The ‘Digital Phantom Limb’ Phenomenon and Bedside Clinical Competency among Nursing Students at Kaduna State College of Nursing Sciences, Kafanchan Campus: A Descriptive Study

Abstract

Background: The pervasive integration of smartphones into nursing education has given rise to a phenomenon termed the “digital phantom limb”—a psychological and tactile dependence on the device characterised by phantom vibrations, compulsive checking urges, and separation anxiety. While nomophobia and smartphone addiction are widely documented, no prior study has examined this specific construct as a form of smartphone-dependent learning or its empirical relationship with multidimensional bedside clinical competence. Objective: This study aimed to (1) quantify the prevalence and intensity of the digital phantom limb phenomenon, (2) determine the level of bedside clinical competency, and (3) examine the direction and strength of the relationship between the two among nursing students at Kaduna State College of Nursing Sciences, Kafancan Campus, Nigeria. Methods: A descriptive correlational design was employed. A total of 162 ND I and ND II nursing students were recruited via proportionate stratified random sampling from a population of 283. Smartphone-dependent learning was measured using the Smartphone Addiction Scale–Short Version (SAS-SV; Kwon et al., 2013). Bedside clinical competency was assessed via self‑report using the adapted Clinical Competency Questionnaire (CCQ‑N), which evaluates physical assessment, procedural accuracy, clinical decision‑making, and documentation. Results: The digital phantom limb phenomenon was highly prevalent, with 61.8% of students scoring above the gender-specific SAS-SV threshold. The mean SAS-SV score was 32.42 (SD = 9.84). Overall clinical competency was moderate (M = 128.73, SD = 24.56), with the lowest ratings in advanced clinical decision-making (59.2% of maximum). A statistically significant, moderate negative correlation was found between the digital phantom limb score and total clinical competency (r = -0.47, p < 0.001). Regression analysis revealed that smartphone-dependent learning independently accounted for 22.1% of the variance in bedside clinical competency (R² = 0.221, β = -0.47, p < 0.001). Conclusion: The digital phantom limb phenomenon is endemic among nursing students and is inversely associated with self‑reported clinical competence, particularly in the domain of clinical decision‑making. These findings, based on self‑reported competency, provide robust evidence for integrating digital wellness interventions into nursing curricula to safeguard patient safety and enhance bedside care. Future research should incorporate objective competency assessments-including Objective Structured Clinical Examinations (OSCEs), preceptor evaluations, and direct clinical observation-to validate the observed associations and establish the magnitude of the relationship with actual patient care performance.