AIM: To describe nursing students' level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries. DESIGN: A cross-sectional comparative design across the countries. METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model. RESULTS: The nursing students' (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.

Department of Biostatistics University of Turku Turku Finland

Department of Fundamentals of Nursing Lisbon School of Nursing Lisbon Portugal

Department of Medical Sciences University of Udine Udine Italy

Department of Nursing and Midwifery Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Nursing Science Fundación San Juan de Dios Centro de Ciencias de la Salud San Rafael Universidad Antonio de Nebrija Madrid Spain

Department of Nursing Science Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovakia

Department of Nursing Science University of Turku Turku Finland

Department of Public Health Azienda Provinciale per i Servizi Sanitari Trento Italy

Diaconia University of Applied Sciences Helsinki Finland

School of Health Sciences University of Aveiro Aveiro Portugal

Turku University Hospital University of Turku Turku Finland

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Aiken, L. H. , Sloane, D. , Griffiths, P. , Rafferty, A. M. , Bruyneel, L. , McHugh, M. , Maier, C. B. , Moreno‐Casbas, T. , Ball, J. E. , Ausserhofer, D. , & Sermeus, W. (2017). Nursing skill mix in European hospitals: Cross‐sectional study of the association with mortality, patient ratings and quality of care. BMJ Quality & Safety, 26(7), 559–568. 10.1136/bmjqs-2016-005567 PubMed DOI PMC

Al Moteri, M. O. (2019). Self‐directed and lifelong learning: A framework for improving nursing students’ learning skills in the clinical context. International Journal of Nursing Education Scholarship, 16(1). 10.1515/ijnes-2018-0079 PubMed DOI

All European Academies . (2017). The European code of conduct for research integrity. Revised edition [Internet document]. https://allea.org/code‐of‐conduct/

American Nurses Association . (2015). Nursing: Scope and standards of practice [EPub] (3rd ed.). https://www.lindsey.edu/academics/majors‐and‐programs/Nursing/img/ANA‐2015‐Scope‐Standards.pdf

Australian Nursing & Midwifery Council . (2016). Registered nurse standards for practice [Web page]. https://www.nursingmidwiferyboard.gov.au/Codes‐Guidelines‐Statements/Professional‐standards/registered‐nurse‐standards‐for‐practice.aspx

Avdal, E. U. (2013). The effect of self‐directed learning abilities of student nurses on success in Turkey. Nurse Education Today, 33(8), 838–841. 10.1016/j.nedt.2012.02.006 PubMed DOI

Behar‐Horenstein, L. S. , Beck, D. E. , & Su, Y. (2018). An initial validation study of the self‐rating scale of self‐directed learning for pharmacy education. American Journal of Pharmaceutical Education, 82(3), 6251. 10.5688/ajpe6251 PubMed DOI PMC

Cadorin, L. , Bortoluzzi, G. , & Palese, A. (2013). The self‐rating scale of self‐ directed learning (SRSSDL): A factor analysis of the Italian version. Nurse Education Today, 33(12), 1511–1516. 10.1016/j.nedt.2013.04.010 PubMed DOI

Cadorin, L. , Bressan, V. , & Palese, A. (2017). Instruments evaluating the self‐directed learning abilities among nursing students and nurses: A systematic review of psychometric properties. BMC Medical Education, 17(1), Article 229. 10.1186/s12909-017-1072-3 PubMed DOI PMC

Cadorin, L. , Cheng, S. F. , & Palese, A. (2016). Concurrent validity of self‐rating scale of self‐directed learning and self‐directed learning instrument among Italian nursing students. BMC Nursing, 15, Article 20. 10.1186/s12912-016-0142-x PubMed DOI PMC

Cadorin, L. , Ghezzi, V. , Camillo, M. , & Palese, A. (2017). The self‐rating scale of self‐directed learning tool: Findings from a confirmatory factor analysis. Journal of Nursing Education and Practice, 7(2), 31–37. 10.5430/jnep.v7n2p31 DOI

