Friends, Family and Government Support Drive Nursing Students’ Startup Ambitions

Nursing students in South Korea are far more likely to dream of launching their own healthcare ventures when their friends and families cheer them on and when they believe the government stands behind them, according to a new cross-sectional study published in Nursing Open. The research, which surveyed 205 undergraduate nursing students using a socio-ecological framework, found that the social and policy environment surrounding a student matters far more than the psychological traits traditionally associated with entrepreneurship. In a profession where fewer than one percent of nurses worldwide engage in entrepreneurial activity, the findings offer a roadmap for how educators and policymakers might unlock an untapped reservoir of healthcare innovation.

The study comes at a moment when healthcare systems worldwide are shifting from hospital-centered models toward community-oriented, diversified and technology-driven care. That transformation demands professionals skilled not only in clinical practice but also in organizational management, data analysis and financial administration. Yet a recent scoping review found that healthcare education frequently neglects entrepreneurial mindsets and the ability to generate healthcare-specific business models. Meanwhile, longitudinal evidence suggests entrepreneurial intention among healthcare students rises substantially over time, from 13 percent at graduation to 25.8 percent within five years, hinting that early seeds of ambition can flourish if properly cultivated.

To capture the full complexity of what shapes a student’s decision to pursue entrepreneurship, the research team, led by investigators at Yonsei University, applied the socio-ecological model originally proposed by McLeroy and colleagues in 1988. This framework organizes influences on behavior into nested levels: individual traits such as self-efficacy and risk tolerance, interpersonal forces like family and peers, organizational factors including school-based education and support, and policy-level conditions such as the national economy and government programs. Most prior studies have examined these factors in isolation, focusing narrowly on individual psychology. By measuring all four levels simultaneously, the Korean team could determine which influences retain their explanatory power when the others are taken into account.

Data were collected in August 2024 through an online survey distributed via closed nursing student communities. The researchers translated and culturally adapted validated instruments from English into Korean using forward-backward translation, then confirmed their psychometric properties with confirmatory factor analysis, removing items with standardized factor loadings below 0.40. Entrepreneurial intention was measured with a refined four-item version of the Entrepreneurial Intention Questionnaire, rated on a seven-point scale, with items such as whether the student has a strong determination to start a business in the future. The final scales showed strong internal consistency, with Cronbach’s alpha values ranging from 0.66 to 0.94 across constructs.

The results revealed a strikingly low baseline of entrepreneurial ambition. The mean entrepreneurial intention score was 12.77 out of a possible 28, corresponding to an item-level mean of 3.19 on the seven-point scale, below the scale midpoint of 4.00. That figure is lower than those reported in comparable studies of MBA students in China and Italian university samples, although the authors caution that differences in instrument versions and participant characteristics make direct comparisons imprecise. The relatively low score may reflect Korean nursing students’ strong orientation toward stable hospital-based employment and their limited exposure to examples of nurse-led entrepreneurship. Only 2.4 percent of participants had any prior start-up experience, even though 77.6 percent had work experience of some kind.

When the researchers ran a multiple linear regression with all ten explanatory variables entered simultaneously, the model explained 45 percent of the variance in entrepreneurial intention, a substantial proportion for research in this field. The standout predictor was peer influence, which carried a standardized beta of 0.39 and a medium effect size. Family influence followed with a beta of 0.22, and perceived government entrepreneurial support came third at 0.26. In sharp contrast, the classic individual-level traits of entrepreneurial self-efficacy, internal locus of control and risk-taking propensity all lost statistical significance once the social and structural variables were accounted for. School-based entrepreneurial education and institutional support likewise failed to reach significance in the adjusted model.

The dominance of peer influence aligns with a growing body of international evidence. Previous surveys of engineering students have linked peer influence to entrepreneurial attitudes, perceived behavioral control and social norms, and other research has shown that peers who actively promote entrepreneurship can amplify the relationship between creativity and intention. Scholars have identified two mechanisms at work: information and approval. Through information channels, peers share informal advice that refines business ideas, expands knowledge and reduces uncertainty. Through approval channels, positive peer attitudes provide social endorsement that reinforces commitment. Because nursing education is inherently collaborative, built on clinical practice groups and team-based learning, these peer effects may be especially amplified among nursing undergraduates, suggesting that peer mentoring and student-led idea-sharing sessions could be powerful levers for change.

Family emerged as the second interpersonal force, a finding that carries particular weight in collectivist societies like Korea, where familial expectations strongly shape career trajectories. International studies have consistently shown that family support and family business backgrounds enhance students’ entrepreneurial knowledge and confidence. The authors suggest that nursing entrepreneurship education in such contexts should actively incorporate family engagement, through informational sessions or discussions that frame entrepreneurial pursuits as consistent with collectivist values and community benefit, rather than as risky departures from respectable career paths.

Perhaps the most counterintuitive finding concerned the national economy. Students who perceived the economic situation more favorably reported lower entrepreneurial intention, with a significant negative beta of -0.17 after adjustment. This inverts the traditional assumption that prosperous conditions stimulate entrepreneurship. The explanation lies in labor market dynamics: robust economies with abundant job opportunities can actually suppress entrepreneurial ambition, because young people prioritize secure employment over entrepreneurial risk. In Korea, where competition for stable positions in established sectors like healthcare is intense and cultural preferences favor secure roles, this effect appears amplified. Meanwhile, perceived government support, including familiarity with policies such as entrepreneurship courses, academies, start-up funding and incubation programs, was positively associated with intention, echoing evidence that entrepreneurial ecosystems enhance students’ perceived feasibility of starting a venture. Notably, awareness of Korea’s existing support infrastructure, including the Ministry of SMEs and Start-ups and special venture business legislation, remains low among young adults, pointing to a communication gap that universities could help close.

The study’s authors emphasize that their findings do not render individual traits or school programs irrelevant; rather, the contributions of these factors appear attenuated when the surrounding social and policy context is considered. They call for multilevel strategies: nursing schools should implement team-based innovation projects and peer mentoring, engage families in conversations about the professional value of nurse-led ventures, and tie entrepreneurship curricula explicitly to clinical innovation, digital health and community-based care rather than generic business concepts. Policymakers and educators should jointly publicize funding, mentoring and incubation opportunities. The team acknowledges limitations, including the cross-sectional design, convenience sampling through online communities that may have attracted digitally engaged or entrepreneurship-curious students, and the absence of pilot testing for the translated instruments. Still, the core message is clear: if health systems want nurses to invent the future of care, they must build social circles and policy environments that make entrepreneurship feel not just possible, but expected.

Subject of Research: Factors associated with entrepreneurial intention among undergraduate nursing students in South Korea, analyzed with a socio-ecological model

Article Title: Factors Associated With Entrepreneurial Intention Among Nursing Students: A Cross‐Sectional Study Using a Socio‐Ecological Model

Article References: Lim, J. Y., Noh, W., Vohidova, M., & Lee, A. (2026). Factors Associated With Entrepreneurial Intention Among Nursing Students: A Cross‐Sectional Study Using a Socio‐Ecological Model. Nursing Open, 13(10), Article e70870. https://doi.org/10.1002/nop2.70870

Image Credits: AI Generated

DOI: 10.1002/nop2.70870

Keywords: nursing students, entrepreneurial intention, socio-ecological model, South Korea, peer influence, family influence, government support, healthcare innovation, nursing education, cross-sectional study, self-efficacy, start-up