• Prof. Dr. Fatma A. Hegazy Department of Physiotherapy, College of Health Sciences, University of Sharjah, UAE Faculty of Physical Therapy, Cairo University


Knowledge, academic skills, students’ lack of interest, confidence, teaching skills, difficulty in clinical practices, experiential learning theory


Background and Aims: This research aims to investigate the relationship between knowledge (K) and difficulty of clinical practices (DCP) while exploring the potential mediating factors of academic skills (AS), confidence (C), students’ lack of interest (SLI), and teaching skills (TS). Clinical practices are vital for educating and training healthcare professionals, and understanding the factors contributing to difficulty during these practices is crucial for improving educational outcomes.

Methodology: The study adopted a quantitative technique, collecting data from a sample of healthcare students through surveys and assessments. Statistical analyses, including mediation analysis, were conducted to examine the relationships between the variables of interest. 

Results: All four mediators significantly impacted the relationship between Knowledge and Difficulty in Clinical Practices.

Limitations: The study is limited to healthcare students. The sample size of the article is limited due to time constraints, and it is not necessarily important that only mentioned mediators cofound between AS and K.

Originality: The mediators significantly impact the originality of the article, which will generate a scholarly contribution to the community.

Conclusion: The implications of these findings suggest the need for educators and policymakers to focus on enhancing academic skills, fostering confidence, addressing students’ lack of interest, and improving teaching practices. 


Hussein MH, Osuji J. Bridging the theory-practice dichotomy in nursing: The role of nurse educators. J. Nurs. Educ. Pract. 2017;7(3):20-5.

Rubertone PP, Nixon-Cave K, Wellmon R. Influence of Clinical Instructor Experience on Assessing Doctor of Physical Therapist Student Clinical Performance: A Mixed-Methods Study. Journal of Physical Therapy Education. 2022 Mar 1;36(1):25-33.

İlçin N, Tomruk M, Yeşilyaprak SS, Karadibak D, Savcı S. The relationship between learning styles and academic performance in TURKISH physiotherapy students. BMC medical education. 2018 Dec;18(1):1-8.

Twose P, Jones U, Cornell G. Minimum standards of clinical practice for physiotherapists working in critical care settings in the United Kingdom: a modified Delphi technique. Journal of the Intensive Care Society. 2019 May;20(2):118-31.

Günay U, Kılınç G. The transfer of theoretical knowledge to clinical practice by nursing students and the difficulties they experience: A qualitative study. Nurse education today. 2018 Jun 1;65:81-6.

Shakeri K, Fallahi-Khoshknab M, Khankeh H, Hosseini M, Heidari M. Knowledge, attitude, and clinical skill of emergency medical technicians from Tehran emergency center in trauma exposure. International journal of critical illness and injury science. 2018 Oct;8(4):188.

Henseler J. Ringle, CM & Sinkovics, RR (2009). The use of partial least squares path modeling in international marketing. Advances in International Marketing.;20:277-319.

F. Hair Jr J, Sarstedt M, Hopkins L, G. Kuppelwieser V. Partial least squares structural equation modeling (PLS-SEM) An emerging tool in business research. European business review. 2014 Mar 4;26(2):106-21.

Hasan Z, Naeem M, Ahmed S, Zeerak S. Impact of Strategic Ambiguity Tagline on Billboard Advertising on Consumers Attention. Market Forces. 2022 Jun 26;17(1):163-84.

Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. Journal of marketing research. 1981 Feb;18(1):39-50.

Moor CC, Oppenheimer JC, Nakshbandi G, Aerts JG, Brinkman P, Maitland-van der Zee AH, Wijsenbeek MS. Exhaled breath analysis by use of eNose technology: a novel diagnostic tool for interstitial lung disease. European Respiratory Journal. 2021 Jan 1;57(1).

Marsh HW, Guo J, Dicke T, Parker PD, Craven RG. Confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), and set-ESEM: Optimal balance between goodness of fit and parsimony. Multivariate behavioral research. 2020 Jan 2;55(1):102-19.

O’brien RM. A caution regarding rules of thumb for variance inflation factors. Quality & quantity. 2007 Oct;41:673-90.

Shi D, Maydeu-Olivares A, Rosseel Y. Assessing fit in ordinal factor analysis models: SRMR vs. RMSEA. Structural Equation Modeling: A Multidisciplinary Journal. 2020 Jan 2;27(1):1-5.

Zhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC medical education. 2020 Dec;20:1-0.

Palopo, i., 2022. Factor analysis of students' lack of interest in online English learning of SMKN 1 luwu timur during the covid-19 pandemic.

Fischer H, Amelung D, Said N. The accuracy of German citizens’ confidence in their climate change knowledge. Nature Climate Change. 2019 Oct;9(10):776-80.

Ulenaers D, Grosemans J, Schrooten W, Bergs J. Clinical placement experience of nursing students during the COVID-19 pandemic: A cross-sectional study. Nurse education today. 2021 Apr 1;99:104746.

Toufic J. What Was I Thinking?. Berlin: Sternberg Press; 2017 Sep 8.

Maydeu-Olivares A, Shi D, Rosseel Y. Assessing fit in structural equation models: A Monte-Carlo evaluation of RMSEA versus SRMR confidence intervals and tests of close fit. Structural Equation Modeling: A Multidisciplinary Journal. 2018 May 4;25(3):389-402.

Aloisio, L.D., Gifford, W.A., McGilton, K.S., Lalonde, M., Estabrooks, C.A. and Squires, J.E., 2018. Individual and organizational predictors of allied healthcare providers’ job satisfaction in residential long-term care. BMC health services research, 18, pp.1-18.

Polanin JR, Espelage DL, Grotpeter JK, Spinney E, Ingram KM, Valido A, El Sheikh A, Torgal C, Robinson L. A meta-analysis of longitudinal partial correlations between school violence and mental health, school performance, and criminal or delinquent acts. Psychological bulletin. 2021 Feb;147(2):115.

Wang Y, Duan Z, Ma Z, Mao Y, Li X, Wilson A, Qin H, Ou J, Peng K, Zhou F, Li C. Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Translational psychiatry. 2020 Jul 31;10(1):263.

Senaviratna NA, A Cooray TM. Diagnosing multicollinearity of logistic regression model. Asian Journal of Probability and Statistics. 2019 Oct 1;5(2):1-9.

Cheung GW, Wang C. Current approaches for assessing convergent and discriminant validity with SEM: Issues and solutions. InAcademy of management proceedings 2017 (Vol. 2017, No. 1, p. 12706). Briarcliff Manor, NY 10510: Academy of Management.

Fusar-Poli P, Sullivan SA, Shah JL, Uhlhaas PJ. Improving the detection of individuals at clinical risk for psychosis in the community, primary and secondary care: an integrated evidence-based approach. Frontiers in psychiatry. 2019 Oct 24;10:774.




How to Cite

Hegazy, P. D. F. A. (2023). UNRAVELLING THE INFLUENCE OF MEDIATING FACTORS ON THE RELATIONSHIP BETWEEN KNOWLEDGE AND DIFFICULTY IN CLINICAL PRACTICES. Pakistan Journal of Rehabilitation, 12(2). Retrieved from http://ojs.zu.edu.pk/ojs/index.php/pjr/article/view/13-23

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.