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Emo ional in elligence and c i ical hinking disposi ion as
p edic o s o ca ing beha io s among nu sing s uden s
Fa emeh Aslani 1, Behnaz Asadizake 2, Meh naz Ahmadi 3* Mahin Gheibizadeh3,
Mohammad Mehdi Aslani1
1S uden Resea ch Commi ee, Ah az Jundishapu Uni e si y o Medical Sciences, Ah az, I an
2Depa men o Nu sing, Facul y o Nu sing and Midwi e y, Teh an Islamic Azad Uni e si y o Medical Sciences, Teh an, I an
3Nu sing Ca e Resea ch Cen e in Ch onic Diseases, School o Nu sing and Midwi e y, Ah az Jundishapu Uni e si y o Medical Sciences,
Ah az, I an
A icle in o Abs ac
In oduc ion
Nu ses, as he p ima y p o ide s o heal hca e, play a
i al ole in deli e ing heal hca e se ices [1]. Nu sing
p ac ice is apidly e ol ing, and nu sing educa ion mus
p og ess in alignmen o ain compe en nu ses [2]. Ca e
is conside ed he essence and co e o nu sing ac ions,
mani es ing as a con inuous p ocess e lec ed in ca ing
beha io s [3]. Ca ing beha io s encompass a
combina ion o in en ional nu sing ac ions and a i udes
ha alle ia e pa ien discom o and mee hei
an icipa ed needs [4]. E idence sugges s ha a educ ion
in ca ing beha io s can lead o diminished us om
pa ien s and amilies, dec eased pe cei ed quali y o
ca e, educed pa ien well-being and heal h, and
inc eased pa ien dissa is ac ion [5, 6]. In con as ,
enhancing ca ing beha io s is associa ed wi h imp o ed
quali y o se ices p o ided o pa ien s, be e ea men
ou comes, and highe le els o pa ien sa is ac ion [6].
S udies ha e shown ha only hal o nu ses demons a e
app op ia e ca ing beha io s [5]. The de elopmen o
ca ing beha io s begins wi h nu sing educa ion, whe e
A icle his o y:
Recei ed 23 Ma . 2025
Accep ed 25 Jun. 2025
Published 13 Jul. 2025
Aslani e al. J Med Edu De . 2025; 18(2): 65-74 Jou nal o Medical Educa ion De elopmen
Backg ound & Objec i e: Gi en he signi icance o ca ing in he nu sing p o ession, i is
essen ial o assess he ca ing beha io s o nu sing s uden s and he ac o s ha may in luence
hese beha io s. This s udy aimed o explo e he ela ionship be ween emo ional in elligence,
c i ical hinking disposi ion, and ca ing beha io s among a sample o I anian nu sing s uden s.
Ma e ials & Me hods: This desc ip i e-co ela ional s udy was conduc ed on 203 nu sing
s uden s. Pa icipan s we e selec ed using a census me hod. The da a we e collec ed om 7
Ap il 2024 o 29 June 2024 using a demog aphic checklis , Wa son and Lea's Ca ing Beha io s
Ques ionnai e, Wang and Law's Emo ional In elligence Ques ionnai e, and Ricke s's C i ical
Thinking Disposi ion Ques ionnai e. Da a we e analyzed using an independen - es , one-way
ANOVA, Pea son's co ela ion coe icien , and mul iple linea eg ession in SPSS-25.
Resul s: The p esen s udy showed a posi i e and signi ican co ela ion be ween ca ing
beha io s and emo ional in elligence (p < 0.001, = 0.34), as well as c i ical hinking disposi ion
(p < 0.001, = 0.56). Mul iple linea eg ession analysis showed ha c i ical hinking disposi ion
(β = 0.49, p < 0.001) was he s onges p edic o o ca ing beha io s, ollowed by academic
yea (β = - 0.14, p = 0.01) and emo ional in elligence (β = 0.14, p = 0.01). These a iables
accoun ed o 34% o he a iance in ca ing beha io s.
Conclusion: The esul s o he s udy showed ha inc easing emo ional in elligence and c i ical
hinking disposi ion leads o imp o ed ca ing beha io s while inc easing he academic yea s
leads o a dec ease in ca ing beha io s. The e o e, nu sing colleges and ins uc o s should
conside in eg a ing c i ical hinking and emo ional in elligence aining in o in e nships as
po en ial in e en ion s a egies o enhance s uden s' ca ing beha io s. In addi ion, he p essu es
associa ed wi h academic yea s mus be e ec i ely managed.
Keywo ds: nu sing ca e, emo ional in elligence, c i ical hinking disposi ion, nu sing s uden s
*Co esponding au ho :
Meh naz Ahmadi, Nu sing Ca e
Resea ch Cen e in Ch onic Diseases,
School o Nu sing and Midwi e y,
Ah az Jundishapu Uni e si y o
Medical Sciences, Ah az, I an.
Email: Me [email protected]
O iginal A icle
How o ci e his a icle:
Aslani F, Asadizake B, Ahmadi M,
Gheibizadeh M, Aslani MM.
