Association between impostor phenomenon and proactive career behavior among new nurses with Master’s degrees in China： A moderated mediation model of career calling and perceived organizational support

Association between impostor phenomenon and proactive career behavior among new nurses with Master’s degrees in China： A moderated mediation model of career calling and perceived organizational support | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association between impostor phenomenon and proactive career behavior among new nurses with Master’s degrees in China： A moderated mediation model of career calling and perceived organizational support Renxiu Wang, Yunfei Zhang, Xinru Liu, Longhui Xu, Mei Yu, Qiumei Wang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7964235/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background： Impostor phenomenon(IP)，is a distressing psychological phenomenon commonly observed among newly graduated nurses. Due to the rapid transition from theoretical student to practicing nurse roles, newly employed master's-level graduate nurses are particularly susceptible to this“high academic credentials, low self-confidence” state, which impedes professional initiative. However, the specific operational mechanisms remain unclear. Aim: This study aims to examine how the mediating role of career calling(CC) and the moderating role of perceived organizational support(POS) influence the relationship between IP and proactive career behaviors(PCB) among new nurses with Master’s degrees in China. Design： A secondary analysis of multicenter cross-sectional correlational survey data was conducted. Methods： This study employed purposive sampling to collect observational data from 642 master's-level nursing students who joined 32 hospitals nationwide. Research variables included the CIPS, PCBS, CCS,POSQ, and general demographic statistics. R software was utilized to test the hypothesized model. Results： Participants exhibited moderate levels of IP (53.14 ± 10.84) and PCB (42.13 ± 7.00). Correlation analysis revealed a moderate negative correlation between SNC and PCB, while CC showed a significant positive correlation with PCB. The structural equation model demonstrated good fit (CFI=0.997, TLI=0.996). CC partially mediated the relationship between IP and PCB. The direct path coefficient from SNC to PCB was -0.456, the indirect effect was -0.367, and the total effect was -0.823. Moderation analysis revealed a significant interaction term between IP and POS (P < 0.001), indicating that POS significantly moderates the effect of IP on CC. Conclusion： Nursing education and management personnel should place greater emphasis on career planning and psychological changes among new graduate nurses. Timely implementation of necessary organizational humanistic care can strengthen new nurses' deep-seated CC, alleviate IP, and thereby enhance their capacity for PCB in new work environments. Master’s degrees proactive career behavior impostor syndrome proactive career behavior perceived organizational support moderated mediation model Figures Figure 1 Figure 2 Figure 3 1. Introduction Newly graduated registered nurses constitute a crucial human resource and serve as a primary source of nursing supply[1]. Benner[2] categorized newly graduated registered nurses as ‘advanced beginners’ who typically require three years of practice in clinical professional settings to complete the transition to becoming proficient nurses. However, numerous studies have indicated that approximately 60% of newly graduated nurses plan to resign within their first year of employment[3], while other studies suggested the percentage expected to quit during the first year of service was as high as74.4%—a proportion significantly higher than that of more experienced nurses[4].This persistent trend poses greater challenges for hospital administrators, as it may substantially exacerbate the ongoing crisis in nursing human resources, thereby posing a threat to patient safety and the provision of health services. In response to international demand for highly educated nurses, master’s-level nursing programs have been offered in mainland China since 2010. By the end of 2020, the number of registered nurses with master's degrees in China had exceeded 9417, emerging as a core force in the development of nursing undertakings[5].A previous study indicated that nurses with higher education can provide higher-quality nursing care through their critical thinking and evidence-based practice skills, thereby improving patient outcomes[6].When the number of highly educated nurses increases, patient mortality and rescue failure rates decrease[7]. However, due to the lack of continuity between clinical internships and entry into formal employment, new nurses with master's degrees are prone to role conflicts under the dual pressures of clinical skill challenges and research demands[1, 8]. In addition, factors such as inadequate preparation of new nurses with master's degrees own conditions, environmental transitions, and practical needs can lead to a series of negative feelings, including powerlessness, stress, and frustration, which reduce their proactive career behaviors[9]. Furthermore, with more career options available, new nurses with master's degrees lack job stability[10]. The high turnover rate of such positions exacerbates the problem of nursing shortages, negatively impacts the quality and safety of patient care provided, and significantly increases the operational costs of medical organizations. Proactive Career Behavior (PCB) refers to career-oriented behaviors with a proactive orientation that individuals adopt in their career development to achieve their own career goals[11]. PCB plays a significant role in the career development of new nurses with master's degrees during their standardized training period[12]. When they exhibit more PCB, they will gain more positive psychological feelings and work-related achievements, which ultimately help them achieve career success and improve the quality of medical care services[13]. Impostor phenomenon (IP) is defined as a psychological state where individuals have an insufficient perception of their own abilities and attribute their achievements to external factors such as luck[14]. It can also be referred to as self-negation of capability (SNC).Psychologists regard the SNC as a very real and specific form of self-doubt[15], which has currently attracted attention as a sub-clinical cognitive characteristic[16]. The SNC not only causes nursing staff to be afraid of expressing their ideas or making changes at work, affecting their correct self-perception and thus limiting their ability to reach their maximum potential, but also triggers anxiety and occupational burnout, seriously impacting PCB and career stability[17, 18]. Career calling (CC) is considered to an individual's strong passion for their occupation, as well as the intense sense of meaning and responsibility derived from work[19]. CC is closely associated with their PCB and feelings of occupational burnout among nurses[20, 21]. Enhancing nurses' CC helps strengthen their perception of the meaning and responsibility of their work, prompting them to exhibit positive behaviors that contribute to recovery and health outcomes of patients, thereby achieving improvements in nursing quality[22]. Perceived organizational support (POS) is defined as employees’ perception of the extent to which their organizations value their contributions and care about their well-being[23]. Researches have shown that POS positively affected job satisfaction and increased emotional attachment to the organization among nurse, as well as POS improved organizational commitment[24, 25]. A study in China found that there was a strong negative correlation between POS and turnover intention among nurses[26].Also fosters a sense of responsibility among nurses to contribute to the achievement of organizational strengths and goals, which contributes to promoting their work engagement and thereby reduces their likelihood of burnout and turnover[27]. There are numerous studies respectively investigating the status quo and influencing factors of PCB, SNC, CC or POS among nurses. However, research from the perspective of new nurses with master’s degrees is lacking. This limits clinical managers’ comprehensive understanding of career management and planning among highly educated nurses, while also impeding the professional development of highly educated clinical nurses. To date, as healthcare systems face increasing strain to meet service demands, there is a critical need to understand new nurses with master's degrees' transition experience and explore more holistic ways to attract and retain them within the nursing workforce. Various interventions in the individual and organization level is needed to retain new nurses with master's degrees[1].Therefore, the purpose of this study was to examine whether the POS moderate the mediating effect that CC has on the relationship between SNC and PCB among new nurses with master's degrees in China based on the Self-Determination theory as the theoretical framework. The findings provide a reference for promoting the career development of nurses with master's degree and improving retention rates as well as quality of nursing service, so as to stabilize nursing teams. Self-Determination theory (SDT) posits that in the process of interaction between individuals and social contexts, the satisfaction of needs for autonomy, competence, and relatedness can stimulate their intrinsic motivation, enhancing their sense of value and proactive behaviors[28]. Based on the SDT model and previous research, we proposed the following hypotheses for new nurses with master's degrees, as also presented in Figure 1: (a) PCB was negatively correlated with SNC and positively correlated with occupational mission among new nurses with master's degrees; (b) CC mediated the relationship between PCB and SNC; and (c) the strength of the mediated effect through CC varies by the varying levels of POS(Fig. 1). Research Hypotheses H1: Self-Negative Cognition (SNC) is negatively associated with Proactive Career Behavior (PCB). H2: The relationship between Self-Negative Cognition (SNC) and Perceived organizational support (POS)is mediated by Career Calling(CC). H3: Perceived organizational support (POS) moderated the mediating effect of H2. 2. Methods 2.1 Study design This is a multicenter cross-sectional study, using self-administered questionnaire to collect data on PCB, SNC, CC and POS among new nurses with master's degrees.This study followed the cross-sectional descriptive study framework outlined in the STROBE guidelines. 2.2 Participants With the method of purposive sampling, new nurses with master's degrees in 32 general hospitals in China were invited to participate in this study. Inclusion criteria were as follows: (a) being a full-time nurse with a master’s degree; (b) holding a nurse qualification certificate; (c) being engaging in clinical nursing work; and (d) having been employed in clinical nursing for three years or less. Exclusion criteria were as follows: (a) nurses who were on sick leave, maternity leave, annual leave or study outside during the investigation and (b) having a language or behavioral impairment. 