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. 2026 Jul 20;28(3):e70396. doi: 10.1111/nhs.70396

The Relationship Between Self‐Efficacy, Emotional Intelligence, and Professional Identity Among Palestinian Intern Nursing Students in the West Bank

Malakeh Z Malak 1,✉, Hisham Zahran 2, Manar Bani Hani 3
PMCID: PMC13385458  PMID: 42477490

ABSTRACT

Research on professional identity and its associated factors among nursing interns remains limited, particularly in the Palestinian context. Therefore, this study aimed to examine the relationship between self‐efficacy, emotional intelligence, and professional identity among Palestinian intern nursing students in the West Bank. A cross‐sectional design was employed. A convenience sample of 201 intern nursing students was recruited between April and May 2025. Data were collected using a structured questionnaire that included the New General Self‐Efficacy Scale (NGSE), the Wong and Law Emotional Intelligence Scale (WLEIS), and the Professional Identity Scale for Nursing Students (PISNS). The results found that participants reported low levels of self‐efficacy (M = 14.65, SD = 3.84), emotional intelligence (M = 2.43, SD = 0.56), and professional identity (M = 31.14, SD = 7.49). Professional identity was positively correlated with self‐efficacy (r = 0.410, p < 0.001) and emotional intelligence (r = 0.477, p < 0.01). Both variables may contribute to professional identity. In conclusion, self‐efficacy and emotional intelligence were positively associated with professional identity. However, causal inferences cannot be established due to the cross‐sectional design. Longitudinal and experimental studies are needed before recommending targeted intervention programs.

Keywords: emotional intelligence, intern nursing students, professional identity, self‐efficacy

Summary

  • The participants had low self‐efficacy, low emotional intelligence, and low professional identity levels.

  • Positive associations existed between professional identity, self‐efficacy, and emotional intelligence.

  • Policymakers and university administrators should integrate the concepts of self‐efficacy, emotional intelligence, and professional identity into nursing education curricula.

1. Introduction

Becoming a professional nurse is a demanding and transformative journey for nursing students (Lundell Rudberg et al. 2022). As integral participants in healthcare education, nursing students undergo a complex developmental process that includes acquiring technical competencies, developing a strong professional identity, and learning to manage ethical, emotional, and interpersonal challenges encountered in clinical practice (Ariffin et al. 2024; Oweidat et al. 2024). According to Henderson et al. (2020), this process is shaped by multiple factors, including academic pressures, clinical experiences, personal resilience, and the broader sociocultural and healthcare environment.

Clinical experiences are vital to shaping nursing students' clinical competence and professional identity. Transitioning from student to practitioner is required to integrate academic knowledge into real‐world practice in high‐pressure environments (Li et al. 2020). Nursing education emphasizes technical skills, empathy, communication, and patient‐centered care, fostering emotional and ethical connections with patients (Lapkin et al. 2021). However, students often face significant challenges, including stress, burnout, and impostor syndrome, which can hinder academic progress and well‐being (Dunn and Hansford 2020). A deeper understanding of these experiences is essential for improving nursing education, supporting student retention, and preparing competent healthcare professionals.

Professional identity has gained growing attention in recent years, particularly in evolving fields such as healthcare and education, where practitioners must adapt to ongoing changes and societal expectations (Kreiner et al. 2020). It is a dynamic and multifaceted concept that shapes how individuals view themselves within their professional roles, extending beyond daily tasks to include values, ethics, and social responsibilities (Ibarra 2019). Professional identity is central to both personal and career development and is influenced by both internal factors (i.e., personal experiences and values) and external ones (i.e., organizational culture and societal norms) (Caza et al. 2018). Professional identity plays a crucial role in shaping nursing interns' career decisions; lower levels of professional identity are associated with a higher intention to leave the profession, ultimately contributing to the loss of valuable nursing talent (Jung 2020; Kim et al. 2021). Developing a strong professional identity influences nursing students' commitment to the profession, ethical conduct, and accountability in patient care (Howle et al. 2025). A strong professional identity correlated with improved academic performance, job satisfaction, and quality of patient care (Cai et al. 2021; Fernández‐Castro et al. 2020).