Emo ional in elligence and c i ical
hinking disposi ion as p edic o s o
ca ing beha io s among nu sing
s uden s . J Med Edu De . 2025;
18(2): 65-74.
[ DOI: 10.61882/edcj.18.2.65 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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: Emo ional in elligence, c i ical hinking disposi ion, and ca ing beha io s in nu sing s uden s
66 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025
s uden s acqui e hese beha io s du ing clinical aining
and apply hem in hei clinical p ac ice a e g adua ion
[7]. The e o e, nu sing educa o s should conside he
de elopmen o ca ing beha io s as a signi ican
componen o nu sing educa ion [8]. Howe e , e idence
sugges s ha he de elopmen o ca ing beha io s among
nu sing s uden s is insu icien . S uden s o en
concen a e mo e on he apeu ic ca ing beha io s while
paying less a en ion o o he impo an aspec s [7, 9]. To
enhance nu sing s uden s' ca ing beha io s, nu sing
educa o s mus iden i y he educa ional and skill needs
o s uden s and add ess a eas equi ing imp o emen [9].
The e o e, i is c ucial o iden i y he ac o s ha
in luence ca ing beha io s.
S udies ha e shown ha he enhancemen o ca ing
beha io s is in luenced by a ious ac o s, including
modeling om clinical ins uc o s and p o essional
nu ses, he es ablishmen o a suppo i e clinical lea ning
en i onmen , p o essional a i udes [10], and he
acquisi ion o a ious skills such as e ec i e
communica ion [7], sel -e icacy [11], emo ional
in elligence [12], and c i ical hinking [13].
Emo ional In elligence (EI) is de ined as he abili y o
unde s and, manage, and e ec i ely di ec one's own
emo ions as well as hose o o he s. I plays a c ucial ole
in enhancing bo h physical and men al well-being [14].
EI encompasses se e al key componen s, including sel -
awa eness, sel - egula ion, mo i a ion, empa hy, and
social skills. These componen s a e essen ial o nu ses
as hey na iga e he complexi ies o pa ien ca e,
pa icula ly in emo ionally cha ged en i onmen s. By
os e ing EI, nu ses can enhance hei abili y o deli e
compassiona e, pa ien -cen e ed ca e, ul ima ely leading
o imp o ed heal h ou comes and inc eased pa ien
sa is ac ion [12, 15-17]. C i ical hinking is de ined as a
p ocess o judgmen and sel - egula ion ha
encompasses in e p e a ion, analysis, e alua ion, and
in e ence [18].
In nu sing educa ion, c i ical hinking is ecognized as an
essen ial componen o p o essional esponsibili y and
high-quali y nu sing ca e. This skill enhances nu ses'
me acogni i e abili ies, which a e i al o clinical
easoning, decision-making, and p oblem-sol ing [13].
Howe e , s udies indica e ha he inclina ion owa d
c i ical hinking among medical s uden s is mode a e,
wi h only a ew s uden s demons a ing a s ong
p opensi y o his skill [19]. Fu he mo e, c i ical
hinking is no adequa ely emphasized in he educa ional
sys em as a undamen al componen o nu sing educa ion
du ing s uden s' academic jou neys, as i should be [20].
In nume ous p e ious s udies, g ea e emphasis has been
placed on physical and echnical ac o s in nu sing
educa ion [7, 8, 21]. A he same ime, less a en ion has
been de o ed o he ole o psychological skills, such as
c i ical hinking and EI, in p omo ing ca ing beha io s.
Despi e he c ucial impo ance o decision-making skills
in enhancing he quali y o ca e and acili a ing e ec i e
in e ac ions wi h pa ien s, esea ch on he di ec
ela ionship be ween hese ac o s and ca ing beha io s
has been limi ed. Addi ionally, he e has been a lack o
simul aneous examina ion o hese a iables among
nu sing s uden s. This lack o in o ma ion unde sco es
he need o a mo e de ailed and comp ehensi e
in es iga ion o hese ela ionships o de elop aining
s a egies ha emphasize so and pe sonali y-based
skills wi hin nu sing educa ion p og ams, ul ima ely
p omo ing ca ing beha io s among nu sing s uden s.
The e o e, he p esen s udy aims o in es iga e he
ela ionship be ween ca ing beha io s, EI, and c i ical
hinking disposi ion in nu sing s uden s.
Ma e ials & Me hods
Design and se ing(s)
This s udy is c oss-sec ional, desc ip i e-co ela ional
esea ch conduc ed om 7 Ap il 2024 o 29 June 2024 a
he nu sing acul y o Ah az Jundishapu Uni e si y o
Medical Sciences.
Pa icipan s and sampling
Ou o 258 eligible nu sing s uden s, 55 declined o
pa icipa e. Consequen ly, he sample consis ed o 203
nu sing s uden s who olun a ily pa icipa ed in he
s udy. The inclusion c i e ia equi ed pa icipan s o ha e
comple ed a leas wo semes e s o unde g adua e
nu sing. This pe iod in ol es mas e ing undamen al
ca e concep s and beginning hei hospi al in e nship.
Addi ionally, pa icipan s we e equi ed o p o ide
consen o pa icipa e in he s udy.
