How NGDLES affect nursing students’ empowering outcomes and professional identity: a cross-sectional study

Abstract

Aim of the study

Explore how the next-generation digital learning environment affects nursing students’ learning, psychological empowerment, and professional identity.

Background

The future of the nursing profession depends on leading the next generation of professional nurses, so it is imperative to empower students academically and psychologically to maintain and advance their professional identity. Nursing students will be more confident in their abilities and knowledge and more fulfilled in their roles if they feel empowered.

Design

Descriptive, correlational, and cross-sectional research designs were utilized in this study.

Methods

384 nursing students, using the following instruments: the next-generation digital learning environment scale (NGDLES), the learning empowering outcomes scale (LEOS), and the nursing students’ professional identity questionnaire (NSPIQ).

Results

A significant positive correlation between NGDLES and LEOS as p ≤ .001. Also, there is a significant positive correlation between NGDLES and NSPIQ, as p ≤ .001.

Conclusions

There were statistically significant positive correlations between the next-generation digital learning environment, learning and psychologically empowering outcomes, and professional identity among nursing students, so providing faculties with professional development in technology skills and improving the work environment for digital learning can improve nursing students’ adaptability to digital learning.

Introduction

Nursing practice is challenged by a variety of burdens, including increased elderly and critically ill patients, elevated healthcare costs, pandemics, nursing staff shortages, and rapid advances in medical knowledge and technology [1, 2]. As a result, nursing education needs to maintain sustainable change, meet global benchmarks to provide high-quality education, and meet worldwide needs [3]. Nurse educators have the main responsibility of educating nursing students for their forthcoming nursing careers [4]. They have a dynamic role in succeeding the next generation of qualified nurses. Therefore, nurse educators must evaluate the nursing curriculum and teaching approaches to qualify their nursing graduates [5, 6].

Recently, digital learning technologies are utilized progressively in nursing education due to the updating scientific evolution and public health pandemic to preserve the social distance [7]. The term next generation digital learning refers to adaptive learning or personalized learning that has been developed recently with modern technology. It encompasses a wide range of services, tools, and curriculum models to offer efficient, effective, and customized learning pathways to involve each student [8].

Using digital learning is not solitary for delivering academic content but correspondingly for applying distance learning [9]. A digital learning environment entails a profound change in the process of teaching and learning. Nurse educators are required to systematize the academic content, the language used, and communication strategies and manage time [10]. Digital learning includes an indispensable role in preparing and qualifying the next generation of nursing graduates with psychologically empowering outcomes and professional identity [11–13].

Empowerment helps nursing students learn to foster several key aspects essential for their development and future practice. Thus, empowerment can be defined as a process of providing opportunity for nursing students to make a choice and convert it into a desired action [14]. So, empowerment is the process of increasing a person’s sense of effectiveness. Empowerment was psychological and organizational [15]. Also, psychological empowerment is intrapersonal and behavioral; pupils find confidence in their aids and duties and reach organizational goals. Moreover, effectively managing and employing structural resources boosts intrapersonal empowerment. Plus, learning environment, student alignment, and teaching-learning strategies can empower nursing students [16, 17].

Digital learning can also change nursing students’ professional identities. Professional identity means a pleasant emotional experience and nursing career perception for nursing students. It shapes nursing students’ careers and strengthens nursing teams. Professional identity building starts in college and evolves over a career [18, 19]. Digital learning allows nursing students to watch online videos on how to handle tough clinical scenarios, boosting self-efficacy compared to lectures. Technology in nursing education creates social platforms that allow students to learn and communicate with peers and educators via email, discussion boards, and blogs, giving them new ways to explore, create, and present their identities [20, 21].

As healthcare increasingly integrates technology, digital learning teaches nursing students essential skills in using electronic health records, telehealth platforms, and other digital tools [22]. Proficiency in these technologies becomes a critical component of their professional identity, as they must navigate and utilize these tools effectively in practice [23]. Also, the broad access allows students to shape their understanding of nursing and develop their professional identities based on diverse perspectives and current evidence-based practices [24].

How this study will address the gap

While previous studies have explored various aspects of digital learning environments in higher education, there is limited empirical evidence specifically focused on how NGDLES can enhance the learning experiences, self-efficacy, and professional identity development of nursing students. This study aims to fill this gap by examining the correlation between the implementation of NGDLES principles and the empowering outcomes for nursing students, thereby providing insights into how tailored digital environments can better support nursing education and contribute to the professional readiness of future nurses.

Significance of the study

Digital learning is a transformative pathway in higher nursing education to keep up with fast-changing technology and the requirement for flexible learning, shaped by advancements in technology and the evolving needs of healthcare professionals. Digital learning in nursing education is shown to benefit students [25–27]. Digital learning allows nursing students to access information immediately at any time or location, giving them more control over their learning process and improving their learning, psychological empowerment, and professional identity [28, 29]. Thus, educators must examine how the next-generation digital learning environment affects nursing students’ learning, psychological empowerment, and professional identity.

Aim of the study

The aim of the study was to explore how the next-generation digital learning environment affects nursing students’ learning, psychological empowerment, and professional identity.

Research questions

• What is the relationship between the next-generation digital learning environment and nursing students’ learning empowerment outcomes?

• What is the relation between the next generation digital learning environment and nursing students’ professional identity?

