Developing a valid and reliable self-efficacy in clinical performance scale

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This paper describes the development and testing of the Self-Efficacy in Clinical Performance (SECP) instrument for nursing students.


Accurate measurement of self-efficacy can be used to predict nursing students' clinical performance. The literature review indicated there is no existing self-efficacy in clinical performance instrument for Iranian nursing students.


To clarify the concept of self-efficacy in clinical performance, 28 semi-structured interviews and three focus groups were conducted. A self-efficacy framework with well-developed theoretical constructs was formed. A review of literature and content analysis of the interview transcripts identified subscales and items to be included in the instrument. Then, a methodological design was used. The SECP was developed into 69 Likert-format items, which were evaluated by 20 nursing experts in the form of content validity index. The scale's validity and reliability were tested in a randomized sample of 207 final year nursing students.


The final scale consists of four dimensions with 37 items. The overall scale internal reliability had α = 0.96; the dimensions Cronbach's α ranged from 0.90 to 0.92. Test-retest reliability with a 2-week time interval was: r = 0.94. In addition, concurrent validity was obtained (r = 0.73, P = 0.01).


The SECP has demonstrated evidence of content validity, construct validity, concurrent validity, internal consistency reliability and stability. Statistical analysis provided an objective tool for assessing nursing students' self-efficacy in clinical performance. It may have been fruitful to further test the instrument with students from other years of their education.

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