Self‐efficacy, defined as one's belief in the ability to perform tasks and achieve goals (Bandura 1997), is recognized as a key factor influencing motivation, academic success, and personal development (Schunk and Zimmerman 2008). In nursing, self‐efficacy shapes students' confidence in performing clinical duties, interacting with patients, and collaborating within healthcare teams. High self‐efficacy correlates with greater clinical competence, better problem‐solving, and stronger resilience (Kendall and Schreiber 2021). Additionally, it plays a critical role in developing professional identity, as students who trust in their abilities are more likely to fully engage in their learning and embrace their roles within the profession (Kumwenda and Ndala 2020).

Emotional intelligence refers to the ability to recognize, understand, regulate, and influence both one's own emotions and those of others (Goleman 1995). It plays a critical role in both personal and professional contexts by influencing leadership, communication, interpersonal relationships, mental health, and overall workplace effectiveness (Cherniss and Goleman 2018). For nursing students, high emotional intelligence is particularly important, as it enables compassionate patient care, effective communication, and the ability to cope with the emotional challenges of the nursing profession (Arpacı et al. 2024). Previous research has highlighted the role of emotional intelligence in enhancing resilience, stress management, and conflict resolution skills, all of which contribute to personal well‐being and professional success (Mayer et al. 2020; Salovey and Mayer 2020).

Developing a professional identity in nursing education involves reflection on personal values, integrity, and lived experiences, which play an important role in shaping personal and professional identities (De La Fosse 2023). However, there is limited research examining professional identity among intern nursing students and its associated factors (Zeng et al. 2022), particularly within the context of Palestine, where no such studies have been conducted to date. This research underscores the role of self‐efficacy and emotional intelligence in shaping professional identity. Gaining insight into these relationships can guide nursing education strategies, enabling institutions to create more supportive learning environments and better prepare students for the challenges of the nursing profession. Accordingly, the study aimed to assess professional identity and its association with emotional intelligence and self‐efficacy among Palestinian intern nursing students in the West Bank. Also, these questions guided the research:

  1. What are the levels of professional identity, emotional intelligence, and self‐efficacy among participants?

  2. What is the association between selected demographics, emotional intelligence, self‐efficacy, and professional identity among participants?

  3. What factors may contribute to professional identity among participants?

2. Conceptual Framework

Professional identity, self‐efficacy, and emotional intelligence are central concepts in nursing education, particularly for undergraduate students. Among these, intern nursing students, having completed most of their theoretical coursework and clinical rotations, are in an advanced stage of their training. This stage enables them to engage more fully with real‐world clinical settings and to meaningfully reflect on their professional identity, self‐efficacy, and emotional intelligence (Liu et al. 2022). As they prepare for licensure and entry into the workforce, their perspectives become particularly valuable, closely aligning with those of newly graduated nurses. Compared to students in earlier stages, interns have had more extensive exposure to patients, healthcare teams, and complex clinical scenarios—experiences that are instrumental in their professional growth (Alruwaili et al. 2024). Consequently, their advanced knowledge and practical experience enable them to participate in more accurate and insightful self‐assessments using the study's evaluation tools (Hanauer and Bauerle 2015). In Palestine, intern nursing students navigate a complex educational environment shaped by socio‐political and cultural challenges. Limited healthcare resources and ongoing political instability can affect their professional development and mental well‐being (Jaber et al. 2020).

Global research indicates that emotional intelligence and self‐efficacy are pivotal in shaping the professional development of nursing students. International studies consistently demonstrated the positive impact of emotional intelligence on clinical competence, stress management, and leadership skills (Aghabarary and Khedmatizare 2025; Almansour 2023; Fereidouni et al. 2024; Mehralian et al. 2025; Shrestha and Mandal 2021). Similarly, within Palestine, studies underscore the importance of emotional intelligence in enhancing communication and leadership abilities among nursing students (Batran 2024; Jawabreh 2024; Khaled 2024). These findings support the integration of emotional intelligence and self‐efficacy training within nursing curricula to prepare students more effectively for the diverse challenges of the healthcare profession. Thus, the following hypotheses were developed: (a) there was a relationship between emotional intelligence and professional identity among participants, (b) there was a relationship between self‐efficacy and professional identity among participants, and (c) there was a relationship between demographic characteristics and professional identity among participants.

