The relationship between nursing students’ digital literacy and their levels of clinical decision-making

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Abstract
Background: The rapid integration of digital health technologies into healthcare has made digital literacy a fundamental competency for nursing students. Digital literacy may facilitate evidence-based practice and enhance clinical decision-making by supporting the effective and critical use of digital health technologies. However, evidence regarding the relationship between digital literacy and clinical decision-making among nursing students remains limited. Therefore, this study aimed to examine the relationship between nursing students’ digital literacy levels and clinical decision-making skills. Methods: This was a descriptive, cross-sectional, and correlational study. A total of 271 nursing students participated in the study. Data were collected between June 2, and June 19, 2026, using an Information Form, the Digital Literacy Scale, and the Clinical Decision-Making in Nursing Scale. Data were analyzed using descriptive statistics, Student’s t-test, one-way ANOVA, Mann–Whitney U test, Pearson correlation analysis, and multiple linear regression analysis. Results: The Digital Literacy Scale mean score was 65.40 ± 10.62, whereas the Clinical Decision-Making in Nursing Scale mean score was 137.49 ± 14.04. Digital literacy scores differed significantly according to gender, academic year, daily internet use, and purpose of internet use (all p < 0.05). Clinical decision-making scores differed significantly by gender, daily internet use, and health information-seeking behavior (all p < 0.05). Digital literacy was positively associated with clinical decision-making, with weak-to-moderate correlations. Multiple linear regression analysis showed that only the Attitude subscale of digital literacy significantly predicted clinical decision-making, explaining 12.6% of the variance ( β = 0.344, p = 0.001). Conclusion: Digital literacy was positively associated with clinical decision-making among nursing students, and the attitude subscale of digital literacy emerged as a significant predictor of clinical decision-making. These results highlight the importance of fostering digital literacy, particularly positive attitudes toward digital technologies, within undergraduate nursing education to better prepare future nurses for digitally supported healthcare environments.

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