2.3 Measurements 2.3.1 General demographic characteristics The general demographic information questionnaire of this study incorporated a total of 7 variables of general demographic and work-related information. The basic information included gender, age, marital status, area, nature of employment and so on. And work-­related information included department, years of service, number of adverse event per year, job satisfaction and so on. 2.3.2 Proactive Career Behavior The Proactive Career Behavior Scale (PCBS) that developed by Strauss[29] and revised by Yang[30] was used to measure proactive career behavior of new nurses with master's degrees. PCBS consists of 13 items across 4 dimensions: namely career planning behavior, career skill development behavior, career consultation behavior and networking behavior. It adopts a 7-point Likert scoring method, where scores range from 1 to 7, corresponding to ‘completely inconsistent’ to ‘completely consistent’. The total score ranges from 13 to 91, with higher scores indicating more proactive career behaviors among nurses. In this study, the Cronbach’s alpha was 0.949. 2.3.3 Impostor phenomenon Impostor phenomenon was measured with the Clance Impostor Phenomenon Scale (CIPS) developed by Clance[31], and the Chinese version was modified by Jiang et al.[32].CIPS contains 18 items, which are categorized into passive disguise dimension, external attribution dimension and self-doubt dimension. The scale asked participants to rate their impostor phenomenon due to work-related issues on a 5-point scale (1=totally inconsistent, 5=completely consistent). Total scores of 90 or higher indicate the more severe the tendency of self-capability denial. In this study, the Cronbach’s alpha was 0.974. 2.3.4 Career calling The Chinese Calling Scale (CCS), developed by Zhang[33] was used to measure career calling. The CCS comprises 10 items on 3 dimensions: orientation (4 items), altruistic contribution (3 items) and initiative (3 items). Each item is rated on a 5-point Likert scale ranging from 1 (‘totally inconsistent’) -5 (‘totally consistent’). The higher the score, the stronger the individual's sense of career calling. The reliability (Cronbach's alpha) of the CCS has been found to be 0.95[22]. In this study, the Cronbach’s alpha was 0.922 and the composite reliability was 0.923. 2.3.5 Perceived organizational support Perceived organizational support was measured using the Perceived Organizational Support Questionnaire (POSQ) developed by Zuo et al.[34].It contains two dimensions of emotional support and instrumental support, with a total of 13 items. It measured on a five-point Likert scale from 1 ‘very inconsistent’ to 5 ‘very consistent’, with high score indicating high the actual support nurses feel in the hospital. The scale has good reliability and validity, and the Cronbach's alpha coefficient of the questionnaire in this study was 0.960. 2.4 Data collection This study utilized the Questionnaire Star questionnaire for data collection. The edited questionnaire was filled into the Questionnaire Star system and checked by two people for accuracy. This study was approved by the scientific research office and nursing department of the hospital where the data was collected. It was carried out in nursing departments of 32 general hospitals in China from October 2024 to February. 2025. The first page of the questionnaire included standardized guidance instructions, specifying the purpose of the survey, the methodology employed, and the precautions to be observed during completion. Upon the conclusion of the survey, two researchers conducted a systematic review of all submitted questionnaires, promptly excluding those that failed to meet the specified criteria. Finally, 642 valid electronic questionnaires were obtained. Based on Kendall's rule for sample size determination which suggested a sample size of 5-10 times the number of independent variables, a 15% expansion was applied to account for potential sample loss, resulting in a target range of 110-220. A total of 664 questionnaires were distributed, with 642 valid responses collected, achieving a recovery rate of 96.69%. 2.5 Ethical considerations Participation in this research was voluntary and anonymous. The study was conducted in accordance with the guidelines for research involving humans following the Helsinki Declaration (World Medical Association, 2013). Ethical approval [YXLL-KY-2025(031)] was granted from the ethics committee in the first author’s institution (The First Affiliated Hospital of Shandong First Medical University) to conduct the current study. Before the investigation, the researchers explained the purpose, significance, methods, potential benefits, and risks of the study to participants in detail. Meanwhile, each participant retains the right to withdraw from the study at any time. 2.6 Statistical analysis All statistical analyses in this study were performed using R software (version 4.3.2). Descriptive statistics (frequency, percentage, standard deviation, and mean) were conducted for the demographic characteristics and primary study variables of the research subjects. Pearson correlation analyses were performed between key variables. Internal consistency for each construct was assessed using Cronbach's α, composite reliability (CR), and average variance extracted (AVE). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were conducted using the lavaan package in R. Model fit was assessed using multiple indices including χ²/df, CFI, TLI, RMSEA, and SRMR. Standardized path coefficients were reported, and the significance of indirect effects in the mediation model was tested using bootstrapping (5000 samples). Path models were created using the semPlot package. 3. Results 3.1 Descriptive statistics and univariate analysis Descriptive statistics for the general demographic characteristics of the 642 participants are presented in Table 1（at the end of the text）. Among them, 71% were female, 51% of graduate students were married or had a partner, 61% of participants had experience as student leaders, and 70% of graduate students had experienced adverse events. 80% had rotated through different departments, and 71% had experienced overtime work. Notably, 58% of new graduate nursing employees currently expressed dissatisfaction with their work status. Table 1 Descriptive statistics of General Information （ n=642) Characteristic Frequency (%) Gender Male 185 (29%) Female 457 (71%) Marriage Married 326 (51%) Unmarried 316 (49%) Student leaders YES 392 (61%) NO 250（39%） Adverse events 0 times 191 (30%) 1 time 169 (26%) 2 times 183 (29%) >2 times 99 (15%) Rotating Departments YES 513 (80%) NO 129（20%） Weekly Overtime Hours Less than 1 hour 184 (29%) 1–2 hours 186 (29%) 2–3 hours 148 (23%) More than 3 hours 124 (19%) Current job satisfaction Satisfied 270 (42%) Dissatisfied 372（58%） 3.2 Pearson correlation analysis Table 2 （Please see the attached document.）present Pearson correlation coefficients between primary variables and relevant control variables. Overall, most correlations were modest—a common finding in social science empirical research—indicating moderate associations without excessive multicollinearity, suitable for subsequent structural equation modeling. First, significant correlations were found between key independent variables and the dependent variable. SNC exhibited a moderate negative correlation with PCB ( r = -0.300, p < 0.001), indicating that individuals with stronger feelings of competence negation demonstrate weaker tendencies toward PCB. CC showed a significant positive correlation with PCB ( r = 0.511, p < 0.001), validating the crucial role of CC as a key component of positive career attitudes.POS showed weak and non-significant correlations with the core variables of CC,( r = -0.057) and PCB( r = -0.007), suggesting that the influence of POS may operate indirectly through moderating mechanisms rather than via a simple linear relationship. Table 2 Correlation Anybodylisis term M SD Gender Marriage Student leaders Adverse events Rotating Departments Weekly Overtime Hours Current job satisfaction SNC CC POS PCB Gender 1.71 0.45 1.000 Marriage 1.49 0.50 -0.042 1.000 Student leaders 1.39 0.49 -0.071 -0.007 1.000 Adverse events 2.3 1.06 0.030 0.013 0.009 1.000 Rotating Departments 1.2 0.40 -0.096 -0.066 -0.010 0.007 1.000 Weekly Overtime Hours 2.33 1.09 0.076 -0.050 -0.005 0.068 -0.027 1.000 Current job satisfaction 1.58 0.49 -0.043 -0.051 -0.019 -0.000 -0.006 -0.063 1.000 SNC 53.14 10.84 0.165 -0.018 -0.046 0.265 -0.006 0.037 -0.009 1.000 CC 32.88 5.45 -0.063 0.091 0.260 -0.030 0.027 -0.268 0.009 0.044 1.000 POS 38.47 7.20 0.025 0.072 -0.019 -0.037 -0.027 -0.004 0.005 -0.008 -0.057 1.000 PCB 42.13 7.00 -0.085 0.091 0.174 -0.116 0.022 -0.172 0.126 -0.300 0.511 -0.007 1.000 Regarding individual traits and control variables, Gender showed a small but significant positive correlation with SNC ( r = 0.165, p < 0.01), suggesting a slight difference in feelings of competence denial between men and women. Marriage showed overall low correlations with other core variables (all | r| < 0.10, and mostly non-significant), reflecting its limited influence on primary research variables. Student leaders showed a weak to moderate positive correlation with CC ( r = 0.260, p < 0.001), indicating that higher-ranking individuals often exhibit stronger professional mission, but it was less correlated with SNC and PCB. Control variables such as job rotation experience, Weekly Overtime Hours, and job satisfaction showed subtle and mostly insignificant relationships with core variables, consistent with expectations. In summary, the correlation analysis preliminarily supports the reasonable theoretical relationships among variables, laying the foundation for subsequent moderation and mediation model testing. 3.3 Model Fit Indices The structural equation model constructed in this study exhibits good fit, with specific metrics detailed in Table 3. χ² = 849.117, degrees of freedom (df) = 776, p = 0.035. Although slightly below the ideal threshold of p > 0.05, this result is acceptable given the model's complexity. The Confirmatory Fit Index (CFI) = 0.997 and Tucker-Lewis Index (TLI) = 0.996 both significantly exceed the acceptable threshold of 0.90, indicating excellent model fit. Root Mean Square Error of Approximation (RMSEA) = 0.012 and Standardized Root Mean Square Residual (SRMR) = 0.020, both substantially below the reasonable threshold of 0.08, further supporting the model's excellent fit. In summary, all model fit indices meet or exceed recommended standards, indicating the research model possesses a sound structure suitable for data interpretation and hypothesis testing. Table 3. Model Fit Indices Chi-square (χ²) Degrees of Freedom (df) pvalue CFI TLI RMSEA SRMR 849.117 776.000 0.035 0.997 0.996 0.012 0.020 Lower is better Model complexity > 0.05 (preferred) > 0.90 (acceptable) > 0.90 (acceptable) < 0.08 (reasonable) < 0.08 (reasonable) 3.4 Mediation analysis This study examined the direct and indirect effects of SNC on PCB using the structural equation model (SEM) presented in Fig. 2. As shown in the SEM results in Table 4, Career Commitment (CC) partially mediated the relationship between SNC and PCB. Direct Effect: The direct path coefficient from SNC to PCB was -0.456 (Standardized β = -0.478, p < 0.001), indicating that stronger feelings of competence denial significantly and substantially reduced nurses' tendency to engage in proactive career behavior. Mediation effect (via CC): SNC exerted a significant negative influence on CC (estimated value -0.675, standardized β = -0.741, p < 0.001), indicating that stronger feelings of competence denial were associated with weaker professional commitment among nurses. CC exerted a significant positive effect on PCB (estimate 0.543, standardized β = 0.519, p < 0.001), meaning stronger professional mission significantly promoted proactive professional behavior. Based on the above path, the indirect effect (ab) was -0.367 (standardized β = -0.385, p < 0.001), indicating that SNC indirectly inhibited proactive professional behavior by reducing professional mission. Total effect: The total effect of SNC on PCB was -0.823 (standardized β = -0.863, p < 0.001), with the mediating effect accounting for approximately 45% (-0.385 / -0.863), indicating that professional sense of mission explains a substantial portion of the mechanism through which perceived competence negation influences proactive career behavior. 