3. Methods

3.1. Design, Setting, Population, and Sampling

This study employed a cross‐sectional design and targeted intern nursing students at Arab American University in the West Bank. In the academic year 2024/2025, approximately 1200 students were enrolled in the Bachelor of Nursing program. The target population included all intern nursing students across various departments during their clinical practice, totaling 230 students distributed on regular (n = 205) and bridging (n = 25) tracks.

The inclusion criteria consisted of intern nurses enrolled in the regular pathway, of all genders, who were willing to participate in this study. Bridging students were excluded because their clinical experience, educational background, and curriculum pathways differ from those of regular nursing students. Including bridging students may have introduced potential confounding factors that could influence their perceptions of the clinical learning environment, academic burnout, and academic satisfaction.

Convenience sampling was used to recruit participants, and all regular students were invited to participate. To determine the appropriate sample size, the G*Power software was used with the following parameters: an α level of 0.05, a moderate effect size of 0.15, a power of 0.95, and 6 contributing factors in a regression model. Based on these criteria, a minimum sample size of 146 students was required. To account for potential withdrawal or dropout, an additional 30% was added, resulting in a final target sample of 190 students. All intern students in the regular track who were willing to participate were included in the study.

3.2. Study Measurements

To gather data, a self‐administered questionnaire was employed from April 1, 2025 to May 31, 2025. The questionnaire comprised the following sections: demographic data (e.g., age, gender, residence, and academic performance), the New General Self‐Efficacy Scale (NGSE), the Wong Law Emotional Intelligence Scale (WLEIS), and the Professional Identity Scale for Nursing Students (PISNS). Academic performance was assessed using students' self‐reported cumulative grade point average (GPA) based on the university's academic classification system. Participants were asked to indicate their overall academic standing, which was subsequently categorized into two groups for analysis purposes: “Good or less” and “Very good or higher.” According to the university grading system, the category “Good or less” included students with a GPA < 76, whereas “Very good or higher” included students with a GPA ≥ this threshold. This categorization was used to simplify comparisons and examine potential associations between academic performance and professional identity.

The NGSE, developed by Chen et al. (2001), was adopted to assess self‐efficacy. It is comprised of eight items. Each item was evaluated on a 5‐point Likert scale ranging from 1 (poor agreement) to 5 (high agreement). The overall score ranged from 8 to 40, with higher values reflecting greater general self‐efficacy. The scoring of this tool was based on the mean, where a mean of < 3 indicated a low level of self‐efficacy and a mean of ≥ 3 indicated a high level of self‐efficacy (Amer et al. 2023; Zahran et al. 2025). The Cronbach's α for this scale was 0.86, indicating satisfactory validity and reliability (Scherbaum et al. 2006). This study used the Arabic version of the scale, which demonstrated strong validity and reliability. Both exploratory and confirmatory factor analyses were conducted and demonstrated an acceptable fit, with a root mean square error of approximation (RMSEA) of 0.07, a comparative fit index (CFI) of 1.00, and a Tucker–Lewis index (TLI) of 0.99 (Crandall et al. 2016). The Arabic version of this scale has been used in previous studies among Palestinian nursing students and demonstrated strong reliability, with Cronbach's α coefficients ranging from 0.91 to 0.95 (Amer et al. 2025; Zahran et al. 2025). In this study, the NGSE had a Cronbach's α value of 0.874.

The WLEIS (Wong and Law 2002) comprises 16 items, each rated on a 7‐point Likert scale from 1 (strongly disagree) to 7 (strongly agree), yielding a total score between 16 and 112, with higher scores indicating better emotional intelligence. The mean score was used to classify emotional intelligence levels, where a mean score < 4 indicated low emotional intelligence, while a mean score ≥ 4 indicated high emotional intelligence (AL Btoush et al. 2025). The original instrument is valid and reliable, with a Cronbach's α of 0.94 (Extremera Pacheco et al. 2019). This study adopted the Arabic version of this tool, which is valid and reliable among Arab students. The WLEIS demonstrated good internal consistency, with a Cronbach's α coefficient of 0.87. Exploratory factor analysis revealed that all four factors, each comprising four items, had eigenvalues greater than 1. Correlations among the factors ranged from 0.58 to 0.75 (p = 0.01), reflecting adequate interrelationships between the dimensions. Factor analysis for the suitability of the data was supported by the Kaiser–Meyer–Olkin measure (KMO = 0.857) and Bartlett's test of sphericity (χ 2  = 4512.837, p < 0.001). Collectively, the four‐factor structure accounted for 66.435% of the total variance (Alkhalaileh et al. 2025). The Arabic version of this scale has previously been used in Palestine and was found to be culturally appropriate (Malak et al. 2025; Zahran et al. 2025). In the current study, the WLEIS demonstrated good internal consistency, with a Cronbach's α of 0.846.