Tools/Ins umen s
Demog aphic In o ma ion Ques ionnai e: This included
he s uden s' age, gende , ma i al s a us, academic yea ,
G ade Poin A e age (GPA), and in e es in he nu sing
ield. The Nu sing Ca ing Beha io s Ques ionnai e
(CDI-25), designed by Wa son and Lea [22], consis s o
25 i ems and 5 dimensions: psychosocial (10 i ems),
echnical (11 i ems), p o essional (one i em),
inapp op ia e (1 i em), and unnecessa y (2 i ems)
ac i i ies. The ques ionnai e uses a Like scale anging
om 1 (s ongly disag ee) o 5 (s ongly ag ee). The
o e all sco e o he ques ionnai e anges om 25 o 125,
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: Emo ional in elligence, c i ical hinking disposi ion, and ca ing beha io s in nu sing s uden s
Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025 67
wi h a highe sco e indica ing be e ca ing beha io s
among nu sing s uden s. The sco e o he scale is
ca ego ized in o h ee le els: weak ca ing beha io s (25-
58), mode a e ca ing beha io s (58-91), and high ca ing
beha io s (91-125). Salimi e al. [23] ha e assessed he
eliabili y and alidi y o his ques ionnai e. In he
p esen s udy, he in e nal consis ency o he
ques ionnai e was e alua ed and con i med using
C onbach's alpha, which yielded a alue o 0.83. The
Wang and Law Emo ional In elligence Scale includes 16
i ems and e alua es ou componen s: sel -emo ion
app aisals (4 i ems), o he s' emo ion app aisals (4 i ems),
egula ion o emo ion (4 i ems), and use o emo ion (4
i ems). Each i em was answe ed using a i e-poin Like
scale, whe e sco es anged om 5 (s ongly ag ee) o 1
(s ongly disag ee). The o al sco es o he ques ionnai e
anged om 16 o 80 [24]. A sco e be ween 16-32
indica es low EI, 32-48 indica es a e age EI, and 48-80
indica es good EI. Ali Babaei e al. [25] ha e assessed
he eliabili y and alidi y o his ques ionnai e. In he
p esen s udy, he in e nal consis ency o he
ques ionnai e was e alua ed and con i med wi h a
C onbach's alpha o 0.90. Ricke s' C i ical Thinking
Disposi ion Ques ionnai e is a sel - epo ques ionnai e
ha e alua es indi iduals' inclina ion owa d c i ical
hinking, consis ing o 33 s a emen s and 3 subscales:
c ea i i y (11 i ems), pe ec ionism (9 i ems), and
commi men (13 i ems). Responses a e sco ed on a 5-
poin Like scale (1 = s ongly disag ee, 5 = s ongly
ag ee), wi h e e se sco ing o ce ain i ems [26]. The
sco es ange om 33 o 165, whe e sco es be ween 33-
66 indica e weak c i ical hinking disposi ion, 66-99
indica e a e age c i ical hinking disposi ion, and sco es
abo e 99 indica e s ong c i ical hinking disposi ion.
Pakmeh e al. [27] ha e es ablished he alidi y and
eliabili y o his ool in I an. In he p esen s udy, he
in e nal consis ency o he ques ionnai e was e alua ed
and con i med wi h a C onbach's alpha o 0.85.
Da a collec ion me hods
To collec da a, he esea che ob ained w i en
pe mission and made he necessa y a angemen s o be
p esen a he esea ch si e o h ee mon hs, om Ap il
o June 2024. She in oduced he sel and explained he
pu pose o he esea ch o he s uden s who me he
inclusion c i e ia. A e secu ing hei w i en consen ,
she comple ed he ques ionnai es wi h hem.
Da a analysis
The analysis was pe o med using SPSS so wa e
e sion 22. Desc ip i e s a is ics, including mean,
s anda d de ia ion, equency, and pe cen age, we e
u ilized o analyze he da a. The s udy employed
independen - es s and one-way ANOVA o compa e he
mean sco es o EI, c i ical hinking disposi ion, and
ca ing beha io s based on di e en demog aphic
a iables. Signi ican demog aphic a iables, along wi h
EI and c i ical hinking disposi ion, we e conside ed
independen a iables in he eg ession model. The
ela ionships be ween he ou come a iables (EI, c i ical
hinking disposi ion, and ca ing beha io s) we e
e alua ed using Pea son's co ela ion coe icien s in
co ela ion ma ices be o e conduc ing he eg ession
analysis. A s epwise mul iple linea eg ession analysis
was conduc ed o iden i y p edic o s o ca ing beha io s.
Desc ip i e s a is ics, including mean, s anda d
de ia ion, equency, and pe cen age, we e u ilized o
analyze he da a.
Resul s
A o al o 203 nu sing s uden s om Jundishapu
Uni e si y o Medical Sciences in Ah az pa icipa ed in
he cu en s udy. The mean age o he s uden s was
22.15 ± 2.39 yea s. Among he pa icipan s, 97 (47.8%)
we e male and 106 (52.2%) we e emale. O he
demog aphic in o ma ion is p esen ed in Table 1.