• Are there correlations between the next generation digital learning environment, learning empowering outcomes, and professional identity among nursing students?

Method

Research design

Descriptive correlational, through cross-sectional research design was utilized.

Research settings

The present study was implemented at Tanta University Faculty of Nursing, one of the governmental universities in the delta region of Egypt affiliated with the Ministry of Higher Education and Scientific Research. It was constructed in 1982/1983as the High Institute of Nursing, then converted officially to the Faculty of Nursing in April 2000 and added to the faculties of nursing in Egypt.

The nursing departments consisted of seven academic departments^, namely, medical-surgical nursing, maternal and gynecological nursing, pediatric nursing, public health nursing, nursing administration, critical care nursing, and mental health and psychiatric nursing.

Subjects

A random sample of nursing students (n = 384) was chosen from the overall number of nursing students (N = 3200). The procedure for choosing the sample from the prior stated setting has been proportionate according to the numeral to each level in the academic year; in 2022/2023, this faculty had 3200 nursing students: 553 first-year students, 1049 s-year students, 1048 third-year students, and 550 fourth-year students. The sample size and power analysis were calculated using the Epi.info software statistical package. The norms used for sample size scheming were as follows: Z = confidence level at 95% (5%). d d = error proportion (0.05).

Ethical considerations

The Declaration of Helsinki’s highest ethical standards were followed in this study to protect each participant’s rights, privacy, and welfare. A formal approval was obtained from the IRB of Tanta University before collecting the data with reference code (no. 202-1-2023). All participants were informed of the study’s purpose, procedures, potential risks, and benefits. They were also assured that their participation was voluntary and that they could withdraw at any time without repercussions.

The confidentiality of personal data was rigorously maintained, and the data were anonymized to prevent any identifiable information from being linked to individual participants. Prior to the collection of data, informed consent was obtained from each participant, ensuring that they were aware of their rights and the objectives of the study. Furthermore, the study adhered to the ethical guidelines and standards for research involving human subjects as set forth by the university’s ethics review board and aligned with international best practices in health research ethics.

Data collection tools

Three tools were expended in this study explicitly: Next Generation Digital Learning Environment Scale (NGDLES), Learning Empowering Outcomes Scale (LEOS), and Nursing Students’ Professional Identity Questionnaire (NSPIQ). In addition, personal data was also encompassed. All tools were translated into the Arabic language.

Tool І: next generation digital learning environment scale (NGDLES)

It entailed of two parts as the subsequent:

Part one, personal data, was planned by the researchers to gather the personal data of the applicant nursing students (such as age, gender, marital status, residency, academic year, and previous academic year grades).

Part two: next generation digital learning environment scale

This tool was adapted from Brown et al. (2015) [30] and Pérez-Garcias et al. (2022) [31] to assess nursing students’ levels regarding next-generation digital learning environment domains. It consisted of 30 descriptive items and was classified into five main domains as (1) Interoperability and integration domain; included four subscales with 12 items: Concerns Content (5 items), Integration (one item), Learning Environment (5 items), and Interoperability Standards (one item). (2) Personalization domain; included two subscales with 4 items: the outfitting and configuration of the learning environment (2 items) and adaptive learning (2 items), respectively. (3) Analytics, advising, and learning assessment domain; included two subscales with 5 items: Learning Analytics (one item) and Integrated Planning and Advising Systems (IPAS) (4 items), respectively. (4) Collaboration domain; included 7 items. Lastly, (5) accessibility and universal design domain included 2 items.

Scoring system of NGDLES

The students’ replies were weighed on a five-point Likert Scale: 5 = strongly agree, 4 = agree, 3 = neutral, 2 = disagree, and 1 = strongly disagree. It was gained as high next-generation digital learning environment level ≥ 75%, moderate next-generation digital learning environment level 60% - <75%, low next-generation digital learning environment level < 60%.

Tool II: learning and psychological empowering outcomes scale (LPEOS)

This tool was adapted from Houser & Frymier (2009) [32], Zraa et al. (2013) [33], and Çakır & Erdoğan (2014) [34]. It is composed of 28 descriptive items and divided into five subscales named Self-directed Learning (4 items), Self-efficacy (4 items), Impact on the Learning Process (10 items), Meaningfulness (6 items), and Competency (4 items), respectively. This tool assessed nursing students’ learning empowerment outcomes levels while utilizing the next generation digital learning environment.

Scoring system of LPEOS

The students’ replies were restrained on a five-point Likert scale: 5 = always, 4 = often, 3 = sometimes, 2 = rarely, and 1 = never. It was expanded as high learning and psychological empowering outcomes level ≥ 75%, moderate learning and psychological empowering outcomes level 60% - <75%, and low learning and psychological empowering outcomes level < 60%.

Tool III: nursing students’ professional identity questionnaire (NSPIQ)

This tool is designed by Hao (2011) [35] and assesses nursing students’ professional identity levels while using the next-generation digital learning environment. It consisted of 17 descriptive items divided into five subscales named Professional Self-Image (6 items), Retention Benefit and Risk of Turnover (4 items), Social Comparison and Self-Reflection (3 items), Career Choice Independence (2 items), and Social Modeling (2 items), respectively.