The PISNS (Hao et al. 2014) was used to assess nursing students' professional identity. The instrument consists of 17 items across five dimensions: Social Modeling, Job Choice Independence, Social Comparison and Self‐Reflection, Perceived Benefits of Staying in or Leaving the Profession, and Mental Image of the Profession. Responses are rated on a 5‐point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), yielding a total score between 17 and 85. The scale was categorized as follows: low (< 61; below the 34th percentile), moderate (61–70), and high (≥ 71; at or above the 67th percentile) (Mukherjee et al. 2024). The original scale demonstrated good reliability (Cronbach's α = 0.83). The questionnaire was translated into Arabic and back‐translated into English to ensure linguistic equivalence. Content validity was confirmed by three nursing experts, yielding excellent I‐CVI and S‐CVI values of 1.00. A pilot test with 20 intern students confirmed clarity and feasibility, and the instrument demonstrated strong internal consistency in the current study (Cronbach's α = 0.864).

3.3. Ethical Considerations

Approval to conduct this study was obtained from the Institutional Review Board (IRB) at Arab American University in Palestine with reference number # R‐2025/A/23/N. Written informed consent was obtained from all participants after explaining the study objectives and procedures. Participation was voluntary, and students were informed that they could withdraw from the study at any time without any consequences, risks, or loss of benefits. Confidentiality and anonymity were maintained throughout all phases of the study, and participants were instructed not to provide any identifying personal information. In addition, all study data were securely stored in a password‐protected computer file accessible only to the research team.

3.4. Data Collection Procedures

Following university approval, a member of the research team contacted the clinical training coordinator to explain the study objectives and significance. The coordinator facilitated the data collection process by providing a list of eligible students and assisting in communication with them. Subsequently, paper‐based questionnaires were distributed to students during their clinical training sessions. Each questionnaire included a cover letter explaining the purpose of the study and instructions for completion. Participants were asked to complete and return the questionnaires directly to the research team, and all completed forms were collected immediately after completion.

3.5. Statistical Analysis

Data were analyzed using SPSS version 29.0. The data were examined for missing values and outliers. Normality of the variables was assessed using visual inspection of histograms and Q–Q plots, the Kolmogorov–Smirnov test, and measures of skewness and kurtosis. The analysis revealed no missing data or significant outliers, and the data were found to be approximately normally distributed, with skewness and kurtosis values within acceptable ranges. Descriptive statistics, such as means, standard deviations, frequencies, and percentages, were used to summarize the findings. Pearson correlation coefficients were applied to explore relationships between study variables while accounting for demographic variables. Likert scales were treated as continuous based on prior literature, which suggests that composite scores obtained by averaging multiple Likert items can be analyzed as continuous variables without substantially violating the assumptions of parametric statistical methods. Correlation coefficients (r) were interpreted according to Cohen's guidelines, where values of 0.10–0.29 indicate small correlations, 0.30–0.49 moderate correlations, and ≥ 0.50 strong correlations.

Furthermore, linear regression analysis was conducted to identify factors may contribute to professional identity, and variables that showed significant associations were subsequently entered into a linear regression model. Multicollinearity was assessed using tolerance values and the variance inflation factor (VIF). Multicollinearity becomes problematic when tolerance values are below 0.10 or VIF values exceed 10. In the current analysis, all values were within acceptable ranges, with VIFs of 1.630 and tolerances of 0.614. Autocorrelation was evaluated using the Durbin–Watson statistic, which yielded a value of 2.304, indicating no significant autocorrelation and supporting the recommended criteria (Kim 2019). A p‐value of ≤ 0.05 was considered statistically significant.