The mean sco es o ca ing beha io s, EI, and c i ical
hinking disposi ion among s uden s we e 103.64 ±
10.44, 62.46 ± 7.56, and 123.38 ± 14.14, espec i ely.
The majo i y o s uden s (86.2%) epo ed ha hei
ca ing beha io s we e a a high le el, while 13.8%
epo ed hem a an a e age le el. Conce ning EI and
c i ical hinking disposi ion, 98% and 95.1% o s uden s,
espec i ely, epo ed high le els o compe ence in hese
a eas (Table 2). Be o e conduc ing eg ession analysis,
he ela ionships be ween a iables we e examined using
independen - es s, one-way ANOVA, and co ela ion
ma ices. The esul s o hese analyses a e epo ed in
Tables 1 and 3. When compa ing ca ing beha io s and
EI ac oss demog aphic cha ac e is ics using he - es , a
signi ican s a is ical di e ence was obse ed in in e es
in he nu sing ield. S uden s wi h a g ea e in e es in
nu sing epo ed be e ca ing beha io s (p = 0.03) and
highe EI (p < 0.001). Addi ionally, he indings showed
a signi ican di e ence in EI by gende , wi h male
s uden s epo ing highe EI (p = 0.03). The e we e no
signi ican di e ences in he o al sco es o ca ing
beha io s, EI, and c i ical hinking disposi ion ac oss
o he demog aphic a iables (Table 1).
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68 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025
Table 1. Demog aphic a iables o nu sing s uden s and hei ela ionship wi h emo ional in elligence, c i ical hinking, and ca ing
beha io s
Va iables
Numbe (%)
To al Emo ional
in elligence (Mean ± SD)
To al C i ical
hinking
(Mean ± SD)
To al Ca ing
beha io s
(Mean ± SD)
Age
< 22
136 (67)
62.44 ± 7.51
122.97 ± 14.22
103.69 ± 10.30
22 ≤
67 (33)
62.52 ± 7.71
124.20 ± 14.04
103.53 ± 10.79
p- alue
0.943
0.561
0.922
Sex
Male
97 (47.8)
63.63 ± 7.34
124.37 ± 14.27
103.58 ± 10.93
Female
106 (52.2)
61.39 ± 7.64
122.48 ± 14.03
103.68 ± 10.02
p- alue
0.035
0.343
0.945
Ma i al s a us
Single
188 (92.6)
62.48 ± 7.59
123.19 ± 14.02
103.45 ± 10.27
Ma ied
15 (7.4)
62.26 ± 7.36
125.80 ± 15.85
105.93 ± 12.55
p- alue
0.915
0.493
0.378
Academic yea
Second-yea
81 (39.9)
62.09 ± 7.28
123.98 ± 12.19
105.55 ± 10.57
Thi d-yea
65 (32)
63.15 ± 8.02
123.20 ± 13.67
103.12 ± 9.14
Fou h-yea
57 (28.1)
62.21 ± 7.48
122.73 ± 17.16
101.50 ± 11.31
p- alue
0.675
0.871
0.072
In e es in he
ield o nu sing
Yes
160 (78.8)
63.50 ± 7.28
124.08 ± 13.65
104.43 ± 10.27
No
43 (21.2)
58.62 ± 7.42
120.79 ± 15.73
100.67 ± 10.64
p- alue
< 0.001
0.176
0.036
Type o
esidence
Li ing in do ms
103 (50.7)
61.90 ± 7.50
123.91 ± 13.08
103.54 ± 10.74
Li ing wi h amily
100 (49.3)
63.05 ± 7.62
122.84 ± 15.20
103.74 ± 10.17
p- alue
0.281
0.590
0.894
GPA a e age
17-20
54 (26.6)
61.88 ± 7.84
121.22 ± 14.06
101.31 ± 9.76
14-17
117 (57.6)
62.50 ± 7.65
123.86 ± 13.85
104.50 ± 10.11
11-14
32 (15.8)
63.31 ± 6.86
125.28 ± 15.29
104.40 ± 12.33
p- alue
0.700
0.375
0.161
No e: T- es and one-way ANOVA we e used o compa e pa icipan s based on quan i a i e demog aphic a iables (n = 203).
Abb e ia ions: SD, s anda d de ia ion; %, pe cen age; GPA, g ade poin a e age; p- alue, p obabili y- alue; n, numbe o pa icipan s.
Table 2. Mean sco es and anges o emo ional in elligence, c i ical hinking, and ca ing beha io s in nu sing s uden s
Ou come a iables
Mean ± SD
Range in he Scales
Sel -emo ion app aisals
16.04 ± 2.31
4-20
O he s’ emo ion app aisals
15.61 ± 2.34
4-20
Use o emo ion
16.54 ± 2.52
4-20
Regula ion o emo ion
14.26 ± 3.35
4-20
To al Emo ional in elligence
62.46 ± 7.56
16-80
C ea i i y
43.02 ± 6.57
11-55
Pe ec ionism
32.55 ± 3.99
9-45
Commi men
47.80 ± 5.52
13-65
To al C i ical hinking
123.38 ± 14.14
33-165
Technical physical beha io s
47.12 ± 4.95
11-55
Inapp op ia e beha io s
5.69 ± 1.64
2-10
Psychosocial beha io s
41.78 ± 4.38
10-50
P o essional beha io s
4.68 ± 0.47
1-5
Unnecessa y ac i i ies
4.33 ± 0.71
1-5
To al Ca ing beha io s
103.64 ± 10.44
25-125
No e: n = 203.