3.5 Moderated mediation analysis This study examined the moderating effect of POS on the relationship between SNC and CC. Table 4, in conjunction with Fig. 3, shows that the interaction term between SNC and POS was significant (p < 0.001), indicating that POS significantly moderated the effect of SNC on CC. Specifically, simple slope tests revealed: at low POS levels (-1 standard deviation), SNC exerted the strongest and most significant negative effect on CC (Estimate = -0.673, p < 0.001); at average POS levels, the negative effect weakened (Estimate = -0.597, p < 0.001); At high levels of POS (+1 standard deviation), the negative impact of SNC on CC further diminished but remained significant (Estimate = -0.522, p < 0.001). These findings indicate that POS buffers the negative relationship between capability denial and professional sense of mission. Specifically, higher organizational support mitigates the detrimental effects of capability denial on professional sense of mission, supporting the moderation hypothesis. Table 4. Standardized Path Coefficients Path Estimate Std_Beta P_value Sig CC ← SNC -0.675 -0.741 0.000 *** PCB ← CC 0.543 0.519 0.000 *** PCB ← SNC -0.456 -0.478 0.000 *** ab -0.367 -0.385 0.000 *** total -0.823 -0.863 0.000 *** Note:ab=Indirect effects; 4. Discussion This study was the first to explore the PCB, SNC, CC and POS among new nurses with master's degrees. Through the construction of a moderated mediation model, the interaction between risk factors and protective factors is examined. This study clarifies how SNC influences the emergence of PCB by CC. Furthermore, it confirms that POS can effectively moderate the mediating path of CC. Moreover, nursing managers can leverage these research outcomes to better understand the impact of role transition during career adaptation and design tailored training systems and programs. These initiatives should aim to help graduate nurses strengthen their professional identity and value perception, and ultimately elevate the quality of clinical nursing practice. During the transition from graduate nursing students to registered newly nurses , they are confronted with multiple pressures, including high-intensity professional workload, high-expectation professional identity, and low-tolerance professional commitment[35]. Consequently, it becomes challenging for them to align their psychology and behavior with those of other nursing staff in the department. Our study findings indicate that new nurses with master's degrees should recognize the significance of the impact of SNC on their personal psychological well-being and work-related health. For nursing managers, POS and stimulating CC are crucial approaches to reducing SNC, promoting PCB, and thereby maintaining the stability of the nursing workforce. In this study, it was found that among new nurses with master's degrees, the score of PCB was relatively low (42.13±7.00), which was lower than that of general nurses in Egypt (46.02±5.85)[36]. This may be related to the gap between the reality of career development and the career expectations formed during the theoretical learning process. Notably, this may lead to a worsening negative trend in the overall mobility of the nursing workforce and a prominent exacerbation of contradictions in the talent structure. This phenomenon could be associated with the lack of a systematic clinical practice training system for graduate students in China during their academic studies. Certainly, the validity of this hypothesis remains to be further explored. In light of the above elaborations and the key variables outlined in the background, investigating the occurrence and development pathways of SNC and PCB among new nurses with master's degrees constitutes a significant highlight of this study. The PCB of newly registered nurses holds significant social and practical value for the stability of the nursing profession. Our study findings reveal that new nurses with stronger PCB demonstrate sufficient cognitive ability regarding their occupations, exhibit lower turnover intention, and experience less occupational burnout—consistent with the research on job embeddedness among new nurses[37]. Additionally, our study further finds a negative correlation between SNC and the ability for PCB (r=-0.829, P <0.01), meaning that new employees with higher SNC to have lower ability for PCB. This indicates that SNC exerts a substantial impact on PCB, which is consistent with our Hypothesis 1. To explore the underlying reasons, it is well-known that the SNC, which is a negative psychological phenomenon, exerts a significant impact on individuals' mental health and career trajectories[38], and serves as an internal barrier to career development. A growing body of evidence indicates that the SNC is relatively common among high-achieving groups such as student nurses on clinical placement[39] and clinical nurse specialists[15], particularly in environments characterized by intense competition or high expectations for "competence". A survey conducted by Scanlan[40] found that 88% of graduate nursing students experience SNC, and the incidence rate is relatively high among new nurses with master's degrees. Evidence suggests that individuals with SNC attribute their successes to luck or assistance from others rather than their own internal abilities, which impairs intrinsic motivation. This perspective is consistent with SDT. SDT emphasizes individuals' initiative and inherent tendency toward intrinsic growth. It has been found that career goals positively predict PCB and promote the early career success[28]. When new nurses with master's degrees enter the workplace, the imbalance between their own practical abilities and existing achievements leads to a decline in their intrinsic career motivation. Therefore, nursing managers should attach great importance to the SNC of new nurses with master's degrees and stimulate the emergence of their PCB. Nurses with a CC pay greater attention to the meaning, value, and responsibilities associated with their work. This not only enhances their work focus but also serves as an intrinsic driver for their career development[41]. The results of this study indicate that impostor phenomenon influences the emergence of PCB through CC, thereby confirming the validity of Hypothesis 2. In addition, our study found that SNC significantly and negatively predicts CC (r=-0.008). From the perspective of motivation activation of SDT, the enhancement of CC requires individuals to continuously invest cognitive resources to explore the in-depth meaning of their occupation. However, SNC tendency triggers defensive cognitive depletion: trapped in a persistent self-denial cycle of "I am incompetent," individuals struggle to allocate their cognitive resources to the active construction and internalization of occupational meaning. Ultimately, this leads to a decrease in the level of CC. On the other hand, this study also found that CC significantly and positively influences PCB ( r =0.511), which is consistent with the research findings of Xin et. al.[42]. As an intrinsic and in-depth psychological motivation, a strong CC is of great value for new nurses with master's degrees to successfully cope with transition shock and stimulate PCB[41]. Therefore, the SNC of new nurses with master's degrees will weaken their CC, thereby reducing their PCB. It is necessary to leverage the driving force of CC to stimulate their intrinsic recognition of professional value and perception of meaning, and enhance their work engagement[43]. In light of the above findings, it is crucial for nursing management to pay early attention to the mental health of graduate nurses and their state of PCB. To this end, it is recommended to improve new nurses with master's degrees awareness of the hazards of SNC and eliminate misunderstandings about it. Specifically, continuous stimulation and activation of the intrinsic driving force of CC should be implemented in the early stage of orientation training and the middle stage of clinical practice[42]. This not only helps improve nurses' professional adaptability and competitiveness but also promotes talent retention and development, while reducing efficiency losses caused by passive management[21]. The results also revealed that the mediating process through which SNC influences PCB via career calling is moderated by POS. This finding supports the model diagram in Figure 1 and validates Hypothesis 3. If new nurses with master's degrees exhibit a high level of SNC, their CC will also be negatively affected[41]. In such cases, if they can promptly POS and care in their work, this will indirectly moderate the negative impact of SNC on CC, thereby stimulating the emergence of proactive career behavior[43]. Conservation of Resources Theory states that employees' POS reflects the extent to which employees feel that the organization values their contributions and well-being[44]. It represents a subjective perception of organizational resources. The stronger the POS of new nurses with master's degrees, the more they tend to believe that they possess sufficient resources and are valued by the hospital. Under such circumstances, they will be more willing to proactively improve their professional competence[45]. Specifically, SNC can be regarded as a type of psychological resource loss. This loss may lead individuals to reduce or diminish their CC. Their doubts about their own abilities imply that the psychological resources invested in their profession may not yield a sense of meaning. However, POS, as a conditional resource, can supplement individuals' resource reserves[46]. Organizational support here refers to the willingness of nursing management to provide resources to alleviate the competence-related doubts of new nurses with master's degrees, thereby reducing the sense of resource loss caused by SNC and further maintaining the perception of CC. Studies have indicated that POS can significantly reduce nurses' turnover intention[27]. Therefore, we encourage and advise new nurses with master's degrees to proactively seek support from their departments and hospitals. Additionally, it is recommended that nursing managers attach importance to understanding the psychological conflicts of these new nurses with master's degrees, establish platforms for competence transformation, reconstruct the evaluation system for graduate nurses, clarify their career development paths, and foster an inclusive culture within departments. These measures will not only help this specific group of nurses build professional confidence but also enable them to realize their unique value in clinical practice and scientific research innovation so as to maintain the stability of high-quality nursing teams. Future research needs to explore the proactive career behavior pathway for new nurses, especially for the new nurses with master's degrees; to better act proactively and to recognize early warning signs of SNC risk in healthcare settings. Our study theoretically introduces vocational calling into the relationship chain between SNC tendencies and proactive career behaviors, thereby expanding the application boundaries of motivational conversion mechanisms within self-determination theory. It confirms that even when graduate-level registered nurses exhibit negative self-perceptions, individuals can still achieve behavioral shifts through the intrinsic drive of vocational calling. Simultaneously, the moderating effect of POS indicates that external environmental resources can mitigate the negative impact of self-denial, providing new evidence for career behavior research from an “individual-environment” interaction perspective. From a practical standpoint, this suggests that nursing management teams should cultivate supportive cultures by empowering new employees to enhance their competence. Simultaneously, guiding individuals to develop a sense of professional meaning can help transform self-doubt into growth momentum, ultimately fostering the sustainable development of proactive professional behavior. 