4. Results

The current study involved 201 intern nursing students. Out of 205 distributed questionnaires, 201 were completed, yielding a response rate of 98.0%. All students completed the study. Findings showed that the average age of the participants was 22.48 years (SD = 0.94). More than half of the participants were female (71.6%), and 75.1% obtained a very good or higher academic performance. Furthermore, 69.2% were residents in the village (see Table 1).

TABLE 1.

Characteristics of the participants (N = 201).

Characteristics Categories n %
Gender Male 57 28.4
Female 144 71.6
Residence City 62 30.8
Village 139 69.2
Academic performance Good or less 50 24.9
Very good or higher 151 75.1
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Note: Age: M = 22.48; SD = 0.94; range = 22–24 years.

Abbreviations: N, number; %, percentage; M, mean; SD, standard deviation.

Table 2 shows that the mean of self‐efficacy was 1.83 (SD = 0.48), indicating that participants reported low self‐efficacy. Also, the emotional intelligence mean was 2.43 (SD = 0.56), reflecting that participants reported low emotional intelligence. The mean of professional identity was 31.14 (SD = 7.49), indicating low professional identity among participants. Table 3 reveals a significant positive moderate correlation between professional identity and self‐efficacy (r = 0.416, p < 0.001), and emotional intelligence (r = 0.480, p < 0.001). Demographic variables, including age, gender, residence, and academic performance, had no association with professional identity (p > 0.05).

TABLE 2.

Levels of study variables (self‐efficacy, emotional intelligence, and professional identity) (N = 201).

Variables Maximum M SD
Self‐efficacy 5 1.83 0.48
Emotional intelligence 7 2.43 0.56
Professional identity 85 31.14 7.49
Social modeling (2 items) 10 3.19 1.34
Job choice independence (2 items) 10 3.14 1.14
Social comparison and self‐reflection (3 items) 15 5.56 1.98
Perceived benefits of staying in or leaving the profession (4 items) 20 7.58 1.94
Mental image of the profession (6 items) 30 11.64 2.93
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Abbreviations: M, mean; SD, standard deviation.

TABLE 3.

Correlating factors with professional identity.

Variable Professional identity
Correlation test Correlation coefficient p
Gender Point‐biserial (p.b.r) −0.102 0.148
Residence Point‐biserial (p.b.r) −0.085 0.229
Academic performance Point‐biserial (p.b.r) 0.094 0.184
Age Pearson's r −0.129 0.069
Self‐efficacy Pearson's r 0.416 0.000**
Emotional intelligence Pearson's r 0.480 0.000**
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Note: Although the residence variable was initially categorized as City, Village, and Camp in the demographic form, none of the participants reported living in camps. Therefore, the final analysis included only two categories (City and Village), allowing residence to be treated as a dichotomous variable. Accordingly, the use of point‐biserial correlation was considered appropriate.

Abbreviation: p.b.r, point‐biserial correlation coefficient.

**

p significant at ≤ 0.01.

As indicated in Table 4, the variables that might contribute to professional identity were entered into the regression model, which included age, gender, residence, academic performance, self‐efficacy, and emotional intelligence. The model, including all professional identity factors, was statistically significant (R = 0.518, R 2 = 0.269, Adjusted R 2 = 0.246, F = 11.81, p < 0.001). Also, emotional intelligence and self‐efficacy may contribute to professional identity (B = 0.363, p < 0.001; B = 0.192, p < 0.05). Also, Figures 1 and 2 show the scatter plot with regression lines showing the relationship between self‐efficacy, emotional intelligence, and professional identity.

TABLE 4.

Factors may contribute to professional identity: linear regression analysis.

Variable Unstandardized b Standardized β t‐test p 95.0% CI
Lower Upper
Self‐efficacy 2.996 0.192 2.401 0.017* 0.535 5.458
Emotional intelligence 3.448 0.363 4.578 0.000** 1.963 4.934
Gender −1.042 −0.062 −0.985 0.326 −3.129 1.044
Residence −1.567 −0.102 −1.636 0.103 −3.455 0.322
Academic performance 0.353 0.035 0.535 0.593 −0.947 1.652
Age 0.222 0.050 0.761 0.448 −0.353 0.796
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Note: R = 0.518, R 2 = 0.269, Adjusted R 2 = 0.246, F = 11.81, df = 6, p = 0.000.