Abb e ia ions: SD, s anda d de ia ion.
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: Emo ional in elligence, c i ical hinking disposi ion, and ca ing beha io s in nu sing s uden s
Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025 69
The esul s o his s udy demons a ed a signi ican
nega i e co ela ion be ween academic yea and ca ing
beha io s. Speci ically, wi h an inc ease in he academic
yea , s uden s' ca ing beha io s signi ican ly dec eased
(Table 3). Addi ionally, he esul s showed a signi ican
posi i e co ela ion be ween EI and c i ical hinking
disposi ion, as well as ca ing beha io s. This sugges s
ha as EI and c i ical hinking disposi ion inc ease, he
le el o ca ing beha io s imp o es signi ican ly.
Addi ionally, an inc ease in s uden s' EI signi ican ly
enhances hei c i ical hinking disposi ion (Table 3).
The esul s o he mul iple linea eg ession analysis
indica ed ha c i ical hinking disposi ion, academic
yea , and EI we e signi ican p edic o s o s uden s'
ca ing beha io s. Speci ically, an inc ease in c i ical
hinking disposi ion and EI was associa ed wi h
espec i e inc eases o 0.36 and 0.20 uni s in ca ing
beha io s. Addi ionally, he eg ession esul s e ealed
ha ca ing beha io s dec eased by 1.83 uni s o each
ad ancing academic yea . These ac o s accoun ed o
34% o he a iance in ca ing beha io s (Table 4).
Table 3. Co ela ion ma ix o emo ional in elligence, c i ical hinking, and ca ing beha io s in nu sing s uden s
Va iables
Technical physical
beha io s
Inapp op ia e
beha io s
Psychosocial
beha io s
P o essional
beha io s
Unnecessa y
ac i i ies
To al Ca ing
beha io s
Academic yea
- 0.159*
- 0.067
- 0.101
- 0.193**
- 0.146*
- 0.147*
Sel -emo ion app aisals
0.315**
0.180**
0.217**
0.180*
0.258**
0.295**
O he s’ emo ion app aisals
0.285**
0.117
0.219**
0.156*
0.200**
0.266**
Use o emo ion
0.240**
0.111
0.189**
0.208**
0.182**
0.233**
Regula ion o emo ion
0.184**
0.217**
0.206**
0.099
0.098
0.219**
To al Emo ional in elligence
0.347**
0.225**
0.289**
0.217**
0.246**
0.348**
C ea i i y
0.551**
0.306**
0.458**
0.236**
0.398**
0.540**
Pe ec ionism
0.491**
0.469**
0.440**
0.191**
0.443**
0.530**
Commi men
0.408**
0.314**
0.334**
0.148*
0.308**
0.411**
To al C i ical hinking disposi ion
0.554**
0.397**
0.468**
0.222**
0.430**
0.561**
No e: Pea son co ela ion coe icien s we e used o assess ela ionships be ween a iables. *p < 0.05; **p < 0.001.
Table 4. Mul iple linea eg ession model o p edic o s o ca ing beha io s in nu sing s uden s
Model
R
R2
AdjR2
F
Independen a iables
B
SE
β
p
Ca ing beha io s
0.59
0.35
0.34
36.17
Cons an
49.16
6.24
-
7.87
< 0.001
C i ical hinking
0.36
0.04
0.49
7.93
< 0.001
Academic yea
- 1.83
0.72
- 0.14
- 2.52
0.010
Emo ional in elligence
0.20
0.08
0.14
2.36
0.010
Abb e ia ions: R2, R squa e; AdjR2, Adjus R squa e; SE, S anda d E o ; B, Uns anda dized coe icien s; β, S anda dized coe icien s; p, p obabili y alue
Discussion
This s udy aimed o in es iga e he ela ionship be ween
c i ical hinking disposi ion, emo ional in elligence, and
ca ing beha io s. Ou esea ch esul s indica ed ha he
majo i y o nu sing s uden s epo ed hei ca ing
beha io s a a high le el. These indings a e consis en
wi h he s udy conduc ed by Konuk and Tanye , which
assessed he ca ing beha io s o nu sing s uden s in
Tu key [4]. A sys ema ic e iew aimed a e alua ing
nu sing s uden s' unde s anding o ca ing beha io s also
ound ha he le el o ca ing beha io s among nu sing
s uden s a ied om medium o high. These a ia ions
we e a ibu ed o s udies conduc ed ac oss di e en
na ionali ies and coun ies, as well as he use o di e se
assessmen ools [28]. Resea ch has demons a ed ha
s uden s' pe cep ions o ca ing beha io s can be
in luenced by hei belie s and a i udes, which a e
shaped by cul u e, en i onmen , indi idual
cha ac e is ics, and he educa ional sys em [29, 30].
