目的 探讨护生实习阶段临床决策能力与职业认同的发展轨迹及两者之间的预测关系，为提高实习护生职业认同提供理论依据。方法 便利选取12所中专以上院校护生为研究对象，对其临床决策能力及职业认同进行纵向追踪调查，使用交叉滞后模型及潜变量增长模型进行数据分析。结果 临床决策能力水平能够正向预测下一节点的职业认同。潜变量增长模型显示，实习阶段的护生临床决策能力(S=2.446，P＜0.001）呈上升趋势，职业认同（S=1.228，P＜0.001）呈上升趋势；初始水平下的临床决策能力能够正向预测职业认同（r=0.462，P=0.003），临床决策能力的初始水平能够正向预测自身（β=0.394，P=0.007）及职业认同（β=0.424，P=0.003）的发展速度，临床决策能力的发展速度能够正向预测职业认同的发展速度（β=0.450，P＜0.001）。结论 院校教师及临床带教老师应注重实习护生临床决策能力程度的评估，根据实习护生的综合能力合理分配护理工作任务，对提高实习护生职业认同有积极作用。

Objective To explore the developmental trajectories of clinical decision-making competence and professional identity during nursing internship and their predictive relationship，providing a theoretical basis for improving interns’ professional identity.Methods Nursing students from 12 secondary vocational schools and above were conveniently selected as participants.Longitudinal surveys were conducted to assess their clinical decision-making competence and professional identity.Data were analyzed using cross-lagged panel models and latent growth curve models.Results The level of clinical decision-making competence positively predicted professional identity at the subsequent time point.The latent growth curve model showed that such competence (S=2.446，P＜0.001) and professional identity (S=1.228，P＜0.001) both exhibited an increasing trend during the internship.The initial level of the competence positively predicted the initial level of professional identity (r=0.462，P=0.003).The initial level of such competence positively predicted its own growth rate (β=0.394，P=0.007) and that of professional identity (β=0.424，P=0.003).The growth rate of the competence positively predicted the growth rate of professional identity (β=0.450，P＜0.001).Conclusions Educators in academic institutions and clinical preceptors should focus on assessing the competence of nursing interns and assigning tasks reasonably based on their comprehensive abilities，which plays a positive role in enhancing professional identity.

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