DOI Number: 10.5958/0976-5506.2017.00145.

Evaluating the Relationship between Clinical Competence

and Clinical Self-efficacy of Nursing Students in Kermanshah
University of Medical Sciences

Yahya Safari1, Nasrin Yoosefpour1

Department of Radiology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
1

ABSTRACT

The aim of study was determining the rate of relationship between clinical competence and clinical self-
efficacy of nursing students in Kermanshah University of medical sciences in 2016. The study has done with
descriptive-analytical method of correlation. 80 people have selected by the simple random sampling. The
data collection tool was standard questionnaire of clinical competence evaluation and Sherer self-efficacy.
The data have analyzed by the Pearson (r) correlation coefficient test. The results have showed that there was
a positive and significant relation between the patients assisting competency (p=0.03, r=0.15), the care self-
efficacy (p=0.04, r=0.13), the legal and moral performance self-efficacy (p=0.003, r=0.21) and the students
competence. In addition, there was a positive and significant relation between the professional development
self-efficacy (p=0.004, r=0.19), the patients safety, security and comfort (p=0.00, r=0.22) and the leadership
and managing self-efficacy (p=0.00, r=0.26), the cooperation with the treatment teams members competence
(p=0.02, r=0.12) and the students efficiency. According to the relation between evaluated variables the self-
efficacy have suggested for improving the clinical competence and as a results improvement of the students
clinical performance.

Keywords: Clinical competence, Clinical Efficiency, Medical sciences, university’s students.

INTRODUCTION employment have caused the above facts too.4, 5 The

Nurses are the largest section, which present the
health, treatment services and have an important role in
cognition of care, and services fulfilling, which these,
have require their self-efficacy.1 The working self-
efficacy in order to maintaining the power and authority
for nursing activities have a significant importance.
2
Self-efficacy have complicated and ambiguous
concepts. Despite of this, there are many ambiguous and
confusions for understanding this concept. 3
Increasing the expectation for receiving services
with appropriate quality with the health services
presenting organization trend in employing skilled
Corresponding author:
Nasrin Yoosefpour
Department of Radiology, Paramedical School,
Kermanshah University of Medical Sciences,
Kermanshah, Iran, Email: n_yousefpoor@yahoo.com
Tel: +989181324798
clinical competence is a combination of moral and values
and their reflex in knowledge and skill. Also honesty and
caring, communications skill and compatibility have
recognized as the individuals self-efficacy signs.6 Of
the most problems is the deficiency of student’s clinical
competence, which caused the incidence of issues in their
mental and endangered the society’s health.7 Therefore,
applying the self-efficacy evaluation criterion determine
the cognition and skills deficiencies of them.8
One of the theories, which have used for evaluating
the assurance degree in doing the clinical skills by the
students, is the Bandura self-efficacy theory.9 The results
of many studies have showed that the self-efficacy for
acquiring knowledge and skills, particularly in applying
the scientific and professional skills have a significant
role.10 The present world needs the self-regulators
learners. A self-regulator student is a person who
finds and present a particular way of learning which
is based on the scientific goals of his/her self-efficacy
 Indian Journal of Public Health Research & Development, April-June 2017, Vol. 8, No. 2
understanding.12
Abedi et al. have noted the knowledge self-efficacy
of clinical role, lack of professional efficiency, the
confidence of disability for meeting the colleague’s
expectation and emotional reaction as a major
problems of educators.13, 14 In addition, a few studies
have evaluated the self-efficacy role in clinical and
educational performances separately.15, 16
Harvey and McMurray have showed that the
possibility of getting less than pass score of lessons unit
among nursing students with less self-efficacy is more
than the students with high self-efficacy.17 Performance
failing necessarily is not because of the deficiency but
the low self-efficacy of the individuals is a factor for
ineffective use of educational skills.18 Therefore, paying
attention to the weak points and improving the clinical
education seems necessary. Especially this fact is always
have considered by teachers and clinical nurses for
medical science apprentices and students.19 Based on
the researches, a positive and significant relation have
observed between clinical performance self-efficacy and
nursing clinical performance.20 The results of research
have showed that self evaluation of the students in
comparison with clinical self-efficacy which could
have provide a valuable and complete data for medical
science students evaluationg.21, 22
The results of the Opacic’s study have showed that
the final terms students self-efficacy have related with
their clinical performance.23 Wahtera showed that there
was a positive relation between self-efficacy and nurses
performance and the self-efficacy was the only variable
which have a statistically significant relation with the
performance process of nursing students.24 The results
of Choi’s study have not showed a relation between
self-efficacy and academic performances.25 Lent et
all. have found that high self-efficacy could cause the
improvement of the students learning and predict the
consequences development.26
The present study has designed with the aim of
evaluating the relation between clinical competence and
clinical self-efficacy of nursing students in Kermanshah
University of medical sciences.
381
MATERIAL AND METHOD
The present study is a descriptive-analytical
study of correlation type. The statistical population
includes all the nursing students of apprentice level
in Kermanshah’s medical science university in 2016,
which were 80 people. The sampling has done by census
method. For collecting data the standard questionnaires
of clinical competence evaluation and Sherer self-
efficacy have used. This questionnaire which include
73 related questions with clinical skills have 100 score.
If the score was closer to zero it, represent its low self-
efficacy and if it was closer to 100 it represent its high
clinical efficiency. In addition, the used rate of each skill
in clinical section has determined by four range Likert
scale. In this scale the zero range means not applying
the skills and the first range means less applying, range
two means some times applying and range three means
repeated applying of the skills.27, 28 In addition, the
Sherer self-efficacy questionnaire have designed by
Sherer et al. (1982) which include 17 components.29
The results of the evaluations showed the existence of
three latent correlation factor which one higher factor is
public self-self-efficacy in this scale.30 The Cronbachs
alpha method 0.70 and internal coefficient of these scale
with the Rater locus control as a criterion validity have
calculated 0.52 31 For observing the moral rules of the
research the samples participation in the project was in
the form of Voluntary and the necessary expectations
about the project, the data evaluation, and presentation,
confidential personal data, not recording the name and
family name and other moral points have presented
for volunteers. For analyzing data, the descriptive
statistical have used and statistical inference the Pearson
correlation coefficient, After all the data have analyzed
by SPSS-21 software.
RESULTS
The results have showed that the student’s average
score of clinical competence was 87.16±22.82. In
addition, the results have showed that the average of the
students clinical self-efficacy score was 69.16±13.57.
Therefore, there was a positive and significant relation
between clinical competence and self-efficacy (table 1).
382 Indian Journal of Public Health Research & Development, April-June 2017, Vol. 8, No. 2