Mo eo e , he ca ing beha io s demons a ed by
educa o s ha e a signi ican impac on his aspec ; when
educa o s p io i ize ca e, s uden s' abili y o demons a e
ca ing beha io s imp o es. Addi ionally, he di e se,
ca ing en i onmen s ha s uden s encoun e , along wi h
he ca e o pa ien s wi h a ying heal h condi ions, such
as ch onic, acu e, and end-o -li e ca e, equi e con ex -
app op ia e ca ing beha io s. This is con ingen upon he
s uden s' exposu e and he educa ional sys em in which
hey a e ained [30]. Con e sely, nu sing s uden s ha e
no ye expe ienced he eal-wo ld condi ions o he
wo kplace, including ime cons ain s and he challenges
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ha nu ses ace in p ac ice. They p o ide ca e o a
limi ed numbe o pa ien s unde he supe ision o hei
educa o s, which may in luence how he pa icipa ing
s uden s in ou s udy pe cei e and assess ca ing
beha io s. The esul s o he cu en s udy indica e ha
nu sing s uden s exhibi a high le el o EI and a s ong
disposi ion owa d c i ical hinking. Addi ionally, he
indings om Fe eidouni e al. suppo hese esul s,
demons a ing ha nu sing s uden s exhibi ele a ed
le els o EI [12]. Howe e , ega ding c i ical hinking,
Shi azi and Heida i epo ed ha nu sing s uden s
displayed a medium le el o c i ical hinking, which
con as s wi h ou indings [31]. One possible eason o
his disc epancy is he a ia ion in he ins umen s used.
We u ilized he Ricke s' C i ical Thinking Disposi ion
Scale, which assesses he p opensi y o c i ical hinking,
whe eas Shi azi and Heida i's s udy employed he
Cali o nia C i ical Thinking Skills Ques ionnai e.
Howe e , i is essen ial o no e ha in an educa ional
se ing, mul iple ac o s can in luence s uden s'
pe cep ions o hei EI and c i ical hinking skills. Key
ac o s include an emphasis on p ac ical skills, he
di e si y o pa ien s and ca e condi ions, suppo om
educa o s, ongoing assessmen s, and a nu u ing lea ning
en i onmen . These elemen s may con ibu e o a mo e
a o able e alua ion o s uden s' ac ual skill le els. The
obse ed di e ences may a ise om a combina ion o
ac o s, including indi idual expe iences, aining in
emo ional managemen and communica ion skills, wo k
condi ions, pe sonali y ai s, and o ganiza ional cul u e
[30, 31]. A signi ican di e ence was obse ed in ca ing
beha io s and EI among nu sing s uden s based on hei
in e es in he ield. S uden s who exp essed a genuine
in e es in hei majo epo ed highe le els o bo h
ca ing beha io s and EI, and his di e ence was
s a is ically signi ican . Addi ionally, eg ession analysis
indica ed ha in e es in he majo is a p edic o a iable
o ca ing beha io s, sugges ing ha an inc ease in
in e es co ela es wi h an inc ease in ca ing beha io s.
S udies no ed ha in e es , by di ec ing ac ions owa d
goals and se ing as a mo i a o , plays a c ucial ole in
in luencing in elligence and lea ning ou comes [32].
Fu he mo e, indi iduals wi h high EI a e mo e adep a
demons a ing g ea e espec o hei pa ien s,
inc eased empa hy, and a mo e genuine conce n o he
well-being o hose hey ca e o [33]. The e o e, he e is
a di ec ela ionship be ween in e es in he ield,
enhanced EI, and ca ing beha io s. This ela ionship has
a signi ican impac on he quali y o heal hca e se ices
p o ided by p o essionals. The cu en s udy e ealed a
signi ican nega i e co ela ion be ween academic yea s
and ca ing beha io s, indica ing ha as s uden s
p og essed o highe semes e s, hei epo ed ca ing
beha io s signi ican ly dec eased. This inding aligns
wi h he esul s o Gözü ok Konuk and Tanye , which
indica ed ha ou h-yea s uden s sco ed lowe in hei
sel -assessmen o ca ing beha io s compa ed o hei
lowe -yea coun e pa s [34]. Se e al ac o s may
con ibu e o he obse ed decline in nu sing s uden s'
ca ing beha io s in hei ad anced yea s. S uden s in
highe semes e s o en become mo e engaged in ou ine
clinical asks, esul ing in less ime o di ec pa ien
in e ac ion [35]. The ansi ion om being a supe ised
s uden in ea lie semes e s o a mo e independen nu se
in la e semes e s may lead o a mo e c i ical e alua ion
o hei skills. Fu he mo e, he inc eased pa ien load in
highe semes e s can limi he ime a ailable o add ess
all aspec s o pa ien ca e. In con as , lowe -semes e
s uden s ypically ha e mo e oppo uni ies o pa ien
in e ac ion due o g ea e supe ision om ins uc o s
and ewe assigned pa ien s, os e ing a suppo i e
lea ning en i onmen ha may con ibu e o a mo e
posi i e sel -assessmen o hei skills [1, 35].
