Occupational anxiety, workplace risk attitudes, and clinical learning safety climate among nursing students: a path analysis

Abstract Occupational anxiety may influence nursing students’ engagement with workplace risks and shape how they perceive safety within clinical learning environments. Understanding these relationships may help inform curricular and placement-based strategies that support both student learning and patient safety. This analytical cross-sectional study was conducted among 591 undergraduate nursing students at Gaziantep University, Türkiye, between April and June 2025. Data were collected using the occupational anxiety scale for healthcare students (OAS-HS), the nurses’ attitudes toward workplace risks scale (NATWRS), and the safety climate questionnaire (SCQ). Internal consistency was high for the three total scales (Cronbach’s α = 0.94–0.97). Independent-samples t tests and one-way ANOVA with Bonferroni correction were used to examine group differences (Welch and Games–Howell procedures where variances were heterogeneous). Path analysis was performed using AMOS 29.0 to model associations among occupational anxiety, attitudes toward workplace risks, and perceptions of the clinical learning safety climate. Participants reported moderate-to-high occupational anxiety (69.6 ± 17.3), generally positive attitudes toward workplace risks (144.5 ± 22.5), and moderately favorable perceptions of the clinical learning safety climate (71.9 ± 11.3). Occupational anxiety was significantly higher among female students, Turkish students, and those with a grade point average of 2.00 or above (all p < 0.001). More positive attitudes toward workplace risks were observed among male students and international students ( p = 0.029 and p = 0.011, respectively). Students who reported no trust in healthcare institutions or inadequate knowledge of occupational risks had higher anxiety and less favorable safety climate perceptions ( p < 0.001). In the path model, more positive attitudes toward workplace risks were associated with more favorable safety climate perceptions (standardized β = 0.52, p < 0.001), explaining 27% of the variance. Occupational anxiety was not significantly associated with safety climate perceptions, either directly (β < 0.001, p = 0.997) or indirectly through attitudes toward workplace risks. Nursing students’ perceptions of safety in clinical learning environments appear to be more closely related to their attitudes toward workplace risks than to their occupational anxiety. Educational strategies that strengthen risk management content, improve the quality and psychological safety of clinical placements, and support professional motivation may help foster a more positive safety climate. Additional support may be warranted for student subgroups reporting higher anxiety or less favorable risk attitudes.