Abbreviations: b, unstandardized beta; β, standardized beta; CI, confidence interval.

*

p significant at ≤ 0.05.

**

p significant at ≤ 0.01.

FIGURE 1.

FIGURE 1

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Scatter plot with regression lines showing the relationship between self‐efficacy and professional identity.

FIGURE 2.

FIGURE 2

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Scatter plot with regression lines showing the relationship between emotional intelligence and professional identity.

5. Discussion

This study is among the first to examine the relationships among self‐efficacy, emotional intelligence, and professional identity in nursing intern students. The findings revealed that participants reported low levels of self‐efficacy. In contrast, previous studies among nursing students reported high (Pitre et al. 2002) and moderate (Liao et al. 2024; Mukherjee et al. 2024; Zahran et al. 2025) levels of self‐efficacy. The contextual and systemic factors may explain these differences. Palestinian intern nursing students often experience limited clinical exposure due to overcrowded healthcare settings, understaffing, and shortages in clinical resources, which may reduce opportunities for hands‐on practice and skill development. This limited practical exposure may contribute to feelings of unpreparedness and reduced confidence in performing clinical tasks independently (Dabak et al. 2024). In addition, shortages of experienced mentors, partly related to professional migration and staff burnout, may limit opportunities for supervision, support, and constructive feedback (Galletta et al. 2017). Educational factors may also contribute to these findings, as some nursing programs place greater emphasis on theoretical instruction than on practical skill development and simulation‐based training. Such gaps may make the transition from academic learning to real clinical practice more difficult and potentially reduce students' confidence and engagement (Zyoud 2023).

Additionally, the ongoing political conflict and economic hardship in Palestine may contribute to chronic stress and psychological insecurity, which can negatively affect students' sense of control, competence, and professional identity (Diab 2024). Furthermore, the lack of structured support systems, such as career counseling, psychosocial services, and self‐efficacy enhancement programs, may leave students without adequate institutional support during a critical stage of their professional training (Baria and Gomez 2022). Poor working conditions, limited employment opportunities, and low societal recognition of healthcare professionals may further reduce students' motivation and perceived professional value (Ogbeivor and Ogbeivor 2021). In addition, the high expectations placed on intern students, coupled with limited clinical competencies and fear of committing errors, may reduce initiative and weaken self‐efficacy (George et al. 2020).

The participants in this study reported low emotional intelligence. Previous studies among nursing students found that they had moderate to high emotional intelligence (Abou Hashish and Bajbeir 2018; Albagawi 2018; Almansour 2023; Almegewly et al. 2022). Low emotional intelligence among intern Palestinian students can be attributed to a combination of chronic stress, educational shortcomings, limited emotional support, and cultural factors that hinder emotional development (Abudayya et al. 2023). Ongoing political conflict and insecurity expose students to trauma and prolonged stress, impairing emotional regulation and empathy, key elements of emotional intelligence (Amro 2024). Additionally, limited access to mental health services restricts their ability to develop self‐awareness and coping skills (Carbonell et al. 2020). The educational system, often focused on technical knowledge and lecture‐based teaching, neglects soft skills such as communication, empathy, and reflective practice (Kumar et al. 2022). Cultural norms that discourage emotional expression, alongside academic and clinical pressures, further contribute to emotional exhaustion and hinder emotional growth (Sun et al. 2024). Without formal training in emotional competencies within the curriculum, students may lack the tools to build emotional intelligence essential for effective healthcare practice (Larsen and White 2024).

Our study revealed that participants had low levels of professional identity, which contrasts with findings from previous studies reporting moderate levels among Chinese (Gong et al. 2025) and high levels among Egyptian nursing interns (Abd Elhamed and Elborai 2024). Other international studies among nursing students also reported moderate levels of professional identity (Liao et al. 2024; Mukherjee et al. 2024). These differences may be explained by several interrelated contextual factors specific to the Palestinian setting. Political instability, occupation, and economic hardship may contribute to uncertainty about future career prospects and reduce students' motivation toward their professional roles (Ives et al. 2019). In addition, overcrowded and under‐resourced healthcare facilities may limit clinical learning opportunities, and shortages of experienced mentors, partly related to burnout and professional migration, may reduce opportunities for effective professional role modeling (Galletta et al. 2017). Educational institutions may also have limited structured career guidance and professional identity development programs. Furthermore, financial strain and psychological stress may weaken students' emotional connection to the nursing profession (Baria and Gomez 2022). Limited societal recognition and inadequate compensation for healthcare professionals may further reduce professional pride and hinder the development of a strong professional identity among Palestinian nursing interns (Malak et al. 2025).