Cadorin, L. , Rei, A. , Dante, A. , Bulfone, T. , Viera, G. , & Palese, A. (2015). Enhancing self‐directed learning among Italian nursing students: A pre‐ and post‐ intervention study. Nurse Education Today, 35(6), 746–753. 10.1016/j.nedt.2015.02.004 PubMed DOI

Cheng, S.‐F. , Lee‐Hsieh, J. , Turton, M. A. , & Lin, K.‐C. (2014). Validation of self‐directed learning instrument and establishment of normative data for nursing students in Taiwan: Using polytomous item response theory. The Journal of Nursing Research, 22(2), 90–100. 10.1097/JNR.0000000000000027 PubMed DOI

European Commission (EC) . (2005). Directive 2005/36/EC. https://eur‐lex.europa.eu/legal‐content/EN/TXT/PDF/?uri=CELEX:32005L0036&from=EN

European Commission (EC) . (2013). Directive 2013/55/EU. http://eur‐lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2013:354:0132:0170:en:PDF

European Higher Education Area (EHEA) . (2020). Rome ministerial communiqué: http://ehea.info/Upload/Rome_Ministerial_Communique.pdf

European Union (EU) . (2018). Description of the eight EQF levels. https://europa.eu/europass/en/description‐eight‐eqf‐levels

Flinkman, M. , Leino‐Kilpi, H. , Numminen, O. , Jeon, Y. , Kuokkanen, L. , & Meretoja, R. (2017). Nurse competence scale: A systematic and psychometric review. Journal of Advanced Nursing, 73(5), 1035–1050. 10.1111/jan.13183 PubMed DOI

Green, R. D. , & Schlairet, M. C. (2017). Moving toward heutagogical learning: Illuminating undergraduate nursing students' experiences in a flipped classroom. Nurse Education Today, 49, 122–128. 10.1016/j.nedt.2016.11.016 PubMed DOI

Greveson, G. C. , & Spence, J. A. (2005). Self‐directed learning – The importance of concepts and contexts. Medical Education, 39(4), 348–349. 10.1111/j.1365-2929.2005.02115.x PubMed DOI

Hill, M. , Peters, M. , Salvaggio, M. , Vinnedge, J. , & Darden, A. (2020). Implementation and evaluation of a self‐directed learning activity for first‐year medical students. Medical Education Online, 25(1), Article 1717780. 10.1080/10872981.2020.1717780 PubMed DOI PMC

Humar, L. , & Sansoni, J. (2017). Bologna process and basic nursing education in 21 European countries. Annali Di Igiene, Medicina Preventiva E Di Comunità, 29, 561–571. 10.7416/ai.2017.2185 PubMed DOI

Hwang, Y. , & Oh, J. (2021). The relationship between self‐directed learning and problem‐solving ability: The mediating role of academic self‐efficacy and self‐regulated learning among nursing students. International Journal of Environmental Research and Public Health, 18(4), Article 1738. 10.3390/ijerph18041738 PubMed DOI PMC

International Council of Nurses . (2021). The ICN code of ethics for nurses. https://www.icn.ch/system/files/2021‐10/ICN_Code‐of‐Ethics_EN_Web_0.pdf PubMed

Järvinen, T. , Virtanen, H. , Kajander‐Unkuri, S. , & Salminen, L. (2021). Nurse educators’ perceptions of factors related to the competence of graduating nursing students. Nurse Education Today, 101, Article 104884. 10.1016/j.nedt.2021.104884 PubMed DOI

Kajander‐Unkuri, S. , Koskinen, S. , Brugnolli, A. , Cerezuela Torre, M. A. , Elonen, I. , Kiele, V. , Lehwaldt, D. , Löyttyniemi, E. , Nemcová, J. , Oliveira, C. S. , Palese, A. , Rua, M. , Salminen, L. , Šateková, L. , Stubner, J. , Sveinsdóttir, H. , Visiers‐Jiménez, L. , & Leino‐Kilpi, H. (2021). The level of competence of graduating nursing students in 10 European countries—Comparison between countries. Nursing Open, 8(3), 1048–1062. 10.1002/nop2.712 PubMed DOI PMC