5. Limitations Some limitations need to be addressed. First, although we selected new nurses with master's degrees from multi-center coastal cities in eastern China, the differences in hospital culture and system may have a certain impact on the research results. Therefore, application of convenience sampling limits the generalization of these results due to potential selection bias and the representativeness of sample. Second, we used self-administered questionnaire to collect data among new nurses with master's degrees in the previous year, some nurses may not remember exactly due to the long span of time, which may lead to recall bias. Last, our study is a cross-sectional investigation; it confines explanations of the causal relationship between PCB, SNC, CC and POS. 6. Conclusions New nurses with master's degrees is an important part of the nursing team. In addition, this study examines the impact of the SNC on PCB among new nurses with master’s degrees through a moderated mediation model of CC and POS. Given that the transition from school to hospital is a critical time, healthcare institutions should provide new nurses with master's degrees with professional skill development and career planning training to help them navigate transitional challenges. Additionally, the results may be beneficial to China and other countries, particularly developing nations in which the training and professional practice of highly educated new nurses with master's degrees remain in the early stages. Abbreviations IP Impostor phenomenon CC career calling POS perceived organizational support PCB proactive career behaviors SNC Self-Negative Cognition PCBS Proactive Career Behavior Scale CIPS Clance Impostor Phenomenon Scale CCS Chinese Calling Scale POSQ Perceived Organizational Support Questionnaire SDT Self-Determination theory Declarations Ethics approval and consent to participate This study is consistent with the Declaration of Helsinki. It has been approved by the Ethics Committee of the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital（YXLL-KY-2025(031)) and has obtained the informed consent of all researchers. Consent for publication All authors agree to its publication. Availability of data and materials The data that support the findings of this study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding There is no project support for this study. Contributions WRX: Writing – review & editing, Writing – original draft, Methodology, Conceptualization. CHWand ZJY: Writing – review & editing, Supervision, Conceptualization. XLH and LYF: Investigation, Formal analysis, Data curation. LXR: Methodology, Investigation, Data curation.YM and WQM: Investigation, Data curation, Investigation, Formal analysis. Acknowledgements We would like to thank all nurses who participants in this study. References See ECW, Koh SSL, Baladram S, Shorey S: Role transition of newly graduated nurses from nursing students to registered nurses: a qualitative systematic review. Nurse Education Today 2023, 121:105702. Benner P: From novice to expert. AJN The American Journal of Nursing 1982, 82(3):402–407. Labrague LJ, De los Santos JAA: Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross‐sectional study. Journal of nursing management 2020, 28(5):1070–1079. 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1","display":"","copyAsset":false,"role":"figure","size":71747,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eHypothetical model\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNote：Impostor phenomenon (IP) can also be referred to as self-negation of capability (SNC).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7964235/v1/2a0f918db64085d155c569dc.png"},{"id":98751671,"identity":"b79bdc5b-2111-4070-9bf4-30477c20b228","added_by":"auto","created_at":"2025-12-22 09:12:23","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":96778,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStructural equation model of PCB, CC, and SNC.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNote: CC=career calling; SNC= self-negation of capability;PCB=proactive career behavior\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7964235/v1/ecd80859fda85d3e0cf2b887.png"},{"id":98751674,"identity":"d9150442-5bab-4b29-883c-866ad5b2f23d","added_by":"auto","created_at":"2025-12-22 09:12:23","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":118810,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eModeration Effect: POSN*SNC on CC\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7964235/v1/c07f5a0e4a36fd6b731fb6dc.png"},{"id":98783530,"identity":"a87e6ec3-b9ea-47af-890a-9b0a8a6b13e0","added_by":"auto","created_at":"2025-12-22 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Introduction","content":"\u003cp\u003eNewly graduated registered nurses constitute a crucial human resource and serve as a primary source of nursing supply[1]. Benner[2] categorized newly graduated registered nurses as \u0026lsquo;advanced beginners\u0026rsquo; who typically require three years of practice in clinical professional settings to complete the transition to becoming proficient nurses. However, numerous studies have indicated that approximately 60% of newly graduated nurses plan to resign within their first year of employment[3], while other studies suggested the percentage expected to quit during the first year of service was as high as74.4%\u0026mdash;a proportion significantly higher than that of more experienced nurses[4].This persistent trend poses greater challenges for hospital administrators, as it may substantially exacerbate the ongoing crisis in nursing human resources, thereby posing a threat to patient safety and the provision of health services.\u003c/p\u003e\n\u003cp\u003eIn response to international demand for highly educated nurses, master\u0026rsquo;s-level nursing programs have been offered in mainland China since 2010. By the end of 2020, the number of registered nurses with master\u0026apos;s degrees in China had exceeded 9417, emerging as a core force in the development of nursing undertakings[5].A previous study indicated that nurses with higher education can provide higher-quality nursing care through their critical thinking and evidence-based practice skills, thereby improving patient outcomes[6].When the number of highly educated nurses increases, patient mortality and rescue failure rates decrease[7]. However, due to the lack of continuity between clinical internships and entry into formal employment, new nurses with master\u0026apos;s degrees are prone to role conflicts under the dual pressures of clinical skill challenges and research demands[1, 8]. In addition, factors such as inadequate preparation of new nurses with master\u0026apos;s degrees own conditions, environmental transitions, and practical needs can lead to a series of negative feelings, including powerlessness, stress, and frustration, which reduce their proactive career behaviors[9]. Furthermore, with more career options available, new nurses with master\u0026apos;s degrees lack job stability[10]. The high turnover rate of such positions exacerbates the problem of nursing shortages, negatively impacts the quality and safety of patient care provided, and significantly increases the operational costs of medical organizations.\u003c/p\u003e\n\u003cp\u003eProactive Career Behavior (PCB) refers to career-oriented behaviors with a proactive orientation that individuals adopt in their career development to achieve their own career goals[11]. PCB plays a significant role in the career development of new nurses with master\u0026apos;s degrees during their standardized training period[12]. When they exhibit more PCB, they will gain more positive psychological feelings and work-related achievements, which ultimately help them achieve career success and improve the quality of medical care services[13].\u003c/p\u003e\n\u003cp\u003eImpostor phenomenon (IP) is defined as a psychological state where individuals have an insufficient perception of their own abilities and attribute their achievements to external factors such as luck[14]. It can also be referred to as self-negation of capability (SNC).Psychologists regard the SNC as a very real and specific form of self-doubt[15], which has currently attracted attention as a sub-clinical cognitive characteristic[16]. The SNC not only causes nursing staff to be afraid of expressing their ideas or making changes at work, affecting their correct self-perception and thus limiting their ability to reach their maximum potential, but also triggers anxiety and occupational burnout, seriously impacting PCB and career stability[17, 18].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCareer calling (CC) is considered to an individual\u0026apos;s strong passion for their occupation, as well as \u0026nbsp;the intense sense of meaning and responsibility derived from work[19]. CC is closely associated with their PCB and feelings of occupational burnout among nurses[20, 21]. Enhancing nurses\u0026apos; CC helps strengthen their perception of the meaning and responsibility of their work, prompting them to exhibit positive behaviors that contribute to recovery and health outcomes of patients, thereby achieving improvements in nursing quality[22].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePerceived organizational support (POS) is defined as employees\u0026rsquo; perception of the extent to which their organizations value their contributions and care about their well-being[23]. Researches have shown that POS positively affected job satisfaction and increased emotional attachment to the organization among nurse, as well as POS improved organizational commitment[24, 25]. A study in China found that there was a strong negative correlation between POS and turnover intention among nurses[26].Also fosters a sense of responsibility among nurses to contribute to the achievement of organizational strengths and goals, which contributes to promoting their work engagement and thereby reduces their likelihood of burnout and turnover[27].