Scoring system of NSPIQ

The students’ responses were assessed on a five-point Likert scale: 5 = strongly agree, 4 = agree, 3 = neutral, 2 = disagree, and 1 = strongly disagree. It was obtained as high professional identity level ≥ 75%, moderate professional identity level 60% - <75%, and low professional identity level < 60%.

Pilot study

Prior to conducting the study, a pilot study of 10% of nursing students demonstrated (n = 39) not contained within the study sample to inspect the feasibility and applicability of the study tools, detect any hitches, and guess the time essential to fill in the form. Also, the essential modification and amplification of some queries were finished.

Procedure and data collection

A board of five experts was asked to appraise the tools from the nursing field (3 of them professors of the Nursing Administration Department and the other 2 professors of Psychiatric Nursing and Mental Health, Faculty of Nursing, Tanta University, Egypt) to judge the face and content validity, as well as to check the significance and appositeness. The experts’ responses were assessed on a four-point Likert scale: 4 = strongly relevant, 3 = relevant, 2 = not relevant, and 1 = strongly not relevant. The values of content validity for tool I, tool II, and tool III are 86.43%, 81.53%, and 87.78%, respectively.

All three tools were experienced for reliability using the Cronbach Alpha Coefficient Factor Test and wholly were satisfactory (α = 0.988, α = 0.813, and α = 0.795) for NGDLES, LEOS, and NSPIQ, respectively.

All three tools of the current study were translated into the Arabic language. The data were collected from undergraduates in different educational levels by giving them a form sheet to fill in. The researchers voiced to them that all material gathered will be utilized only for research goals, and the results of the study will be published in total. The predictable time to complete all questionnaires was 10–15 min. The data assortment stage of the study was pragmatic at all periods of the 2nd semester of the standing academic year 2022/2023 (about three months, from half of February to half of May 2023).

Data analysis

SPSS version 20 (Statistical Package for the Social Sciences) was used. The data was fed into the processor and analyzed with IBM SPSS 20. Numbers and percentages were used to denote the quantitative data in a report by IBM (Armonk, NY: IBM Corp.). For verification of distribution normality, the minimum and maximum values, as well as the mean, standard deviation, and median, were assigned to the numerical information. The obtained results were deemed significant at the 5% level. For categorical variables, the chi-square test was used alongside the Monte Carlo correction and the correction for chi-square when more than 20% of the cells have an expected count of less than 5, and for quantitative variables.

Results

Table 1 Shows personal data of nursing students. The table revealed that half of the studied nurses were female and 48.3% were male. Also, most of them (83.3%) live in rural areas. In addition, the highest percentages of them (87.5%) completed secondary school education and have excellent previous academic year grades, respectively.

Table 1.

Personal data of nursing students (N = 384)

Personal data	1st year (n = 72)		2nd year (n = 120)		3rd year (n = 120)		4th year (n = 72)		Total (n = 384)
	No.	%	No.	%	No.	%	No.	%	No.	%
Gender
Women	62	86.1	97	80.8	88	73.3	55	76.4	302	78.6
Men	10	13.9	23	19.2	32	26.7	17	23.6	82	21.4
Father education
Illiterate reads and writes	2	2.8	6	5.0	2	1.7	3	4.2	13	3.4
Below average	4	5.6	14	11.7	13	10.8	6	8.3	37	9.6
Intermediate education	27	37.5	49	40.8	63	52.5	26	36.1	165	43.0
High education	39	54.2	51	42.5	42	35.0	37	51.4	169	44.0
Mother education
Illiterate reads and writes	4	5.6	8	6.7	3	2.5	3	4.2	18	4.7
Below average	4	5.6	10	8.3	12	10.0	7	9.7	33	8.6
Intermediate education	28	38.9	60	50.0	69	57.5	32	44.4	189	49.2
High education	36	50.0	42	35.0	36	30.0	30	41.7	144	37.5
Previous study
Secondary school	72	100.0	105	87.5	93	77.5	53	45.6	323	84.1
Technical institute of nursing	0	0.0	15	12.5	27	22.5	19	26.4	61	15.9
Residency
Rural	60	83.3	84	70.0	83	69.2	51	70.8	278	72.4
Urban	12	16.7	36	30.0	37	30.8	21	29.2	106	27.6
Previous academic year grades
Acceptable	–	–	7	5.8	1	0.8	17	23.6	25	6.5
Good	–	–	2	1.7	2	1.7	5	6.9	9	2.3
Very Good	–	–	85	70.8	73	60.8	8	11.1	166	43.2
Excellent	–	–	98	81.7	44	36.7	42	58.3	184	47.9

Table 2 Illustrates nursing students’ levels regarding the next generation digital learning environment (NGDLE). The table revealed that there was a statistically significant difference between all subscales of NGDLS among the four academic years of nursing students (p < .001), with a total mean percent score of 64.77 ± SD = 8.10.

Table 2.