Kaulback, M. K. (2020). Correlating self‐directed learning abilities to lifelong learning orientation in Baccalaureate nursing students. Nurse Educator, 45(6), 347–351. 10.1097/NNE.0000000000000803 PubMed DOI

Kaunonen, M. , Gobbi, M. , Meier, K. , Østergaard, B. , Nielsen, D. , Kollak, S. , McCready, I. (2018). Tuning educational structures in europe: guidelines and reference points for the design and delivery of degree programmes in nursing. https://findresearcher.sdu.dk:8443/ws/portalfiles/portal/143642267/2018_WP_4_Del._1.4_Guidelines_and_Reference_Points_for_the_Design_and_Delivery_of_Degree_Programmes_in_Nursing_FINAL.pdf

Kelley, K. , Clark, B. , Brown, V. , & Sitzia, J. (2003). Good practice in the conduct and reporting of survey research. International Journal for Quality in Health Care, 15(3), 261–266. 10.1093/intqhc/mzg031 PubMed DOI

Knowles, M. S. , Holton, E. F. III , & Swanson, R. A. (2015). The adult learner: The definitive classic in adult education and human resource development (8th ed.). Routledge.

Lahtinen, P. , Leino‐Kilpi, H. , & Salminen, L. (2014). Nursing education in the European higher education area – Variations in implementation. Nurse Education Today, 34(6), 1040–1047. 10.1016/j.nedt.2013.09.011 PubMed DOI

Lee, S. , Kim, D. , & Chae, S.‐M. (2020). Self‐directed learning and professional values of nursing students. Nurse Education in Practice, 42, Article 102647. 10.1016/j.nepr.2019.102647 PubMed DOI

Loeng, S. (2020). Self‐directed learning: A core concept in adult education. Education Research International, 2020, 3816132. 10.1155/2020/3816132 DOI

Meretoja, R. , Isoaho, H. , & Leino‐Kilpi, H. (2004). Nurse Competence Scale: Development and psychometric testing. Journal of Advanced Nursing, 47(2), 124–133. 10.1111/j.1365-2648.2004.03071.x PubMed DOI

Murad, M. H. , Coto‐Yglesias, F. , Varkey, P. , Prokop, L. J. , & Murad, A. L. (2010). The effectiveness of self‐directed learning in health professions education: A systematic review. Medical Education, 44(11), 1057–1068. 10.1111/j.1365-2923.2010.03750.x PubMed DOI

Nursing and Midwifery Council . (2014). Standards for competence for registered nurses. https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc‐standards‐for‐competence‐for‐registered‐nurses.pdf

OECD . (2012). Fostering quality teaching in higher education: Policies and practices. https://www.oecd.org/education/imhe/QT%20policies%20and%20practices.pdf

OECD . (2018). The future of education and skills. Education 2030. https://www.oecd.org/education/2030‐project/about/documents/E2030%20Position%20Paper%20(05.04.2018).pdf

OECD . (2020). Nursing graduates (indicator) [Web page]. https://data.oecd.org/healthres/nursing‐graduates.htm#indicator‐chart

OECD/European Union . (2020). Health at a Glance: Europe 2020: State of health in the EU cycle. OECD Publishing. 10.1787/82129230-en DOI

Polit, D. F. , & Beck, C. T. (2018). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). Wolters Kluwer Health.

Pryce‐Miller, M. (2010). Are first year undergraduate student nurses prepared for self directed learning? Nursing Times, 106(46), 21–24. PubMed

Pryce‐Miller, M. , & Serrant, L. (2019). Students’ perceptions of self‐direction in pre‐registration nurse education. Nurse Education in Practice, 40, 102626. 10.1016/j.nepr.2019.102626 PubMed DOI

Qalehsari, M. Q. , Khaghanizadeh, M. , & Ebadi, A. (2017). Lifelong learning strategies in nursing: A systematic review. Electronic Physician, 9(10), 5541–5550. 10.19082/5541 PubMed DOI PMC

