The relationship between cognitive flexibility and decision-making styles of midwifery and nursing students

BMC Med Educ. 2026 Feb 18;26(1):410. doi: 10.1186/s12909-026-08734-6.

Abstract

Objective: This study was conducted to examine the relationship between midwifery and nursing students' cognitive flexibility levels and their decision-making styles.

Method: This descriptive study included 320 students enrolled in the midwifery and nursing departments at Lokman Hekim University in Ankara between February and June 2025. The study was completed with 302 students who were present at school on the day the data was collected and agreed to participate in the study. Data were collected using the “Personal Information Form,” “Cognitive Flexibility Inventory,” and “Melbourne Decision Making Scale I-II.” In addition to descriptive statistics, Pearson correlation and linear regression analyses were used in the analysis of the data.

Results: tudents' levels of cognitive flexibility were found to be high; careful decision-making was determined to be the most frequently used decision-making style. A positive and significant relationship was found between cognitive flexibility and self-esteem in decision-making (r = 0.540) and careful decision-making (r = 0.559), while negative and significant relationships were determined with avoidant, procrastinating, and panicked decision-making styles (p < 0.01). Regression analyses revealed that cognitive flexibility showed significant relationships with self-esteem in decision-making (R2 = 0.289) and careful decision-making styles (R2 = 0.311).

Conclusion: Students with high cognitive flexibility were found to prefer more careful and self-esteem-based decision-making styles and to avoid negative decision strategies. The findings indicate the importance of supporting cognitive flexibility in developing decision-making skills among students studying in the health field.

Keywords: Cognitive flexibility; Decision-making style; Midwifery; Nursing students; Self-esteem.