Nursing students’ levels regarding next generation digital learning environment (NGDLE)

NGDLES Domains	1st year (n = 72)		2nd year (n = 120)		3rd year (n = 120)		4th year (n = 72)		Total (n = 384)		P
	No.	%	No.	%	No.	%	No.	%	No.	%
1. Interoperability and integration domain
- Concerns											< 0.001***
Low	9	12.5	12	10.0	10	8.3	2	2.8	33	8.6
Moderate	60	83.3	102	85.0	99	82.5	58	80.6	319	83.1
High	3	4.2	6	5.0	11	9.2	12	16.7	32	8.3
- Integration
Low	9	12.5	13	10.8	8	6.7	3	4.2	33	8.6	0.029**
Mod	61	84.7	103	85.8	104	86.7	59	81.9	327	85.2
High	2	2.8	4	3.3	8	6.7	10	13.9	24	6.3
- Learning Environment
Low	16	22.2	19	15.8	11	9.2	3	4.2	49	12.8	0.007**
Moderate	54	75.0	95	79.2	101	84.2	60	83.3	310	80.7
High	2	2.8	6	5.0	8	6.7	9	12.5	25	6.5
- Interoperability Standards
Low	17	23.6	11	9.2	8	6.7	6	8.3	42	10.9	< 0.001***
Mod	53	73.6	102	85.0	103	85.8	54	75.0	312	81.3
High	2	2.8	7	5.8	9	7.5	12	16.7	30	7.8
Total Interoperability and integration
Low	23	31.9	18	15.0	8	6.7	2	2.8	51	13.3	< 0.001***
Moderate	47	65.3	97	80.8	100	83.3	59	81.9	303	78.9
High	2	2.8	5	4.2	12	10.0	11	15.3	30	7.8
Mean (SD)	61.89 (10.78)		63.59 (9.43)		67.86 (6.01)		70.77 (6.47)		65.96 (8.86)		< 0.001***
Median (IQR)	66.67 (58.33 − 66.67)		64.58 (62.50–66.67)		68.75 (64.58–70.83)		68.75 (68.75–70.83)		66.67 (64.58–68.75)
2. Personalization domain
- The Outfitting and Configuration of The Learning Environment
Low	25	34.7	12	10.0	11	9.2	5	6.9	53	13.8	< 0.001***
Moderate	44	61.1	98	81.7	98	81.7	55	76.4	295	76.8
High	3	4.2	10	8.3	11	9.2	12	16.7	36	9.4
- Adaptive Learning
Low	18	25.0	13	10.8	10	8.3	7	9.7	48	12.5	0.003**
Moderate	48	66.7	96	80.0	96	80.0	50	69.4	290	75.5
High	6	8.3	11	9.2	14	11.7	15	20.8	46	12.0
Total levels of Personalization
Low	33	45.8	14	11.7	15	12.5	9	12.5	71	18.5	< 0.001***
Moderate	36	50.0	94	78.3	94	78.3	46	63.9	270	70.3
High	3	4.2	12	10.0	11	9.2	17	23.6	43	11.2
Mean (SD)	54.69 (12.62)		62.19 (8.94)		63.28 (6.81)		67.01 (11.31)		62.03 (10.38)		< 0.001***
Median (IQR)	62.50 (50.0–62.50)		62.50 (62.50 − 62.50)		62.50 (62.50 − 62.50)		62.50 (62.5–68.75)		62.50 (62.50–62.50)
3. Analytics, advising, and learning assessment
- Learning Analytics
Low	13	18.1	12	10.0	8	6.7	5	6.9	38	9.9	< 0.001***
Moderate	55	76.4	98	81.7	101	84.2	48	66.7	302	78.6
High	4	5.6	10	8.3	11	9.2	19	26.4	44	11.5
- Integrated Planning and Advising systems
Low	27	37.5	11	9.2	9	7.5	6	8.3	53	13.8	< 0.001***
Moderate	44	61.1	100	83.3	102	85.0	61	84.7	307	79.9
High	1	1.4	9	7.5	9	7.5	5	6.9	24	6.3
Total Analytics, advising, and learning assessment
Low	29	40.3	12	10.0	11	9.2	6	8.3	58	15.1	< 0.001***
Moderate	42	58.3	95	79.2	94	78.3	49	68.1	280	72.9
High	1	1.4	13	10.8	15	12.5	17	23.6	46	12.0
Mean (SD)	57.99 (14.86)		65.67 (10.73)		66.96 (7.60)		67.43 (6.66)		64.96 10.70)		< 0.001***
Median (IQR)	65.0 (55.0 − 70.0)		65.0 (65.0–70.0)		65.0 (65.0–70.0)		65.0 (65.0–70.0)		65.0 (65.0–70.0)
4. Collaboration domain
Low	19	26.4	14	11.7	13	10.8	8	11.1	54	14.1	0.001***
Moderate	47	65.3	99	82.5	98	81.7	50	69.4	294	76.6
High	6	8.3	7	5.8	9	7.5	14	19.4	36	9.4
Mean (SD)	59.28 (18.69)		66.46 (12.64)		66.61 (9.75)		68.16 (13.97)		65.48 (13.76)		< 0.001***
Median (IQR)	67.86 (50.0–67.86)		67.86 (67.86–71.43)		67.86 (60.71–71.43)		67.86 (66.08–71.43)		67.86 (60.71–71.43)
5. Accessibility and universal design
Low	19	26.4	13	10.8	13	10.8	7	9.7	52	13.5	< 0.001***
Moderate	51	70.8	104	86.7	101	84.2	56	77.8	312	81.3
High	2	2.8	3	2.5	6	5.0	9	12.5	20	5.2
Mean (SD)	55.03 (17.51)		60.00 (9.80)		61.77 (4.94)		63.37 (13.49)		60.25 (11.65)		< 0.001***
Median (IQR)	62.50 (50.0–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)
Total NGDLES
Low	21	29.2	14	11.7	6	5.0	5	6.9	46	12.0	< 0.001***
Moderate	50	69.4	104	86.7	112	93.3	62	86.1	328	85.4
High	1	1.4	2	1.7	2	1.7	5	6.9	10	2.6
Mean (SD)	59.21 (10.84)		64.18 (8.63)		66.40 (4.46)		68.61 (5.15)		64.77 (8.10)		< 0.001***
Median (IQR)	62.50 (55.0–65.83)		65.83 (64.17 − 67.50)		66.67 (65.0–68.33)		68.33 (66.67 − 70.83)		66.67 (63.33 − 68.33)

