A Psychometric Evaluation of the Modified Self-Efficacy in Clinical Performance Scale with Undergraduate Nursing Students Across Year Levels: A Cross-Sectional Study

Abstract

Self-efficacy in clinical performance reflects nursing students’ confidence in their ability to perform clinical activities and is an important contributor to competence and confidence at graduation. Understanding and evaluating this construct requires valid and reliable instruments that can be used across different stages of a nursing degree. Using a cross-sectional design, Year 1, 2 and 3 students enrolled in a three-year undergraduate nursing programme completed a Modified Self-Efficacy in Clinical Performance Scale. Content validity was investigated through nurse education expert review, construct validity through known-group comparisons and confirmatory factor analysis, and convergent validity and internal consistency using correlation measures, Cronbach’s alpha and McDonald’s omega. An analysis of 512 surveys demonstrated expected differences between known groups, including students with and without clinical placement experience. A revised four-factor model demonstrated acceptable but not unequivocally strong structural validity (CMIN/df = 4.84). Scores were strongly correlated with visual analogue self-efficacy ratings (r = 0.77, p < 0.001). Internal consistency was acceptable (Cronbach’s alpha = 0.98, McDonald’s omega = 0.98). The Modified Self-Efficacy in Clinical Performance Scale demonstrated promising validity and strong internal consistency for assessing clinical performance self-efficacy among nursing students in this sample and may facilitate the evaluation of curricular initiatives. Further cross-institutional, cross-cultural and longitudinal research should be conducted to test its performance.