Fu he mo e, h oughou hei in e nships and highe
educa ion, s uden s o en ocus mo e on using ools and
echniques o pa ien ca e a he han on he e hical and
emo ional dimensions o nu sing. This end can likely
be a ibu ed o he educa ional sys em; as s uden s’
p og ess h ough hei semes e s, he nu sing cu iculum
becomes mo e specialized and complex [34].
Consequen ly, s uden s end o concen a e on mas e ing
ad anced echniques and managing c i ical si ua ions.
Since physical and echnical ca e is mo e angible and
measu able, his emphasis can lead s uden s o p io i ize
hese aspec s o e o he dimensions o ca e.
Addi ionally, as s uden s ad ance in hei s udies, hey
ace g ea e challenges ha may hinde hei abili y o
ocus on ca ing beha io s. These challenges include
inc eased wo kload demands, a heigh ened emphasis on
exams and end-o -semes e p ojec s, and ewe
oppo uni ies o p ac ical engagemen wi h pa ien s [34-
36]. Mo eo e , he p esence o ins uc o s who model
compassiona e ca e and conside all aspec s o pa ien
ca e can suppo s uden s and enhance hei
unde s anding o holis ic ca e [35]. The p esen s udy
demons a ed a posi i e and signi ican co ela ion
be ween EI, c i ical hinking disposi ion, and ca ing
beha io s among nu sing s uden s. Essen ially, as EI and
c i ical hinking disposi ion inc ease, he equency o
ca ing beha io s also ises. Addi ionally, linea
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Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025 71
eg ession analysis e ealed ha c i ical hinking
disposi ion and EI a e p edic i e ac o s o ca ing
beha io s, indica ing ha highe le els o bo h c i ical
hinking disposi ion and EI a e associa ed wi h g ea e
exp essions o ca e. These indings align wi h p e ious
s udies [37-39]. Consis en wi h he esul s o he p esen
s udy, Ka aca e al. ound a posi i e ela ionship be ween
nu ses' c i ical hinking abili ies and hei ca ing oles
[37]. Simila ly, Taylan e al. u he suppo ed his by
demons a ing a posi i e ela ionship be ween EI and
ca ing beha io s, indica ing ha heigh ened awa eness
acili a ed by inc eased EI enhances ca e p ac ices [38].
Acco ding o Bandu a's social lea ning heo y, e ec i e
job pe o mance can also be in luenced by EI [40]. EI
encompasses he abili y o eason wi h emo ions
e ec i ely. Indi iduals wi h high EI can u ilize
emo ional in o ma ion o enhance cogni i e p ocesses,
such as p oblem sol ing and decision-making [38, 39].
By in eg a ing eelings wi h logic, hey can e alua e
si ua ions holis ically, conside ing bo h a ional and
emo ional ac o s. This in eg a ion leads o decisions ha
a e no only logically sound bu also emo ionally
sensi i e and app op ia e. EI os e s empa hy and
communica ion, which a e essen ial o building s ong
nu se-pa ien ela ionships. Addi ionally, i enables
s uden s o make in o med decisions swi ly and o sol e
complex p oblems e ec i ely, allowing hem o adap o
he dynamic na u e o heal hca e en i onmen s [41].
Fu he mo e, c i ical hinking is closely linked o sel -
e lec ion, compassion, imp o ed analy ical skills,
e hical conside a ions, and p oblem-sol ing abili ies. I
se es as he ounda ion o e ec i e decision-making
and p oblem-sol ing, ensu ing sa e and e icien ca e
[42]. As c i ical hinking skills imp o e, s uden s become
mo e adep a iden i ying pa ien s' p oblems, selec ing
app op ia e ca e solu ions, and e alua ing he
e ec i eness o hese in e en ions. This capabili y is
i al in complex clinical si ua ions ha equi e deep
hinking and apid decision-making, ul ima ely leading
o enhanced ca egi ing beha io s [2]. Fu he mo e, he
indings o he p esen s udy indica e a signi ican
posi i e co ela ion be ween EI and c i ical hinking
disposi ion, which aligns wi h he esul s o he esea ch
conduc ed by Baghe i e al. Thei s udy highligh ed he
po en ial connec ion be ween c i ical hinking and EI in
nu sing s uden s, demons a ing ha os e ing EI can
enhance c i ical hinking skills [41]. Ou esul s sugges
ha EI and c i ical hinking disposi ion con ibu e o
ca ing beha io s bo h di ec ly and indi ec ly h ough
hei in e ac ions. Indi iduals wi h highe EI excel a
in eg a ing emo ional insigh s in o hei c i ical hinking
p ocesses, hanks o hei supe io skills in emo ional
awa eness, egula ion, empa hy, easoning, and
adap abili y. These capabili ies enable hem o na iga e
complex decision-making scena ios mo e e ec i ely,
conside ing bo h logical and emo ional aspec s.
Consequen ly, hey a e mo e likely o make con ex -
sensi i e, delibe a e, and accu a e decisions [39]. This
in e ac ion no only imp o es he quali y o ca e
p o ided bu also en iches nu se-pa ien ela ionships,
ul ima ely leading o he deli e y o compassiona e,
high-quali y ca e ha mee s pa ien s' needs and
expec a ions [39, 41]. To he bes o ou knowledge, ew
s udies ha e explo ed he ela ionship be ween ca ing
beha io s, EI, and c i ical hinking disposi ion in nu sing
s uden s, which is one o he s eng hs o ou esea ch.