*p < .05, **p < .01, ***p < .001 NGDLES: Next Generation Digital Learning Environment

Table 3 Shows nursing students’ levels regarding learning empowering outcomes (LEOs). The table revealed that there was a statistically significant difference among the four academic years of nursing students’ levels for learning and psychological empowering outcomes, p ≤ .05, with a total mean percent score of 65.79 ± SD = 8.42.

Table 3.

Nursing students’ levels regarding learning and psychological empowering outcomes (LPEOS)

LPEOS	1st year (n = 72)		2nd year (n = 120)		3rd year (n = 120)		4th year (n = 72)		Total (n = 384)		P
	No.	%	No.	%	No.	%	No.	%	No.	%
- Self-directed Learning
Low	7	9.7	10	8.3	34	28.3	8	11.1	59	15.4	< 0.001***
Moderate	57	79.2	101	84.2	75	62.5	59	81.9	292	76.0
High	8	11.1	9	7.5	11	9.2	5	6.9	33	8.6
Mean (SD)	67.10 (10.59)		65.36 (9.09)		62.60 (13.82)		65.02 (8.63)		64.76 (11.06)		0.001***
Median (IQR)	65.63 (62.50–68.75)		62.50 (62.50–68.75)		62.50 (50.0–68.75)		68.75 (62.50–68.75)		62.50 (62.50–68.75)
- Self-efficacy
Low	8	11.1	10	8.3	29	24.2	5	6.9	52	13.5	0.001***
Moderate	60	83.3	103	85.8	76	63.3	59	81.9	298	77.6
High	4	5.6	7	5.8	15	12.5	8	11.1	34	8.9
Mean (SD)	65.36 (7.70)		66.20 (8.40)		64.43 (14.91)		66.75 (10.05)		65.59 (11.030)		0.378
Median (IQR)	68.75 (62.50–68.75)		68.75 (62.50–68.75)		68.75 (62.50–68.75)		62.50 (62.50–68.75)		68.75 (62.50–68.75)
- Impact on Learning Process
Low	8	11.1	11	9.2	38	31.7	6	8.3	63	16.4	< 0.001***
Moderate	59	81.9	97	80.8	66	55.0	61	84.7	283	73.7
High	5	6.9	12	10.0	16	13.3	5	6.9	38	9.9
Mean (SD)	68.51 (9.56)		67.31 (12.29)		63.73 (14.00)		66.67 (8.33)		66.30 (11.87)		0.042*
Median (IQR)	70.0 (67.50–71.25)		67.50 (60.0–72.50)		65.0 (52.50–70.0)		67.50 (61.25–72.50)		67.50 (60.0–72.50)
- Meaningfulness
Low	7	9.7	9	7.5	30	25.0	4	5.6	50	13.0	< 0.001***
Moderate	61	84.7	106	88.3	76	63.3	61	84.7	304	79.2
High	4	5.6	5	4.2	14	11.7	7	9.7	30	7.8
Mean (SD)	66.09 (6.61)		66.56 (8.50)		64.76 (14.13)		69.62 (9.42)		66.48 (10.57)		< 0.001***
Median (IQR)	70.0 (67.50–71.25)		67.50 (60.0–72.50)		65.0 (52.50–70.0)		67.50 (61.25–72.50)		67.50 (60.0–72.50)
- Competency
Low	7	9.7	9	7.5	28	23.3	4	5.6	48	12.5	< 0.001***
Moderate	64	88.9	106	88.3	85	70.8	67	93.1	322	83.9
High	1	1.4	5	4.2	7	5.8	1	1.4	14	3.6
Mean (SD)	65.45 (7.03)		65.73 (8.14)		62.55 (11.78)		65.71 (5.03)		64.68 (8.93)		< 0.001***
Median (IQR)	68.75 (62.50–68.75)		68.75 (62.50–68.75)		62.50 (62.50–68.75)		68.75 (62.50–68.75)		68.75 (62.50–68.75)
Total Levels of LPEOS
Low	8	11.1	9	7.5	31	25.8	5	6.9	53	13.8	< 0.001***
Moderate	59	81.9	101	84.2	80	66.7	63	87.5	303	78.9
High	5	6.9	10	8.3	9	7.5	4	5.6	28	7.3
Mean (SD)	66.90 (6.36)		66.49 (7.43)		63.72 (11.13)		66.93 (5.57)		65.79 (8.42)		0.049*
Median (IQR)	67.86 (66.07–68.75)		66.07 (65.18–68.75)		66.96 (59.38–68.30)		67.86 (64.73–68.75)		66.96 (65.18–68.75)

*p < .05, **p < .01, ***p < .001 LPEOs: Learning and Psychological Empowering Outcomes

Table 4 Illustrates nursing students’ levels regarding professional identity (NSPIQ). The table confirmed that there was a statistically significant difference among all nursing students’ levels for all professional identity subscales, with a total mean percent score of 63.87 (SD = 9.48).