Rascón‐Hernán, C. , Fullana‐Noell, J. , Fuentes‐Pumarola, C. , Romero‐Collado, A. , Vila‐Vidal, D. , & Ballester‐Ferrando, D. (2019). Measuring self‐directed learning readiness in health science undergraduates: A cross‐sectional study. Nurse Education Today, 83, 104201. 10.1016/j.nedt.2019.08.019 PubMed DOI

Shen, W. Q. , Chen, H. L. , & Hu, Y. (2014). The validity and reliability of the self‐directed learning instrument (SDLI) in mainland Chinese nursing students. BMC Medical Education, 14, 108. 10.1186/1472-6920-14-108 PubMed DOI PMC

Shirazi, F. , Sharif, F. , Molazem, Z. , & Alborzi, M. (2017). Dynamics of self‐directed learning in M.Sc. nursing students: A qualitative research. Journal of Advances in Medical Education & Professionalism, 5(1), 33–41. PubMed PMC

Slater, C. E. , & Cusick, A. (2017). Factors related to self‐directed learning readiness of students in health professional programs: A scoping review. Nurse Education Today, 52, 28–33. 10.1016/j.nedt.2017.02.011 PubMed DOI

Squires, A. , Aiken, L. H. , van den Heede, K. , Sermeus, W. , Bruyneel, L. , Lindqvist, R. , Schoonhoven, L. , Stromseng, I. , Busse, R. , Brzostek, T. , Ensio, A. , Moreno‐Casbas, M. , Rafferty, A. M. , Schubert, M. , Zikos, D. , & Matthews, A. (2013). A systematic survey instrument translation process for multi‐country, comparative health workforce studies. International Journal of Nursing Studies, 50(2), 264–273. 10.1016/j.ijnurstu.2012.02.015 PubMed DOI PMC

Tekkol, İ. A. , & Demirel, M. (2018). An investigation of self‐directed learning skills of undergraduate students. Frontiers in Psychology, 9, 2324. 10.3389/fpsyg.2018.02324 PubMed DOI PMC

Tuning . (i.a.). Approaches to teaching, learning and assessment and the subject area competences. Nursing. https://www.unideusto.org/tuningeu/images/stories/teaching/TLA___NURSING.pdf

Turjamaa, R. , Hartikainen, S. , Kangasniemi, M. , & Pietilä, A.‐M. (2014). Living longer at home: A qualitative study of older clients’ and practical nurses’ perceptions of home care. Journal of Clinical Nursing, 23(21–22), 3206–3217. 10.1111/jocn.12569 PubMed DOI

Wang, Y. , Ma, J. , Gu, Y. , Wang, J. , Chen, C. , Zhang, Y. , & Wang, R. (2021). How does group cooperation help improve self‐directed learning ability in nursing students? A trial of one semester intervention. Nurse Education Today, 98, 104750. 10.1016/j.nedt.2021.104750 PubMed DOI

Williamson, S. N. (2007). Development of a self‐rating scale of self‐directed learning. Nurse Researcher, 14(2), 66–83. 10.7748/nr2007.01.14.2.66.c6022 PubMed DOI

Wong, F. M. F. , Tang, A. C. Y. , & Cheng, W. L. S. (2021). Factors associated with self‐directed learning among undergraduate nursing students: A systematic review. Nurse Education Today, 104, 104998. 10.1016/j.nedt.2021.104998 PubMed DOI

World Health Organization . (2016). Nurse educator core competencies [Internet document]. https://www.who.int/hrh/nursing_midwifery/nurse_educator050416.pdf

World Health Organization . (2020). State of the world's nursing 2020: Investing in education, jobs and leadership. https://apps.who.int/iris/bitstream/handle/10665/331677/9789240003279‐eng.pdf?sequence=1&isAllowed=y

World Medical Association . (2013). The World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. https://www.wma.net/policies‐post/wma‐declaration‐of‐helsinki‐ethical‐principles‐for‐medical‐research‐involving‐human‐subjects/ PubMed

Zhoc, K. C. H. , & Chen, G. (2016). Reliability and validity evidence for the self‐directed learning scale (SDLS). Learning and Individual Differences, 49, 245–250. 10.1016/j.lindif.2016.06.013 DOI