The Relationship Between Transition Shock and Nursing Informatics Competency in Nursing Interns: A Moderated Mediation Model of Psychological Empowerment and Teaching Hospital Grade.

BACKGROUND: From academic study at school to clinical practice, changes in the environment, social role, and learning objectives can lead student nurses to experience varying degrees of transition shock. In today's digitally driven healthcare environment, where information literacy is a core competency, this transition shock may seriously hinder interns' nursing informatics competency. However, the exact mechanism by which transition shock impacts the interns' nursing informatics competency remains underexplored. AIM: To explore the effects of transition shock on the nursing informatics competency of interns, as well as the roles of psychological empowerment and teaching hospital grade. METHODS: A total of 450 participants were recruited from an undergraduate medical college and a health vocational college in Anhui Province, eastern China, between October and December 2025 in this cross-sectional study. Data collection instruments included the General Information Questionnaire, the Nursing Informatics Competency Scale for Undergraduate Nursing Students, the Psychological Empowerment Scale, and the Clinical Practicum Transition Shock Scale. Moderated mediation analysis was performed using the PROCESS Macro for SPSS 26.0. RESULTS: A total of 435 valid questionnaires were included in this study. Participants' nursing informatics competency was moderate to high. Transition shock did not directly affect interns' nursing informatics competency (β = -0.014, p > 0.05). However, psychological empowerment played a complete mediating role between transition shock and nursing informatics competency (95% CI: -0.275, -0.152), with a mediating effect size of -0.211. Moreover, teaching hospital grade played a moderating role in the first half of the aforementioned mediation model pathway (β = 0.354, t = 2.783, p < 0.01). Specifically, the mediating effect of psychological empowerment in this pathway was significant for nursing interns in both tertiary-A hospitals (effect value = -0.153, p < 0.001) and non-tertiary-A hospitals (effect value = -0.332, p < 0.001). CONCLUSIONS: Psychological empowerment fully mediates the impact of transition shock on nursing informatics competency among interns. Tertiary-A hospitals mitigate the negative effects of transition shock on psychological empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should prioritize psychological empowerment interventions for nursing interns, particularly in non-tertiary-A hospitals, to counteract the indirect negative association between transition shock and nursing informatics competency.