Table 4.

Nursing students’ levels regarding professional identity (NSPIQ)

Professional Identity (NSPIQ)	1st year (n = 72)		2nd year (n = 120)		3rd year (n = 120)		4th year (n = 72)		Total (n = 384)		P
	No.	%	No.	%	No.	%	No.	%	No.	%
- Professional Self-Image
Low	11	15.3	12	10.0	28	23.3	7	9.7	58	15.1	0.002**
Moderate	59	81.9	101	84.2	79	65.8	64	88.9	303	78.9
High	2	2.8	7	5.8	13	10.8	1	1.4	23	6.0
Mean (SD)	64.53 (12.63)		66.35 (12.33)		65.35 (14.44)		66.49 (5.70)		65.72 (12.17)		0.538
Median (IQR)	66.67 (62.50–70.83)		66.67 (66.67–70.83)		66.67 (62.50–70.83)		66.67 (64.59–70.83)		66.67 (62.50–70.83)
- Retention Benefit and Risk of Turnover
Low	15	20.8	18	15.0	27	22.5	8	11.1	68	17.7	0.003**
Moderate	54	75.0	89	74.2	68	56.7	48	66.7	259	67.4
High	3	4.2	13	10.8	25	20.8	16	22.2	57	14.8
Mean (SD)	59.46 (12.54)		64.11 (13.86)		63.96 (17.71)		66.23 (12.53)		63.59 (14.83)		0.001***
Median (IQR)	62.50 (62.50–62.50)		62.50 (62.50–68.75)		62.50 (62.50–68.75)		62.50 (62.50–68.75)		62.50 (62.50–68.75)
- Social Comparison and Self-reflection
Low	10	13.9	11	9.2	20	16.7	10	13.9	51	13.3	0.741
Moderate	60	83.3	105	87.5	96	80.0	59	81.9	320	83.3
High	2	2.8	4	3.3	4	3.3	3	4.2	13	3.4
Mean (SD)	64.01 (12.88)		65.21 (8.48)		64.03 (11.69)		64.35 (10.49)		64.46 (10.78)		0.521
Median (IQR)	66.67 (66.67–66.67)		66.67 (66.67–66.67)		66.67 (66.67–66.67)		66.67 (66.67–66.67)		66.67 (66.67–66.67)
- Career Choice Independence
Low	11	15.3	14	11.7	24	20.0	8	11.1	57	14.8	0.352
Moderate	58	80.6	94	78.3	89	74.2	59	81.9	300	78.1
High	3	4.2	12	10.0	7	5.8	5	6.9	27	7.0
Mean (SD)	60.59 (11.03)		62.50 (11.57)		60.63 (12.52)		62.33 (7.71)		61.52 (11.17)		0.171
Median (IQR)	62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)
- Social Modeling
Low	8	11.1	9	7.5	19	15.8	7	9.7	43	11.2	0.152
Moderate	62	86.1	111	92.5	99	82.5	65	90.3	337	87.8
High	2	2.8	0	0.0	2	1.7	0	0.0	4	1.0
Mean (SD)	60.42 (11.10)		60.42 (9.50)		59.79 (9.05)		61.11 (4.48)		60.35 (8.96)		0.452
Median (IQR)	62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)		62.50 (62.50–62.50)
Total Levels of NSPIQ
Low	10	13.9	13	10.8	24	20.0	7	9.7	54	14.1	0.050*
Moderate	61	84.7	102	85.0	86	71.7	63	87.5	312	81.3
High	1	1.4	5	4.2	10	8.3	2	2.8	18	4.7
Mean (SD)	62.30 (10.46)		64.48 (9.31)		63.58 (10.59)		64.93 (6.11)		63.87 (9.48)		0.007**
Median (IQR)	64.71 (63.24–66.18)		66.18 (64.71–67.65)		66.18 (63.24–67.65)		66.18 (64.71–67.65)		66.18 (64.71–67.65)

*p < .05, **p < .01, ***p < .001 NSPIQ: Professional Identity

Table 5 Shows the correlation between next-generation digital learning environments (NGDLES) and learning-empowering outcomes (LEOS). It is noticed that there was a highly significant positive correlation between NGDLES and LEOS as p ≤ .001.

Table 5.

Correlation between next generation digital learning environment (NGDLES), learning empowering outcomes scale (LPEOS), and nursing students’ professional identity (NSPIQ) among nursing students

Variables		Next Generation Digital Learning Environment Scale (NGDLES)
		Total (n = 384)	1st year (n = 72)	2nd year (n = 120)	3rd year (n = 120)	4th year (n = 72)
Learning and Psychological Empowering Outcomes Scale (LPEOS)	rs	0.522	0.318	0.182	991	0.924
	p	< 0.001***	0.006**	0.047**	< 0.001***	< 0.001***
Nursing Students’ Professional Identity (NSPIQ)	rs	0.715	0.637	768	808	0.723
	p	< 0.001***	< 0.001***	< 0.001***	< 0.001***	< 0.001***

r_s: Spearman coefficient *p < .05 **p < .01 ***p < .001

Figure 1 Shows the correlation between next-generation digital learning environments (NGDLES), learning empowering outcomes (LEOS), and nursing students’ professional identity (NSPIQ).