Table 1. The Pearson correlation coefficient for the relation between clinical competence and self-efficacy
of the students

Variables N Mean S.D Correlation coefficient P

Clinical competence 80 87.16 22.82
0.15 <0.004
Clinical self-efficacy 80 69.16 13.57

The results have showed that the patient assisting competency average of the students was 61.8±1.84, and
student’s self-efficacy was 69.16±13.57. There was a positive and significant relation between patients assisting
competency and self-efficacy (table 2).

Table 2. The Pearson correlation for the relation between patients’ assisting competency and self-efficacy

Variables N Mean S.D Correlation coefficient P

Patients’ assisting competency 80 61.8 1.84
0.15 <0.03
Clinical self-efficacy 80 69.16 13.57

The results have showed that the students care competency average was 61.59±2.01, and the the student’s
self-efficacy score average was 69.16±13.57. There was a positive and significant relation between students care
competency and self-efficacy (table 3).

Table 3. The Pearson correlation for the relation between care competency and self-efficacy

Variables N Mean S.D Correlation coefficient P

Care competency 80 61.59 2.01
0.13 <0.04
Clinical self-efficacy 80 69.16 13.57

The results have showed that the moral and legal performance competency of the students was 59.93±1.74, and
student’s self-efficacy score average was 69.16±13.57. There was a positive and significant relation between legal
and moral performance competency with the self-efficacy of the students (table 4).

Table 4. The Pearson correlation of the relation between moral and legal performance competency and
self-efficacy of the students

Variables N Mean S.D Correlation coefficient P

Moral and legal performance competency 80 59.53 1.74
0.21 <0.003
Clinical self-efficacy 80 69.16 13.57

The results have showed that the professional development competency average in the students was 65.94±1.59.
In addition, the results have showed that the student’s self-efficacy score average was 69.16±13.57. There was a
positive and significant relation between professional development and the self-efficacy of the students (table 5).

