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Background <p>Problem-solving is essential for healthcare professionals; nevertheless, the psychological mechanisms influencing it in educational settings remain insufficiently examined. Guided by an integrated framework combining Cognitive Load Theory, Self-Determination Theory, and Professional Identity Formation, this study examined how self-esteem and anxiety interact to influence problem-solving, anticipating systematic variations across programs and gender.</p> Methods <p>This cross-sectional study included 513 participants (397 medical and 116 dental students) who completed validated instruments: the Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Problem-Solving Inventory. Structural equation modeling assessed direct and indirect relationships among the constructs, and multigroup comparisons, mediation and moderation analyses tested differences between medical and dental students as well as by gender.</p> Results <p>Self-esteem significantly predicted problem-solving ability (β = 0.50, <i>p</i> &lt; 0.001). Multigroup analyses revealed significant differences between medical and dental students, with dental students showing stronger direct self-esteem effects (β = 0.41 vs. β = 0.34, <i>p</i> &lt; 0.05). Trait anxiety partially mediated the self-esteem–problem-solving relationship (β = 0.16, <i>p</i> &lt; 0.001), whereas state anxiety did not demonstrate significant mediation (β = 0.08, <i>p</i> = 0.062). A serial mediation pathway was identified wherein self-esteem influenced problem-solving through sequential effects on state anxiety and trait anxiety (β = 0.07, <i>p</i> &lt; 0.001), with total indirect effects accounting for 38.9% of the self-esteem effect on problem-solving. Gender comparisons revealed no statistically significant differences in structural paths (all <i>p</i> &gt; 0.216), though males showed numerically larger direct self-esteem effects (β = 0.41 vs. β = 0.33), while females exhibited significant state anxiety effects not observed in males.</p> Conclusions <p>Psychological mechanisms involving self-esteem and anxiety, both directly and through mediation pathways, shape the problem-solving abilities of healthcare students. These relationships differ between medical and dental students, underscoring the need for program-specific educational strategies. Theory-informed interventions that integrate self-esteem enhancement with anxiety management, grounded in cognitive load and motivational principles, may strengthen professional problem-solving among future healthcare practitioners.</p>

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Problem-solving capabilities in healthcare education: a multigroup analysis of psychological factors in medical and dental students

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月17日

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  • Gökçe İşcan,
  • Osman Gurdal

摘要

Background

Problem-solving is essential for healthcare professionals; nevertheless, the psychological mechanisms influencing it in educational settings remain insufficiently examined. Guided by an integrated framework combining Cognitive Load Theory, Self-Determination Theory, and Professional Identity Formation, this study examined how self-esteem and anxiety interact to influence problem-solving, anticipating systematic variations across programs and gender.

Methods

This cross-sectional study included 513 participants (397 medical and 116 dental students) who completed validated instruments: the Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Problem-Solving Inventory. Structural equation modeling assessed direct and indirect relationships among the constructs, and multigroup comparisons, mediation and moderation analyses tested differences between medical and dental students as well as by gender.

Results

Self-esteem significantly predicted problem-solving ability (β = 0.50, p < 0.001). Multigroup analyses revealed significant differences between medical and dental students, with dental students showing stronger direct self-esteem effects (β = 0.41 vs. β = 0.34, p < 0.05). Trait anxiety partially mediated the self-esteem–problem-solving relationship (β = 0.16, p < 0.001), whereas state anxiety did not demonstrate significant mediation (β = 0.08, p = 0.062). A serial mediation pathway was identified wherein self-esteem influenced problem-solving through sequential effects on state anxiety and trait anxiety (β = 0.07, p < 0.001), with total indirect effects accounting for 38.9% of the self-esteem effect on problem-solving. Gender comparisons revealed no statistically significant differences in structural paths (all p > 0.216), though males showed numerically larger direct self-esteem effects (β = 0.41 vs. β = 0.33), while females exhibited significant state anxiety effects not observed in males.

Conclusions

Psychological mechanisms involving self-esteem and anxiety, both directly and through mediation pathways, shape the problem-solving abilities of healthcare students. These relationships differ between medical and dental students, underscoring the need for program-specific educational strategies. Theory-informed interventions that integrate self-esteem enhancement with anxiety management, grounded in cognitive load and motivational principles, may strengthen professional problem-solving among future healthcare practitioners.