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere are numerous studies respectively investigating the status quo and influencing factors of PCB, SNC, CC or POS among nurses. However, research from the perspective of new nurses with master\u0026rsquo;s degrees is lacking. This limits clinical managers\u0026rsquo; comprehensive understanding of career management and planning among highly educated nurses, while also impeding the professional development of highly educated clinical nurses.\u003c/p\u003e\n\u003cp\u003eTo date, as healthcare systems face increasing strain to meet service demands, there is a critical need to understand new nurses with master\u0026apos;s degrees\u0026apos; transition experience and explore more holistic ways to attract and retain them within the nursing workforce. Various interventions in the individual and organization level is needed to retain new nurses with master\u0026apos;s degrees[1].Therefore, the purpose of this study was to examine whether the POS moderate the mediating effect that CC has on the relationship between SNC and PCB among new nurses with master\u0026apos;s degrees in China based on the Self-Determination\u0026nbsp;theory as the theoretical framework. The findings provide a reference for promoting the career development of nurses with master\u0026apos;s degree and improving retention rates as well as quality of nursing service, so as to stabilize nursing teams.\u003c/p\u003e\n\u003cp\u003eSelf-Determination theory (SDT) posits that in the process of interaction between individuals and social contexts, the satisfaction of needs for autonomy, competence, and relatedness can stimulate their intrinsic motivation, enhancing their sense of value and proactive behaviors[28]. Based on the SDT model and previous research, we proposed the following hypotheses for new nurses with master\u0026apos;s degrees, as also presented in Figure 1: (a) PCB was negatively correlated with SNC and positively correlated with occupational mission among new nurses with master\u0026apos;s degrees; (b) CC mediated the relationship between PCB and SNC; and (c) the strength of the mediated effect through CC varies by the varying levels of POS(Fig. 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Hypotheses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eH1:\u0026nbsp;\u003c/strong\u003eSelf-Negative Cognition (SNC) is negatively associated with Proactive Career Behavior (PCB).\u003c/p\u003e\n\u003cp\u003eH2: The relationship between Self-Negative Cognition (SNC) and Perceived organizational support (POS)is mediated by Career Calling(CC).\u003c/p\u003e\n\u003cp\u003eH3: Perceived organizational support (POS) moderated the mediating effect of H2.\u003c/p\u003e"},{"header":"2.\tMethods","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a multicenter cross-sectional study, using self-administered questionnaire to collect data on PCB, SNC, CC and POS among new nurses with master\u0026apos;s degrees.This study followed the cross-sectional descriptive study framework outlined in the STROBE guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWith the method of purposive sampling, new nurses with master\u0026apos;s degrees in 32 general hospitals in China were invited to participate in this study. Inclusion criteria were as follows: (a) being a full-time nurse with a master\u0026rsquo;s degree; (b) holding a nurse qualification certificate; (c) being engaging in clinical nursing work; and (d) having been employed in clinical nursing for three years or less. Exclusion criteria were as follows: (a) nurses who were on sick leave, maternity leave, annual leave or study outside during the investigation and (b) having a language or behavioral impairment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Measurements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3.1 General\u003c/strong\u003e \u003cstrong\u003edemographic characteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe general demographic information questionnaire of this study incorporated a total of 7 variables of general demographic and work-related information. The basic information included gender, age, marital status, area, nature of employment and so on. And work-\u0026shy;related information included department, years of service, number of \u0026nbsp;adverse event per year, job satisfaction and so on.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3.2 Proactive Career Behavior\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Proactive Career Behavior Scale (PCBS) that developed by Strauss[29] and revised by Yang[30] was used to measure proactive career behavior of new nurses with master\u0026apos;s degrees. PCBS consists of 13 items across 4 dimensions: namely career planning behavior, career skill development behavior, career consultation behavior and networking behavior. It adopts a 7-point Likert scoring method, where scores range from 1 to 7, corresponding to \u0026lsquo;completely inconsistent\u0026rsquo; to \u0026lsquo;completely consistent\u0026rsquo;. The total score ranges from 13 to 91, with higher scores indicating more proactive career behaviors among nurses. In this study, the Cronbach\u0026rsquo;s alpha was 0.949.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3.3 Impostor phenomenon\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Impostor phenomenon was measured with the Clance Impostor Phenomenon Scale (CIPS) developed by Clance[31], and the Chinese version was modified by Jiang et al.[32].CIPS contains 18 items, which are categorized into passive disguise dimension, external attribution dimension and self-doubt dimension. The scale asked participants to rate their impostor phenomenon due to work-related issues on a 5-point scale (1=totally inconsistent, 5=completely consistent). Total scores of 90 or higher indicate the more severe the tendency of self-capability denial. In this study, the Cronbach\u0026rsquo;s alpha was 0.974.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3.4 Career calling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Chinese Calling Scale (CCS), developed by Zhang[33] was used to measure career calling. The CCS comprises 10 items on 3 dimensions: orientation (4 items), altruistic contribution (3 items) and initiative (3 items). Each item is rated on a 5-point Likert scale ranging from 1 (\u0026lsquo;totally inconsistent\u0026rsquo;) -5 (\u0026lsquo;totally consistent\u0026rsquo;). The higher the score, the stronger the individual\u0026apos;s sense of career calling. The reliability (Cronbach\u0026apos;s alpha) of the CCS has been found to be 0.95[22].\u0026nbsp;In this study, the Cronbach\u0026rsquo;s alpha was 0.922 and the composite reliability was 0.923.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3.5 Perceived organizational support\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePerceived organizational support was measured using the Perceived Organizational Support Questionnaire (POSQ) developed by Zuo et al.[34].It contains two dimensions of emotional support and instrumental support, with a total of 13 items. It measured on a five-point Likert scale from 1 \u0026lsquo;very inconsistent\u0026rsquo; to 5 \u0026lsquo;very consistent\u0026rsquo;, with high score indicating high the actual support nurses feel in the hospital. The scale has good reliability and validity, and the Cronbach\u0026apos;s alpha coefficient of the questionnaire in this study was 0.960.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Data collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study utilized the Questionnaire Star questionnaire for data collection. The edited questionnaire was filled into the Questionnaire Star system and checked by two people for accuracy. This study was approved by the scientific research office and nursing department of the hospital where the data was collected. It was carried out in nursing departments of 32 general hospitals in China from October 2024 to February. 2025. The first page of the questionnaire included standardized guidance instructions, specifying the purpose of the survey, the methodology employed, and the precautions to be observed during completion. Upon the conclusion of the survey, two researchers conducted a systematic review of all submitted questionnaires, promptly excluding those that failed to meet the specified criteria. Finally, 642 valid electronic questionnaires were obtained.\u003c/p\u003e\n\u003cp\u003eBased on Kendall\u0026apos;s rule for sample size determination which suggested a sample size of 5-10 times the number of independent variables, a 15% expansion was applied to account for potential sample loss, resulting in a target range of 110-220. A total of 664 questionnaires were distributed, with 642 valid responses collected, achieving a recovery rate of 96.69%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Ethical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipation in this research was voluntary and anonymous. The study was conducted\u0026nbsp;in\u0026nbsp;accordance\u0026nbsp;with the guidelines for research involving humans following the Helsinki Declaration (World Medical Association, 2013). Ethical approval [YXLL-KY-2025(031)] was granted from the ethics committee in the first author\u0026rsquo;s institution (The First Affiliated Hospital of Shandong First Medical University) to conduct the current study. Before the investigation, the researchers explained the purpose, significance, methods, potential benefits, and risks of the study to participants in detail. Meanwhile, each participant retains the right to withdraw from the study at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Statistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll statistical analyses in this study were performed using R software (version 4.3.2). Descriptive statistics (frequency, percentage, standard deviation, and mean) were conducted for the demographic characteristics and primary study variables of the research subjects. Pearson correlation analyses were performed between key variables. Internal consistency for each construct was assessed using Cronbach\u0026apos;s \u0026alpha;, composite reliability (CR), and average variance extracted (AVE). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were conducted using the lavaan package in R. Model fit was assessed using multiple indices including \u0026chi;\u0026sup2;/df, CFI, TLI, RMSEA, and SRMR. Standardized path coefficients were reported, and the significance of indirect effects in the mediation model was tested using bootstrapping (5000 samples). Path models were created using the semPlot package.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Descriptive statistics and univariate analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics for the general demographic characteristics of the 642 participants are presented in Table 1（at the end of the text）. Among them, 71% were female, 51% of graduate students were married or had a partner, 61% of participants had experience as student leaders, and 70% of graduate students had experienced adverse events. 80% had rotated through different departments, and 71% had experienced overtime work. Notably, 58% of new graduate nursing employees currently expressed dissatisfaction with their work status.