Fig. 1.

Correlation between next generation digital learning environment (NGDLES) and learning empowering outcomes (LPEOS) among nursing students

Figure 2 It is noticed that there was a significant positive correlation between NGDLES and LEOS as p ≤ .001 (r = .715). A significant positive correlation between NGDLES and NSPIQ as p ≤ .001 (r = .522).

Fig. 2.

Correlation between next generation digital learning environment (NGDLES) and professional identity (NSPIQ) among nursing students

Discussion

The COVID-19 epidemic has accelerated the online educational environment for nursing college undergraduates, which is expected to continue. Online platforms enhance nursing students’ knowledge and capabilities, promoting collaboration, self-efficacy, and professional identity. The Next Generation Digital Learning Environment (NGDLES) offers various digital resources, enabling students to take control of their education and fostering a stronger professional identity through accessible knowledge and simulation-based learning. This hands-on experience builds confidence and competence, essential for students’ professional identities, and enhances their cultural competency.

The study found significant differences in the next-generation digital learning environment (NGDLE) subscales among four-year nursing students, which may be attributed to varying educational backgrounds. Most students came from secondary education, while others graduated from nursing institutes, leading to differences in areas such as interoperability, personalization, analytics, and collaboration within the NGDLE. Additionally, first- and second-year students had a less favorable perception of their nursing practice compared to third- and fourth-year students.

Most nursing students rated their use of Next-Generation Digital Learning Systems (NGDLS) moderately, particularly regarding the role of digital technology as a primary source of academic data and its ability to create new learning opportunities. They also indicated that integrating digital resources into the learning environment was relatively straightforward without requiring extensive support. Additionally, nursing students moderately agreed that digital learning environments encouraged active participation, enhanced confidence and motivation, and reduced barriers related to computer literacy.

Lodge et al. (2020) [36] was online with the current study, which assumed that increasing usage of technologies has consequences for all levels of education, perhaps most manifest in a higher education context where pupils are spending less time on campus and more time online than they did in the past. Plus, Jeon and Kim (2022) [37] supported the current study findings and signposted that even though attitudes toward online learning affected digital literacy, they did not directly influence electronic health literacy.

Meedya et al. (2019) [38] found that two-thirds of students strongly agreed they learned more about science after an assessment task, although a smaller percentage found searching for scientific knowledge boring. Many students faced difficulties with the technology and ungraded work. While digital explanations were viewed positively by nursing students, a lengthy, graded evaluation is necessary to fully enhance its effectiveness as a teaching tool. In contrast, Adewoyin and Ebabhi (2022) [39] reported that learners had a more positive perception of open and distance learning (ODL) and expressed satisfaction with the digital content.

The existing study found a highly statistically significant difference in four-year nursing students’ learning and psychological empowerment outcomes. Most nursing students’ responses showed mid-range levels for self-directed learning, self-efficacy, impact on the learning process, meaningfulness, and competency subscales, respectively, because their educators encourage competition and encourage them to critique their own work and analyze their strengths and weaknesses. Nursing students’ comments showed that their educators accept and accommodate individual diversity, interests, abilities, and experiences and treat them as co-creators and partners in teaching and learning.

Indeed, students require digital learning environments that engage them in meaningful tasks and provide opportunities for deep knowledge development. Effective digital learning environments involve diverse, stimulating activities aligned with students’ learning goals, promoting engagement by incorporating their cultural backgrounds and experiences. This approach encourages students to think critically, discuss, explore concepts, solve problems, and build knowledge rather than merely memorizing information.

As a supported result, Kim and Park (2021) [40] found that nursing students’ COVID-19 worries hindered remote e-learning. Nursing school instructors and staff must lessen students’ COVID-19-related fear to improve distance e-learning’s empowerment of nursing students. In addition, Fandos-Herrera et al. (2023) [41] found that the three personality qualities affect either perceived learning outcomes or students’ attitudes toward discussing their classmates’ work and being discussed by peers. The three student profiles are ‘proactive emphatic leader,’ ‘speculative leader,’ and ‘passive follower.’ Torbergsen et al. (2023) [42] found that instructor autonomy support influences first-year nursing students’ intrinsic motivation, study exertion, and perceived learning outcomes. Self-support from a teacher is directly and indirectly linked to students’ learning outcomes and study effort.

In contrast, Wu et al. (2022) [43] found that both groups’ learning outcomes improved from pretest to posttest. Simulation-based interprofessional education had significantly higher posttest scores in medical task performance, critical medical task performance, and team behavior performance than video-enhanced interactive discussion. No significant difference was found in interprofessional alliance attitudes between groups. Sukkha et al. (2023) [44] found 226 students in their study (traditional learning (TL), n = 118; interactive strategies of online learning (ISOL), n = 108), which contradicted current findings. The medium ISOL investigation score was higher than the TL class. ISOL students scored > 80% compared to 39% for TL pupils.