Howe e , ou s udy also had se e al limi a ions. Fi s , i
concen a ed on he e ec s o speci ic a iables on ca ing
beha io s, while o he ac o s—such as clinical
expe ience, o ganiza ional cul u e, and educa ional
policies— ha could in luence hese beha io s we e no
examined. Secondly, he measu emen ool employed in
his s udy was a sel - epo ques ionnai e, which may
in oduce bias in he esul s. Consequen ly, he indings
may no ully e lec he ac ual le el o ca ing beha io s
among pa icipan s. I may be necessa y o conduc
obse a ional s udies o assess nu sing s uden s' ca ing
beha io s mo e accu a ely. In addi ion, he cu en s udy
u ilized Ricke s' C i ical Thinking Disposi ion Scale,
which does no assess c i ical hinking skills. This
limi a ion may ha e in luenced he esul s. Finally, due
o i s c oss-sec ional design, his s udy was unable o
ack changes in a iables o e ime, which limi ed ou
abili y o es ablish causal ela ionships among he
a iables examined.
Conclusion
The esul s o he p esen s udy indica e ha an inc ease
in EI and c i ical hinking disposi ion leads o an
imp o emen in ca ing beha io s. Con e sely, an
inc ease in an academic yea is associa ed wi h a decline
in hese beha io s. Based on hese indings, educa ional
s a egies should be de eloped o enhance bo h c i ical
hinking and EI while also add essing he p essu es
associa ed wi h ad ancing h ough he academic yea s.
Educa o s should p io i ize he cul i a ion o s uden s' EI
and c i ical hinking skills, which may include
educa ional ac i i ies ocused on p oblem-sol ing, s ess
managemen , in e pe sonal communica ion, and pa ien
in e ac ion. Fu he mo e, c ea ing mo e oppo uni ies o
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72 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 2 ¦ 2025
p ac ical expe ience and pa ien in e ac ion can help
s uden s main ain and enhance hei ca egi ing abili ies
h ough inc eased expe ience and knowledge. O e all,
his s udy unde sco es he impo ance o a holis ic
app oach o educa ion in nu sing p og ams, emphasizing
he need o balance academic p og ess wi h he
de elopmen o essen ial skills and c i ical hinking
abili ies.
By add essing hese indings, educa o s can es ablish a
mo e e ec i e and sus ainable educa ional model ha
ul ima ely esul s in he aining o nu ses who a e bo h
academically p o icien and p ac ically compe en in
deli e ing high-quali y pa ien ca e.
E hical conside a ions
The e hics commi ee o Ah az Jundishapu Uni e si y
o Medical Sciences, Ah az, I an, has app o ed his
esea ch (E hical Code: IR.AJUMS.REC.1402.632).
E hical guidelines we e s ic ly ollowed, which included
ob aining app o al om ele an au ho i ies, clea ly
explaining he s udy's objec i es o pa icipan s, ensu ing
da a con iden iali y, and secu ing e bal consen om all
indi iduals in ol ed.
A i icial in elligence u iliza ion o a icle
w i ing
We acknowledge he use o WORDVICE.AI
(h ps://wo d ice.ai/p oo eading/6c21e242-4286-4ed0-
93c7-ea479dd98 86) o p oo ead some sen ences in his
manusc ip .
Acknowledgmen
This s udy was ex ac ed om a esea ch p oposal
app o ed by he S uden Resea ch Commi ee, Ah az
Jundishapu Uni e si y o Medical Sciences, Ah az, I an
(NO: 02s84).
The esea che s would like o exp ess hei app ecia ion
o all s a membe s o he "S uden Resea ch
Commi ee" and "Resea ch & Technology Chancello "
a Ah az Jundishapu Uni e si y o Medical Sciences o
hei inancial suppo . Addi ionally, he esea che s
would like o exp ess hei g a i ude o all he nu sing
s uden s who pa icipa ed in his s udy.
Con lic o in e es s a emen
The au ho s decla ed no po en ial con lic s o in e es
conce ning he esea ch, au ho ship, and/o publica ion
o his a icle.
Au ho con ibu ions
M.A. and F.A. con ibu ed o he s udy's concep ion and
design. M.A., F.A., B.A., M.Gh, and MM.A pe o med
ma e ial p epa a ion, da a collec ion, and analysis. M.A.
F.A. and B.A. w o e he i s d a o he manusc ip . All
au ho s commen ed on p e ious e sions o he
manusc ip . All au ho s ead and app o ed he inal
manusc ip . M.A., as p incipal in es iga o , supe ised
he p ojec .
Funding
Ah az Jundishapu Uni e si y o Medical Sciences,
Ah az, I an (NO: 02s84)
Da a a ailabili y s a emen
The da ase s used and/o analyzed du ing he cu en
s udy a e a ailable om he co esponding au ho upon
easonable eques . Fo access o addi ional da a, please
each ou o he co esponding au ho .
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