Table 5. The Pearson correlation for the relation between professional development competence and self-
efficacy of the students

Variables N Mean S.D Correlation coefficient P

Professional development competence 80 69.94 1.59
0.19 <0.004
Clinical self-efficacy 80 69.16 13.57

The results have showed that the patient’s safety, security, and comfort competency of students was 69.80±2.78.
In addition, the results have showed that the student’s self-efficacy score was 69.16±13.57. There was a positive and
significant relation between patients safety, security, and comfort competency and self-efficacy of the students (table
6).
 Indian Journal of Public Health Research & Development, April-June 2017, Vol. 8, No. 2 383

Table 6. The Pearson correlation for the relation between patient’s safety, security, and comfort
competency and self-efficacy of the students

Correlation
Variables N Mean S.D P
coefficient

Patient’s safety, security,

80 69.80 2.78
and comfort competency
0.22 <0.0001
Clinical self-efficacy 80 69.16 13.57

The results of table7 have showed that the student’s leadership and management self-efficacy average was
63.39±3.52. In addition, the results have showed that the student’s self-efficacy score average was 69.6±13.57. There
was a significant and positive relation between leadership and management competency and self-efficacy of the
students (table 7).

Table 7. The Pearson correlation for the relation between leadership and management competency and
self-efficacy of the students

Correlation
Variables N Mean S.D P
coefficient

Leadership and
80 63.39 3.52
management competency
0.26 <0.0001

Clinical self-efficacy 80 69.16 13.57

Member competency of the students was 78.43±2.12. In addition, the result shave showed that the student’s
self-efficacy score average was 69.16±13.57. There was a significant and positive relation between assisting with
treatment team’s member’s competency and self-efficacy of the students (table 8).

Table 8. The Pearson correlation for the relation between assisting with the treatment teams and self-
efficacy of the students

Correlation
Variables N Mean S.D P
coefficient

Assisting with the treatment

teams and self-efficacy of 80 78.43 2.12
the students 0.12 <0.02

Clinical self-efficacy 80 69.16 13.57

DISCUSSION Lent et al. in study have found that high self-efficacy

could help the students learning development and
The obtained results of this study have represented
predict the consequences development.27 In addition,
that there was a significant relation between clinical
the results of this research are not consistent with Choi
competences and clinical self-efficacy of the students.
(2005) study. 26 Mohammadi et al. have showed that the
The results of this study is consistent with some study’s
student’s evaluation in comparison with clinical self-
results. 20, 21, 24, 25, 26, 27 The results of Opacic have showed
efficacy could provide valuable and complement data in
that the final term student’s self-efficacy has relation with
student’s evaluation. 22
their clinical performance in the clinical apprenticing
field.24 Wahtera showed a positive relation between self- Applying self-efficacy evaluation criteria not only
efficacy and nursing performance process.25 In addition, caused more knowledge and cognition in students but
384 Indian Journal of Public Health Research & Development, April-June 2017, Vol. 8, No. 2
also revealed the skilled and cognitive deficiencies in
them.8 As a result, it have expected that the students
reach the highest level of learning and self-efficacy
during their academic period.
Therefore, if the basis of the major is rich, the
science independency is richer.21 According to the
present study’s results and similar results of other
studies; the self-efficacy relation is effective in care
ability and nursing active role. Therefore, the teacher
should create effective and motivate environment in
order to students could improve the planning ability
and metacognition skills.32, 33 Lack of attention to the
self-efficacy promotion of students, undoubtedly caused
the educated human sources quality reduction in nursing
professions.16
In addition, this study has faced with so many
limits during the project implementation. These limits
are as nursing students personal differences like the
way of connection, the motivation and interest level
in nursing major, personal judgment in questionnaires
filling, different of personal style and management in
each students, motivation and interest for education and
clinical in comparison with education. These variables
in this research effect the nursing student’s concept
and consideration for their opinion and they were
uncontrollable.
CONCLUSION
The present study’s results have supported the
hypothesis of “there was a significant relation between
clinical and self-efficacy of the students “therefore,
promotion and paying attention to non-school factors
such as self-efficacy have caused the nursing students
performance evaluation.
Ethical Clearance- Taken from ethical committee
of Kermanshah University of Medical Sciences
Source of Funding- Research Council
Kermanshah University of Medical Sciences
Conflict of Interest - The authors declare no
conflict of interest.
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