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 Descriptive statistics of General Information\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en=642)\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"65%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e185 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e457 (71%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eMarriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e326 (51%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e316 (49%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eStudent leaders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eYES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e392 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e250（39%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eAdverse events\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0 times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e191 (30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1 time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e169 (26%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e2 times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e183 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026gt;2 times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e99 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRotating Departments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eYES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e513 (80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e129（20%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eWeekly Overtime Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eLess than 1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e184 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1\u0026ndash;2 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e186 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e2\u0026ndash;3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e148 (23%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eMore than 3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e124 (19%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eCurrent job satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eSatisfied\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e270 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eDissatisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e372（58%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Pearson correlation analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2\u0026nbsp;（Please see the attached document.）present Pearson correlation coefficients between primary variables and relevant control variables. Overall, most correlations were modest\u0026mdash;a common finding in social science empirical research\u0026mdash;indicating moderate associations without excessive multicollinearity, suitable for subsequent structural equation modeling. First, significant correlations were found between key independent variables and the dependent variable. SNC exhibited a moderate negative correlation with PCB (\u003cem\u003er\u0026nbsp;\u003c/em\u003e= -0.300, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), indicating that individuals with stronger feelings of competence negation demonstrate weaker tendencies toward PCB. CC showed a significant positive correlation with PCB (\u003cem\u003er\u003c/em\u003e = 0.511, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), validating the crucial role of CC as a key component of positive career attitudes.POS showed weak and non-significant correlations with the core variables of CC,(\u003cem\u003er\u003c/em\u003e = -0.057) and PCB(\u003cem\u003er\u0026nbsp;\u003c/em\u003e= -0.007), suggesting that the influence of POS may operate indirectly through moderating mechanisms rather than via a simple linear relationship.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Correlation Anybodylisis\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eterm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eStudent leaders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAdverse events\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRotating Departments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eWeekly Overtime Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCurrent job satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePCB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMarriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eStudent leaders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAdverse events\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRotating Departments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWeekly Overtime Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCurrent job satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e53.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e38.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePCB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eRegarding individual traits and control variables, Gender showed a small but significant positive correlation with SNC (\u003cem\u003er\u003c/em\u003e = 0.165, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01), suggesting a slight difference in feelings of competence denial between men and women. Marriage showed overall low correlations with other core variables (all |\u003cem\u003er|\u0026nbsp;\u003c/em\u003e\u0026lt; 0.10, and mostly non-significant), reflecting its limited influence on primary research variables. Student leaders showed a weak to moderate positive correlation with CC (\u003cem\u003er\u003c/em\u003e = 0.260, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), indicating that higher-ranking individuals often exhibit stronger professional mission, but it was less correlated with SNC and PCB. Control variables such as job rotation experience, Weekly Overtime Hours, and job satisfaction showed subtle and mostly insignificant relationships with core variables, consistent with expectations. In summary, the correlation analysis preliminarily supports the reasonable theoretical relationships among variables, laying the foundation for subsequent moderation and mediation model testing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Model Fit Indices\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe structural equation model constructed in this study exhibits good fit, with specific metrics detailed in Table 3. \u0026chi;\u0026sup2; = 849.117, degrees of freedom (df) = 776, p = 0.035. Although slightly below the ideal threshold of p \u0026gt; 0.05, this result is acceptable given the model\u0026apos;s complexity. The Confirmatory Fit Index (CFI) = 0.997 and Tucker-Lewis Index (TLI) = 0.996 both significantly exceed the acceptable threshold of 0.90, indicating excellent model fit. Root Mean Square Error of Approximation (RMSEA) = 0.012 and Standardized Root Mean Square Residual (SRMR) = 0.020, both substantially below the reasonable threshold of 0.08, further supporting the model\u0026apos;s excellent fit. In summary, all model fit indices meet or exceed recommended standards, indicating the research model possesses a sound structure suitable for data interpretation and hypothesis testing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Model Fit Indices\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"112%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003eChi-square (\u0026chi;\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eDegrees of Freedom (df)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003epvalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eCFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eTLI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eRMSEA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eSRMR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e849.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e776.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.996\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003eLower is better\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eModel complexity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026gt; 0.05 (preferred)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026gt; 0.90 (acceptable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026gt; 0.90 (acceptable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026lt; 0.08 (reasonable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026lt; 0.08 (reasonable)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Mediation analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study examined the direct and indirect effects of SNC on PCB using the structural equation model (SEM) presented in Fig. 2. As shown in the SEM results in Table 4, Career Commitment (CC) partially mediated the relationship between SNC and PCB. Direct Effect: The direct path coefficient from SNC to PCB was -0.456 (Standardized \u0026beta; = -0.478, p \u0026lt; 0.001), indicating that stronger feelings of competence denial significantly and substantially reduced nurses\u0026apos; tendency to engage in proactive career behavior.\u003c/p\u003e\n\u003cp\u003eMediation effect (via CC): SNC exerted a significant negative influence on CC (estimated value -0.675, standardized \u003cem\u003e\u0026beta;\u003c/em\u003e = -0.741, \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001), indicating that stronger feelings of competence denial were associated with weaker professional commitment among nurses. CC exerted a significant positive effect on PCB (estimate 0.543, standardized \u003cem\u003e\u0026beta;\u003c/em\u003e = 0.519, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), meaning stronger professional mission significantly promoted proactive professional behavior. Based on the above path, the indirect effect (ab) was -0.367 (standardized \u003cem\u003e\u0026beta;\u003c/em\u003e = -0.385, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), indicating that SNC indirectly inhibited proactive professional behavior by reducing professional mission. Total effect: The total effect of SNC on PCB was -0.823 (standardized \u003cem\u003e\u0026beta;\u003c/em\u003e = -0.863, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), with the mediating effect accounting for approximately 45% (-0.385 / -0.863), indicating that professional sense of mission explains a substantial portion of the mechanism through which perceived competence negation influences proactive career behavior.