.org/10.1097/jnr.0000000000000636
Johnston, S. (2024). Australian nursing students’ experiences of workplace violence during clinical placement: A cross-sectional study. Journal of Advanced Nursing, 80(12), 4933–4945. https://doi.org/10.1111/jan.16189
Kashmeeri, M. (2024). Challenges experienced by health care providers working in both hospital and home-based palliative care units in Dhaka city: A multi-center based cross-sectional study. Plos One, 19(9). https://doi.org/10.1371/journal.pone.0306790
Khatatbeh, H. (2024). Paediatric nurses’ burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling. Journal of Clinical Nursing, 33(1), 255–264. https://doi.org/10.1111/jocn.16114
Knight, A. (2024). Communication Skills: A Scoping Review of Experiences, Perceptions, and Use in Dietetics Practice. Journal of the Academy of Nutrition and Dietetics, 124(9), 1162–1180. https://doi.org/10.1016/j.jand.2023.12.008
Kõrgemaa, U. (2024). Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades. Heliyon, 10(4). https://doi.org/10.1016/j.heliyon.2024.e26211
Lewis, A. (2025). Professional Identity Formation in Allied Health: A Systematic Review with Narrative Synthesis. Teaching and Learning in Medicine, 37(1), 24–40. https://doi.org/10.1080/10401334.2023.2290608
Li, C. (2024). Missed Nursing Care as a Mediator in the Relationship between Career Calling and Turnover Intention. International Nursing Review, 71(1), 62–68. https://doi.org/10.1111/inr.12842
Li, H. (2025). Profiles of innovative behavior and associated predictors among clinical nurses: A multicenter study using latent profile analysis. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-02716-7
Marriott, P. H. M. (2024). Preparedness for a first clinical placement in nursing: A descriptive qualitative study. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01916-x
Park, S. K. (2024). Relationship between hospital ethical climate, critical thinking disposition, and nursing task performance. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02366-1
Piispanen, N. (2024). Nursing students’ perceptions of interaction in a multiplayer virtual reality simulation: A qualitative descriptive study. Nursing Open, 11(8). https://doi.org/10.1002/nop2.2245
Qutishat, M. (2024). Relationship between burnout and fear of missing out among nurses in Oman: Implication for nursing practice. Journal of Education and Health Promotion, 13(1). https://doi.org/10.4103/jehp.jehp_429_24
Qutishat, M. (2025). Relationship between death anxiety and resilience among critical care nurses in Oman. Nursing in Critical Care, 30(3). https://doi.org/10.1111/nicc.13177
Reeves, K. (2024). Provider cultural competence and humility in healthcare interactions with transgender and nonbinary young adults. Journal of Nursing Scholarship, 56(1), 18–30. https://doi.org/10.1111/jnu.12903
Rony, M. K. K. (2025). Nursing Students’ Perspectives on Integrating Artificial Intelligence Into Clinical Practice and Training: A Qualitative Descriptive Study. Health Science Reports, 8(4). https://doi.org/10.1002/hsr2.70728
Shubayr, N. (2025). Assessment of emotional intelligence, self-efficacy, and perceived stress among nursing students in clinical practice: A cross-sectional study. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03109-6
Smith, C. M. (2024). Nursing practice in modern healthcare environments: A systematic review of attributes, characteristics, and demonstrations. Journal of Advanced Nursing, 80(9), 3481–3498. https://doi.org/10.1111/jan.16088
Song, M. (2024). Nursing students’ emotions, educational concerns, and the impact of study careers and professional futures during the COVID-19 pandemic: A cross-sectional study. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-024-05231-6
Tarsuslu, S. (2025). Can digital leadership transform AI anxiety and attitude in nurses? Journal of Nursing Scholarship, 57(1), 28–38. https://doi.org/10.1111/jnu.13008
Topal, S. (2024). Professional competences of emergency department nurses working in the earthquake region on triage management in children and the difficulties experienced by nurses in the decision-making process: A qualitative study. International Journal of Disaster Risk Reduction, 113(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.ijdrr.2024.104844
Vauhkonen, A. (2024). Professional competence, personal occupational well-being, and mental workload of nurse educators – A cross-sectional study in four European countries. Nurse Education Today, 133(Query date: 2026-04-03 14:51:03). https://doi.org/10.1016/j.nedt.2023.106069
Wilson, C. B. (2024). Co-designing an interprofessional digital education resource on delirium: A student-led approach. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-024-06023-8
Zoromba, M. A. (2025). Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses. Journal of Advanced Nursing, 81(10), 6406–6416. https://doi.org/10.1111/jan.16783