Critical Thinking and Ethical Decision-Making among Nursing Interns

BackgroundEthical decision-making is a core competency for nursing interns, supported by critical thinking as a central cognitive skill. However, the mechanisms linking these constructs remain unclear. This study examined the influence of critical thinking on ethical decision-making and the chain mediating roles of ethical sensitivity and sense of power. MethodsA cross-sectional study was conducted from December 2024 to June 2025 among 429 nursing interns at a tertiary hospital in Zhejiang Province, using validated scales and structural equation modeling. ResultsCritical thinking, ethical sensitivity, sense of power, and ethical decision-making were positively correlated (P < 0.01). Ethical sensitivity and sense of power each mediated, and jointly serially mediated, the relationship between critical thinking and ethical decision-making. ConclusionCritical thinking enhances nursing interns ethical decision-making through ethical sensitivity and sense of power. Strengthening these factors in education may better translate cognition into ethical action.