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 Moderated mediation analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study examined the moderating effect of POS on the relationship between SNC and CC. Table 4, in conjunction with Fig. 3, shows that the interaction term between SNC and POS was significant (p \u0026lt; 0.001), indicating that POS significantly moderated the effect of SNC on CC. Specifically, simple slope tests revealed: at low POS levels (-1 standard deviation), SNC exerted the strongest and most significant negative effect on CC (Estimate = -0.673,\u003cem\u003e\u0026nbsp;p\u003c/em\u003e \u0026lt; 0.001); at average POS levels, the negative effect weakened (Estimate = -0.597, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001); At high levels of POS (+1 standard deviation), the negative impact of SNC on CC further diminished but remained significant (Estimate = -0.522, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). These findings indicate that POS buffers the negative relationship between capability denial and professional sense of mission. Specifically, higher organizational support mitigates the detrimental effects of capability denial on professional sense of mission, supporting the moderation hypothesis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Standardized Path Coefficients\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003ePath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eEstimate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eStd_Beta\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003eP_value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003eSig\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003eCC \u0026larr; SNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e-0.675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003ePCB \u0026larr; CC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e0.519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003ePCB \u0026larr; SNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e-0.456\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003eab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e-0.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.385\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e-0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eNote:ab=Indirect effects;\u003c/strong\u003e\u003c/p\u003e"},{"header":"4.\tDiscussion","content":"\u003cp\u003eThis study was the first to explore the PCB, SNC, CC and POS among new nurses with master\u0026apos;s degrees. Through the construction of a moderated mediation model, the interaction between risk factors and protective factors is examined. This study clarifies how SNC influences the emergence of PCB by CC. Furthermore, it confirms that POS can effectively moderate the mediating path of CC. Moreover, nursing managers can leverage these research outcomes to better understand the impact of role transition during career adaptation and design tailored training systems and programs. These initiatives should aim to help graduate nurses strengthen their professional identity and value perception, and ultimately elevate the quality of clinical nursing practice.\u003c/p\u003e\n\u003cp\u003eDuring the transition from graduate nursing students to registered newly nurses , they are confronted with multiple pressures, including high-intensity professional workload, high-expectation professional identity, and low-tolerance professional commitment[35]. Consequently, it becomes challenging for them to align their psychology and behavior with those of other nursing staff in the department. Our study findings indicate that new nurses with master\u0026apos;s degrees should recognize the significance of the impact of SNC on their personal psychological well-being and work-related health. For nursing managers, POS and stimulating CC are crucial approaches to reducing SNC, promoting PCB, and thereby maintaining the stability of the nursing workforce. In this study, it was found that among new nurses with master\u0026apos;s degrees, the score of PCB was relatively low (42.13\u0026plusmn;7.00), which was lower than that of general nurses in Egypt (46.02\u0026plusmn;5.85)[36]. This may be related to the gap between the reality of career development and the career expectations formed during the theoretical learning process. Notably, this may lead to a worsening negative trend in the overall mobility of the nursing workforce and a prominent exacerbation of contradictions in the talent structure. This phenomenon could be associated with the lack of a systematic clinical practice training system for graduate students in China during their academic studies. Certainly, the validity of this hypothesis remains to be further explored. In light of the above elaborations and the key variables outlined in the background, investigating the occurrence and development pathways of SNC and PCB among new nurses with master\u0026apos;s degrees constitutes a significant highlight of this study.\u003c/p\u003e\n\u003cp\u003eThe PCB of newly registered nurses holds significant social and practical value for the stability of the nursing profession. Our study findings reveal that new nurses with stronger PCB demonstrate sufficient cognitive ability regarding their occupations, exhibit lower turnover intention, and experience less occupational burnout\u0026mdash;consistent with the research on job embeddedness among new nurses[37]. Additionally, our study further finds a negative correlation between SNC and the ability for PCB (r=-0.829, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.01), meaning that new employees with higher SNC to have lower ability for PCB. This indicates that SNC exerts a substantial impact on PCB, which is consistent with our Hypothesis 1. To explore the underlying reasons, it is well-known that the SNC, which is a negative psychological phenomenon, exerts a significant impact on individuals\u0026apos; mental health and career trajectories[38], and serves as an internal barrier to career development.\u003c/p\u003e\n\u003cp\u003eA growing body of evidence indicates that the SNC is relatively common among high-achieving groups such as student nurses on clinical placement[39] and clinical nurse specialists[15], particularly in environments characterized by intense competition or high expectations for \u0026quot;competence\u0026quot;. A survey conducted by Scanlan[40] found that 88% of graduate nursing students experience SNC, and the incidence rate is relatively high among new nurses with master\u0026apos;s degrees. Evidence suggests that individuals with SNC attribute their successes to luck or assistance from others rather than their own internal abilities, which impairs intrinsic motivation. This perspective is consistent with SDT. SDT emphasizes individuals\u0026apos; initiative and inherent tendency toward intrinsic growth. It has been found that career goals positively predict PCB and promote the early career success[28]. When new nurses with master\u0026apos;s degrees enter the workplace, the imbalance between their own practical abilities and existing achievements leads to a decline in their intrinsic career motivation. Therefore, nursing managers should attach great importance to the SNC of new nurses with master\u0026apos;s degrees and stimulate the emergence of their PCB.\u003c/p\u003e\n\u003cp\u003eNurses with a CC pay greater attention to the meaning, value, and responsibilities associated with their work. This not only enhances their work focus but also serves as an intrinsic driver for their career development[41]. The results of this study indicate that impostor phenomenon influences the emergence of PCB through CC, thereby confirming the validity of Hypothesis 2. In addition, our study found that SNC significantly and negatively predicts CC (r=-0.008). From the perspective of motivation activation of SDT, the enhancement of CC requires individuals to continuously invest cognitive resources to explore the in-depth meaning of their occupation. However, SNC tendency triggers defensive cognitive depletion: trapped in a persistent self-denial cycle of \u0026quot;I am incompetent,\u0026quot; individuals struggle to allocate their cognitive resources to the active construction and internalization of occupational meaning. Ultimately, this leads to a decrease in the level of CC. On the other hand, this study also found that CC significantly and positively influences PCB (\u003cem\u003er\u003c/em\u003e=0.511), which is consistent with the research findings of Xin et. al.[42]. As an intrinsic and in-depth psychological motivation, a strong CC is of great value for new nurses with master\u0026apos;s degrees to successfully cope with transition shock and stimulate PCB[41]. Therefore, the SNC of new nurses with master\u0026apos;s degrees will weaken their CC, thereby reducing their PCB. It is necessary to leverage the driving force of CC to stimulate their intrinsic recognition of professional value and perception of meaning, and enhance their work engagement[43]. In light of the above findings, it is crucial for nursing management to pay early attention to the mental health of graduate nurses and their state of PCB. To this end, it is recommended to improve new nurses with master\u0026apos;s degrees awareness of the hazards of SNC and eliminate misunderstandings about it. Specifically, continuous stimulation and activation of the intrinsic driving force of CC should be implemented in the early stage of orientation training and the middle stage of clinical practice[42]. This not only helps improve nurses\u0026apos; professional adaptability and competitiveness but also promotes talent retention and development, while reducing efficiency losses caused by passive management[21].\u003c/p\u003e\n\u003cp\u003eThe results also revealed that the mediating process through which SNC influences PCB via career calling is moderated by POS. This finding supports the model diagram in Figure 1 and validates Hypothesis 3. If new nurses with master\u0026apos;s degrees exhibit a high level of \u0026nbsp;SNC, their CC will also be negatively affected[41]. In such cases, if they can promptly POS and care in their work, this will indirectly moderate the negative impact of SNC on CC, thereby stimulating the emergence of proactive career behavior[43].\u003c/p\u003e\n\u003cp\u003eConservation of Resources Theory states that employees\u0026apos; POS reflects the extent to which employees feel that the organization values their contributions and well-being[44]. It represents a subjective perception of organizational resources. The stronger the POS of new nurses with master\u0026apos;s degrees, the more they tend to believe that they possess sufficient resources and are valued by the hospital. Under such circumstances, they will be more willing to proactively improve their professional competence[45]. Specifically, SNC can be regarded as a type of psychological resource loss. This loss may lead individuals to reduce or diminish their CC. Their doubts about their own abilities imply that the psychological resources invested in their profession may not yield a sense of meaning. However, POS, as a conditional resource, can supplement individuals\u0026apos; resource reserves[46]. Organizational support here refers to the willingness of nursing management to provide resources to alleviate the competence-related doubts of new nurses with master\u0026apos;s degrees, thereby reducing the sense of resource loss caused by SNC and further maintaining the perception of CC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudies have indicated that POS can significantly reduce nurses\u0026apos; turnover intention[27]. Therefore, we encourage and advise new nurses with master\u0026apos;s degrees to proactively seek support from their departments and hospitals. Additionally, it is recommended that nursing managers attach importance to understanding the psychological conflicts of these new nurses with master\u0026apos;s degrees, establish platforms for competence transformation, reconstruct the evaluation system for graduate nurses, clarify their career development paths, and foster an inclusive culture within departments. These measures will not only help this specific group of nurses build professional confidence but also enable them to realize their unique value in clinical practice and scientific research innovation so as to maintain the stability of high-quality nursing teams. Future research needs to explore the proactive career behavior pathway for new nurses, especially for the new nurses with master\u0026apos;s degrees; to better act proactively and to recognize early warning signs of SNC risk in healthcare settings.