Self-Care Competence and AI-Supported Learning as Predictors of Enhanced Clinical Decision-Making Skills Among Nurses

Clinical decision-making is a critical competency for nurses particularly in resource-constrained healthcare systems where frontline practitioners must integrate clinical knowledge judgment and contextual constraints to ensure optimal patient outcomes. Although prior research highlights the benefits of artificial intelligence supported learning and individual competencies it largely assumes a direct relationship between technological support and decision quality overlooking the cognitive-regulatory mechanisms through which such effects occur. This study addresses this gap by examining self-care competence as a mediating pathway linking perceived AI based learning support to enhance clinical decision-making among nurses in Benue State, Nigeria. A descriptive cross-sectional design was employed with data collected from 600 registered nurses across public and private healthcare facilities using the Self-Care Competence Scale (SCCS) AI-Based Learning Support Scale (PAILS) and the Clinical Decision-Making Scale (CDMNS). Data were analyzed using structural equation modelling (SEM) to test direct and indirect relationships complemented by bootstrapped mediation analysis and rigorous assessment of common method bias through Harmans single-factor test and full collinearity variance inflation factors ensuring robustness of the findings. Results indicated moderately high levels of self-care competence perceived AI-based learning support and enhance clinical decision-making skills. Self-care competence and AI-based learning support significantly predicted clinical decision-making with self-care competence partially mediating this relationship and the model explaining 58 percent of the variance. The findings extend theory by demonstrating that AI supported learning enhances enhance clinical decision-making not directly, but through nurses cognitive and psychological readiness, positioning self-care competence as a central mechanism in evidence-based practice.