Role stress, emotional labor, sense of belonging in nursing school, and failure mindset among nursing students during clinical practice: a cross-sectional network analysis

Abstract

Nursing students often face considerable challenges when transitioning from classroom learning to clinical practice. Role stress and emotional labor may increase psychological strain during this period, whereas a sense of belonging in nursing school and adaptive interpretations of failure may support students’ adjustment. However, previous studies have largely used variable-centered approaches, making it difficult to identify key psychological and educational targets within an interconnected system. This study aimed to examine the network structure of role stress, emotional labor, sense of belonging in nursing school, and failure mindset among nursing students during clinical practice. A cross-sectional survey was conducted between November and December 2025 among 308 nursing students undertaking clinical practice at a college in Wuzhou, Guangxi, China. Participants completed measures of role stress, emotional labor, sense of belonging in nursing school, and failure mindset. A regularized partial correlation network was estimated using a Gaussian graphical model with the EBICglasso procedure. Expected influence was used to identify central nodes, and bridge expected influence was used to identify nodes connecting different domains. Network accuracy and centrality stability were evaluated using bootstrap procedures. Clinical practice belonging, role overload, and role conflict were among the more highly connected nodes in the network. Role overload also showed a high level of strength and predictability, indicating that it was strongly connected with other nodes and largely explained by its neighboring nodes. The strongest edge was observed between role conflict and role overload, followed by the edges between clinical practice belonging and clinical teaching, clinical teaching and school teachers, and surface acting and deep acting. Positive failure mindset showed the highest point estimate for bridge expected influence, followed by role overload and surface acting, suggesting that these nodes may serve as exploratory candidate bridge nodes connecting different domains. The centrality estimates showed good stability, with correlation stability coefficients of 0.672 for both strength and expected influence. Clinical practice belonging, positive failure mindset, surface acting, and role overload were among the more highly connected and cross-domain dimensions in this sample. These findings suggest that educational and psychological support for nursing students during clinical practice may consider strategies aimed at reducing excessive role demands, strengthening students’ belonging in clinical practice, promoting adaptive interpretations of failure, and reducing reliance on surface acting. Because the present study was cross-sectional and exploratory, these dimensions should be regarded as candidate hypotheses for longitudinal or intervention research rather than as established causal factors.

The authors' abstract, as published at the source. BMC Nursing, 2026 · DOI ↗