The study found no significant differences in nursing students’ professional identity across academic years, except for aspects related to retention benefits and turnover risks. Many nursing students view the profession positively, seeing it as a viable career that allows them to utilize their skills and creativity. While some may be influenced by parents or teachers to pursue nursing, most students are motivated to develop their professional identity independently and look up to successful figures in the field for inspiration.

The study revealed significant positive correlations between the next-generation digital learning environment and both learning outcomes and psychological empowerment for nursing students. Most students aspire to be professional nurses and aim to overcome stigma in their careers. They expressed confidence that their diverse interests, personalities, abilities, and values would contribute to their success and satisfaction in the nursing profession.

The current study was online with the study conducted by Lodge et al., 2020 [36], which assumed that the relationship between teachers and their students is being progressively intermediated via educational technologies. Developments in emerging educational technologies are already significantly impacting education and the professional identity and personality of them positively. This is apparent through the changing student-teacher dynamic in all levels of education. Also, Jeon and Kim 2022 [37] reinforced the present study findings and signposted that digital literacy and self-efficacy were also found to be allied with electronic health literacy (eHL) and mediate the relationship between online learning attitudes and eHL. Electronic health literacy (eHL) is considered an imperative competency among healthcare providers in healthcare systems, especially following the introduction of professional identity and its relation to communication technologies.

However, Wu et al. (2022) [43] study confirmed that the simulation-based interprofessional education module group had more favorable learning outcomes, students’ styles, and identity, but the associated costs were higher. Educators should consider both learning outcomes and students styles, identity, and cost when choosing a design strategy (simulation-based interprofessional education vs. video-enhanced interactive discussion interprofessional education) for interprofessional education module development. But both modules effectively improved medical and nursing students’ task performance, team behavior performance, and their professional identity toward the nursing and medical professions.

Conclusion

A statistically significant positive correlation between next-generation digital learning environments (NGDLES), learning empowering outcomes (LEOS), and professional identity (NSPIQ) among nursing students. Also, a statistically significant difference was found regarding nursing students’ responses to most items of next-generation digital learning environments (NGDLES), learning empowering outcomes (LEOS), and professional identity (NSPIQ) levels. So, effectively involving faculty members in digital learning design, providing faculty with professional development in technology skills, and improving the work environment for digital learning can improve nursing students’ adaptability to digital learning.

Implications of the study

The findings could inform nursing educators about best practices for integrating NGDLES into the nursing curriculum. This can lead to the development of more engaging and effective educational strategies that enhance students’ learning experiences and professional growth. NGDLES can encourage educators to adopt these digital tools more widely. This could foster an environment where nursing students feel more confident in their abilities and more prepared for real-world clinical scenarios. NGDLES can increase student engagement through interactive and collaborative learning opportunities. This can lead to better academic performance and a deeper commitment to the nursing profession. Promoting NGDLES could be part of broader efforts to modernize nursing education in alignment with contemporary educational and technological trends.

Limitations and further research

This study’s findings contribute to existing research on exploring how the next-generation digital learning environment affects nursing students’ learning, psychological empowerment, and professional identity. The limitation of this study is the use of a single faculty of nursing sample, which may limit the generalizability of the findings to other educational institutions or countries. Organizational and cultural differences could impact the outcomes, thus suggesting that the findings may not be easily replicable in different settings. Additionally, exploring the influence of cultural and organizational factors on these relationships would be valuable in broadening the applicability of the findings. Another limitation of this study is the reliance on self-reported questionnaires, which can introduce response biases such as social desirability.

Future research should aim to include a more diverse sample from various nursing faculties, regions, and countries to assess the consistency of these results across different educational nursing students’ contexts. Additionally, it should aim to benefit from incorporating mixed methods approaches (e.g., interviews or observational data) to reduce the likelihood of response bias. Using longitudinal designs would be beneficial in tracking these variables over time to better understand causal relationships and the lasting effects of next-generation digital learning environments on nursing students’ learning, psychological empowerment, and professional identity.

Author contributions

M.S. designed and led the study, overseeing data collection, project management, and the analysis, interpretation, and writing of the original manuscript. S.E. O.S. A.W. also contributed to the study design, conducted data analysis and interpretation, and assisted in manuscript writing. A.I. R.M. S.E. played a role in data interpretation and manuscript writing. M.S. S.E. O.S. A.W. curated the data and performed formal analysis, while M.S. W.A. S.I were responsible for designing the methodology. A.I. R.M. W.A. S.I. supervised the study’s execution. All authors participated in validating the study and reviewing and editing the manuscript. Each author has read and approved the final version of the manuscript.

Funding

The authors did not receive any funding for this research. The present study does not contain any financial disclosures.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

The Declaration of Helsinki’s highest ethical standards were followed in this study to protect each participant’s rights, privacy, and welfare. A formal approval was obtained from the IRB of Tanta University before collecting the data with reference code (no. 202-1-2023). All participants were informed of the study’s purpose, procedures, potential risks, and benefits. They were also assured that their participation was voluntary and that they could withdraw at any time without repercussions. The confidentiality of personal data was rigorously maintained, and the data were anonymized to prevent any identifiable information from being linked to individual participants. Prior to the collection of data, informed consent was obtained from each participant, ensuring that they were aware of their rights and the objectives of the study. Furthermore, the study adhered to the ethical guidelines and standards for research involving human subjects as set forth by the university’s ethics review board and aligned with international best practices in health research ethics.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.