This study found a positive association between self‐efficacy and professional identity among participants, with higher self‐efficacy associated with stronger professional identity, consistent with previous studies (Eren and Turkmen 2020; Liao et al. 2024; Mei et al. 2022; Mukherjee et al. 2024; Qiu et al. 2019; Yao et al. 2021). These findings suggest that students who have greater confidence in their ability to perform clinical tasks, make appropriate clinical decisions, adapt to professional roles, and fulfill nursing responsibilities are more likely to develop a stronger sense of professional identity (Lundell Rudberg et al. 2022). Increased confidence in clinical competence may enhance students' perception of themselves as capable future nurses, encouraging them to internalize the values, expectations, and responsibilities associated with the nursing profession (Mderis et al. 2024). In addition, higher self‐efficacy may promote motivation, resilience, and active engagement in academic and clinical learning experiences, all of which are important factors in the development of a strong professional identity (Liao et al. 2024; Mei et al. 2022).

Our study found a positive relationship between emotional intelligence and professional identity among participants, with higher emotional intelligence associated with stronger professional identity, consistent with previous studies (Ma et al. 2024; Vyas et al. 2023; Yu et al. 2025). This finding suggests that nursing students with greater emotional intelligence are more likely to develop a clearer and stronger sense of professional identity. Emotional intelligence, which includes self‐awareness, empathy, emotional regulation, and interpersonal communication skills, may help students adapt more effectively to complex clinical environments, establish positive professional relationships with patients and colleagues, and cope with academic and clinical stressors (Ali et al. 2025; Dou et al. 2022; Hui et al. 2025). These competencies may enhance students' confidence, perceived competence, and alignment with the values and expectations of the nursing profession, thereby strengthening their professional identity (Ali et al. 2025; Dou et al. 2022; Ordu et al. 2022). Furthermore, emotionally intelligent students may be better able to internalize professional roles, responsibilities, and ethical standards, thereby contributing to more confident professional socialization and identity formation (Dou et al. 2022; Hui et al. 2025).

The model explained 25.3% of the variance, indicating that additional factors may influence professional identity, including cultural factors, organizational influences, clinical and academic environments, empowerment, motivation, and other contextual variables. Therefore, future studies using mixed‐methods approaches are recommended to provide a more comprehensive understanding of these factors and their potential association with professional identity.

5.1. Limitations of the Study

Despite providing important insights, this study had several limitations that should be acknowledged. The cross‐sectional design limited the ability to establish causal relationships among the study variables; therefore, future longitudinal studies are recommended to provide stronger evidence regarding temporal and causal associations. In addition, the cross‐sectional nature of the data restricted the examination of causal pathways typically explored using structural equation modeling (SEM) frameworks. Accordingly, future research using larger samples and theory‐driven models is encouraged to apply SEM techniques to examine potential mediating and moderating relationships among the study variables. Furthermore, the use of self‐reported questionnaires may have introduced response and social desirability biases, which could influence the accuracy of the findings.

The study used a convenience sampling method, which may have introduced selection bias, as students who agreed to participate may differ from nonparticipants in their perceptions, experiences, and personal characteristics. Consequently, the sample may not fully represent the broader population of intern nursing students. In addition, the study was conducted within a single institution and geographic setting, which may limit the external validity and generalizability of the findings beyond the studied population. Therefore, the findings should be interpreted cautiously within the specific study context. Future studies employing multicenter designs and probability sampling techniques are recommended to improve representativeness and strengthen the generalizability of the results.