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur study theoretically introduces vocational calling into the relationship chain between SNC tendencies and proactive career behaviors, thereby expanding the application boundaries of motivational conversion mechanisms within self-determination theory. It confirms that even when graduate-level registered nurses exhibit negative self-perceptions, individuals can still achieve behavioral shifts through the intrinsic drive of vocational calling. Simultaneously, the moderating effect of POS indicates that external environmental resources can mitigate the negative impact of self-denial, providing new evidence for career behavior research from an \u0026ldquo;individual-environment\u0026rdquo; interaction perspective. From a practical standpoint, this suggests that nursing management teams should cultivate supportive cultures by empowering new employees to enhance their competence. Simultaneously, guiding individuals to develop a sense of professional meaning can help transform self-doubt into growth momentum, ultimately fostering the sustainable development of proactive professional behavior.\u003c/p\u003e"},{"header":"5.\tLimitations","content":"\u003cp\u003eSome limitations need to be addressed. First, although we selected new nurses with master\u0026apos;s degrees from multi-center coastal cities in eastern China, the differences in hospital culture and system may have a certain impact on the research results. Therefore, application of convenience sampling limits the generalization of these results due to potential selection bias and the representativeness of sample. Second, we used self-administered questionnaire to collect data among new nurses with master\u0026apos;s degrees in the previous year, some nurses may not remember exactly due to the long span of time, which may lead to recall bias. Last, our study is a cross-sectional investigation; it confines explanations of the causal relationship between PCB, SNC, CC and POS.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"6.\tConclusions","content":"\u003cp\u003eNew nurses with master\u0026apos;s degrees is an important part of the nursing team. In addition, this study examines the impact of the SNC on PCB among new nurses with master\u0026rsquo;s degrees through a moderated mediation model of CC and POS. Given that the transition from school to hospital is a critical time, healthcare institutions should provide new nurses with master\u0026apos;s degrees with professional skill development and career planning training to help them navigate transitional challenges. Additionally, the results may be beneficial to China and other countries, particularly developing nations in which the training and professional practice of highly educated new nurses with master\u0026apos;s degrees remain in the early stages.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIP \u0026nbsp; \u0026nbsp; \u0026nbsp;Impostor phenomenon\u003c/p\u003e\n\u003cp\u003eCC \u0026nbsp; \u0026nbsp; career calling\u003c/p\u003e\n\u003cp\u003ePOS \u0026nbsp; \u0026nbsp;perceived organizational support\u003c/p\u003e\n\u003cp\u003ePCB \u0026nbsp; \u0026nbsp;proactive career behaviors\u003c/p\u003e\n\u003cp\u003eSNC \u0026nbsp; \u0026nbsp;Self-Negative Cognition\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePCBS \u0026nbsp; Proactive Career Behavior Scale\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCIPS \u0026nbsp; Clance Impostor Phenomenon Scale \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCCS \u0026nbsp; \u0026nbsp;Chinese Calling Scale\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePOSQ \u0026nbsp; Perceived Organizational Support Questionnaire\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSDT \u0026nbsp; \u0026nbsp;Self-Determination theory \u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is consistent with the Declaration of Helsinki. It has been approved by the Ethics Committee of the First Affiliated Hospital of Shandong First Medical University \u0026amp; Shandong Provincial Qianfoshan Hospital（YXLL-KY-2025(031)) and has obtained the informed consent of all researchers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors agree to its publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no project support for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWRX: Writing\u0026nbsp;\u0026ndash;\u0026nbsp;review \u0026amp; editing, Writing\u0026nbsp;\u0026ndash;\u0026nbsp;original draft, Methodology, Conceptualization. CHWand ZJY: Writing\u0026nbsp;\u0026ndash;\u0026nbsp;review \u0026amp; editing, Supervision, Conceptualization. XLH and LYF: Investigation, Formal analysis, Data curation. LXR: Methodology, Investigation, Data curation.YM and WQM: Investigation, Data curation, Investigation, Formal analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all nurses who participants in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSee ECW, Koh SSL, Baladram S, Shorey S: Role transition of newly graduated nurses from nursing students to registered nurses: a qualitative systematic review. \u003cem\u003eNurse Education Today \u003c/em\u003e2023, 121:105702. \u003c/li\u003e\n\u003cli\u003eBenner P: From novice to expert. \u003cem\u003eAJN The American Journal of Nursing \u003c/em\u003e1982, 82(3):402\u0026ndash;407. \u003c/li\u003e\n\u003cli\u003eLabrague LJ, De los Santos JAA: Transition shock and newly graduated nurses\u0026apos; job outcomes and select patient outcomes: A cross‐sectional study. \u003cem\u003eJournal of nursing management \u003c/em\u003e2020, 28(5):1070\u0026ndash;1079. \u003c/li\u003e\n\u003cli\u003eZhang Y, Wu J, Fang Z, Zhang Y, Wong FKY: Newly graduated nurses\u0026apos; intention to leave in their first year of practice in Shanghai: A longitudinal study. \u003cem\u003eNursing outlook \u003c/em\u003e2017, 65(2):202\u0026ndash;211. \u003c/li\u003e\n\u003cli\u003eKang XF, Yang LJ, Yang HM, Ding M: The current situation of work readiness among newly hired nurse with master degree and its related factors. \u003cem\u003eJournal of nurse training \u003c/em\u003e2025, 40(10):1049\u0026ndash;1055. \u003c/li\u003e\n\u003cli\u003eAbu-Qamar MeZ, Vafeas C, Ewens B, Ghosh M, Sundin D: Postgraduate nurse education and the implications for nurse and patient outcomes: A systematic review. \u003cem\u003eNurse education today \u003c/em\u003e2020, 92:104489. \u003c/li\u003e\n\u003cli\u003eTamata AT, Mohammadnezhad M: A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. \u003cem\u003eNursing open \u003c/em\u003e2023, 10(3):1247\u0026ndash;1257. \u003c/li\u003e\n\u003cli\u003eLi XD, Zhang SY, Zhao TY, Guo Y, Le X, Li M: The mediating effect of professional self-concept between job satisfaction and turnover intention among nurses with master\u0026apos;s degree. \u003cem\u003eChinese journal of nursing \u003c/em\u003e2021, 56(07):1038\u0026ndash;1043. \u003c/li\u003e\n\u003cli\u003eMasso M, Sim J, Halcomb E, Thompson C: Practice readiness of new graduate nurses and factors influencing practice readiness: A scoping review of reviews. \u003cem\u003eInternational Journal of Nursing Studies \u003c/em\u003e2022, 129:104208. \u003c/li\u003e\n\u003cli\u003eWu J, Wang Y, Ye J, Wen H, Song X: Barriers to early career development for Chinese nurses with master\u0026rsquo;s degrees: A qualitative study. \u003cem\u003eNurse Education in Practice \u003c/em\u003e2025, 84:104339. \u003c/li\u003e\n\u003cli\u003eSeibert SE, Kraimer ML, Crant JM: What do proactive people do? 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Due to the rapid transition from theoretical student to practicing nurse roles, newly employed master's-level graduate nurses are particularly susceptible to this“high academic credentials, low self-confidence” state, which impedes professional initiative. However, the specific operational mechanisms remain unclear.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim: \u003c/strong\u003eThis study aims to examine how the mediating role of career calling(CC) and the moderating role of perceived organizational support(POS) influence the relationship between IP and proactive career behaviors(PCB) among new nurses with Master’s degrees in China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesign：\u003c/strong\u003eA secondary analysis of multicenter cross-sectional correlational survey data was conducted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods：\u003c/strong\u003eThis study employed purposive sampling to collect observational data from 642 master's-level nursing students who joined 32 hospitals nationwide. Research variables included the CIPS, PCBS, CCS,POSQ, and general demographic statistics. R software was utilized to test the hypothesized model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults：\u003c/strong\u003eParticipants exhibited moderate levels of IP (53.14 ± 10.84) and PCB (42.13 ± 7.00). Correlation analysis revealed a moderate negative correlation between SNC and PCB, while CC showed a significant positive correlation with PCB. The structural equation model demonstrated good fit (CFI=0.997, TLI=0.996). CC partially mediated the relationship between IP and PCB. The direct path coefficient from SNC to PCB was -0.456, the indirect effect was -0.367, and the total effect was -0.823. Moderation analysis revealed a significant interaction term between IP and POS (P \u0026lt; 0.001), indicating that POS significantly moderates the effect of IP on CC.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion：\u003c/strong\u003eNursing education and management personnel should place greater emphasis on career planning and psychological changes among new graduate nurses. Timely implementation of necessary organizational humanistic care can strengthen new nurses' deep-seated CC, alleviate IP, and thereby enhance their capacity for PCB in new work environments.\u003c/p\u003e","manuscriptTitle":"Association between impostor phenomenon and proactive career behavior among new nurses with Master’s degrees in China： A moderated mediation model of career calling and perceived organizational support","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 09:12:18","doi":"10.21203/rs.3.rs-7964235/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-12-12T10:37:39+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-29T08:51:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-29T07:46:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-29T07:45:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-10-28T00:02:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"37a8b1ff-c1fe-4d7d-9bb3-741afae0ec9d","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-22T09:12:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-22 09:12:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7964235","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7964235","identity":"rs-7964235","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}