Another limitation of the study is the restricted age range of the participants, as only intern nursing students enrolled in the regular pathway were included, resulting in a relatively homogeneous age group (primarily 22–24 years). This limited age variability may have reduced the ability of the Pearson correlation analysis to identify meaningful associations between age and professional identity. Therefore, age‐related findings should be interpreted cautiously. Further studies, including students from different academic pathways (regular and bridging) and broader age ranges, are recommended to examine the potential influence of age on study outcomes. Because confirmatory factor analysis was not conducted, the construct validity of the Arabic PISNS was not established in this study. Accordingly, findings related to professional identity should be interpreted with caution. Furthermore, future studies with larger sample sizes are recommended to perform more extensive psychometric evaluations, including exploratory and confirmatory factor analyses, to validate the PISNS. Absence of SEM (or path analysis) prevents examination of more complex relationships among the study variables, and that this should be addressed in future research with larger samples.

6. Conclusion

This study found that nursing interns exhibited low levels of self‐efficacy, emotional intelligence, and professional identity. Moderate positive correlations were identified among these variables, highlighting their interrelationships. The findings suggest that self‐efficacy and emotional intelligence may be associated with stronger professional identity among intern nursing students. However, due to the cross‐sectional design, causal relationships cannot be established. Future longitudinal and experimental studies are needed before recommending targeted intervention programs. Nevertheless, supportive educational and clinical strategies, including career counseling, psychosocial support, mentorship, and professional development training, may help enhance students' competencies, confidence, and professional growth. In addition, promoting clinical environments that encourage accountability, teamwork, and effective communication may further support the professional development and socialization of nursing interns.

7. Relevance to Clinical Practice

This study provides a foundational perspective for policymakers and university administrators of the potential value of incorporating self‐efficacy and emotional intelligence concepts into nursing education curricula to support the professional identity and academic development of nursing students. Strengthening professional identity is particularly important, as it has been associated with improved academic engagement and greater long‐term commitment to the nursing profession. A strong professional identity may enhance students' sense of purpose, accountability, and resilience, helping them better adapt to the demands and challenges of healthcare environments.

The study highlights the importance of providing appropriate clinical training environments and simulation laboratories to support nursing students' learning and professional development. These settings offer structured and safe opportunities for students to apply theoretical knowledge, practice clinical skills, and participate in reflective learning experiences. Simulation laboratories, in particular, may help students enhance their confidence and clinical competence by exposing them to realistic clinical scenarios without compromising patient safety. In addition, clinical training environments may promote accountability, strengthen clinical decision‐making, and foster effective communication and teamwork, which are essential competencies in nursing practice. Furthermore, in settings where access to certain specialized clinical placements, such as psychiatric hospitals, is limited, alternative training sites that provide comparable learning experiences should be considered. Ensuring exposure to diverse clinical conditions, including mental health disorders such as psychosis, is important for supporting comprehensive nursing education and developing students' practical and professional competencies.

Moreover, the study supports implementation of supportive programs aimed at enhancing self‐efficacy and emotional intelligence among nursing students. These may include structured career counseling, psychosocial support services, and skills‐based training workshops. Such initiatives can help students better manage the emotional and interpersonal demands of nursing practice, strengthen their commitment to the profession, reduce the risk of attrition, and improve overall educational outcomes.

Previous studies have suggested that improving self‐efficacy and emotional intelligence may positively contribute to the development of professional identity among nursing students (Liao et al. 2024; Shubayr and Dailah 2025). Earlier research demonstrated that interventions aimed at enhancing self‐efficacy were associated with greater professional confidence, improved role adaptation, and stronger professional identity formation among nursing students (Liao et al. 2024; Mei et al. 2022; Mukherjee et al. 2024). Similarly, emotional intelligence training programs have been linked to improvements in communication skills, emotional regulation, self‐confidence, and professional socialization, all of which may support the development of professional identity. However, additional longitudinal and experimental studies are needed to examine the long‐term effectiveness of these interventions within educational and clinical settings.

Author Contributions

Hisham Zahran: investigation, writing – original draft, writing – review and editing, methodology. Malakeh Z. Malak: conceptualization, writing – original draft, methodology, visualization, writing – review and editing, formal analysis, supervision. Manar Bani Hani: writing – review and editing.

Funding

The authors have nothing to report.

Ethics Statement

All procedures performed in studies involving human participants were by the ethical standards of the institutional and/or national research committee at Arab American University in Palestine with reference No# R‐2025/A/23/N.

Consent

Each participant provided informed consent before beginning the study.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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