FACTORS AFFECTING CONFIDENCE AND COMPETENCE IN MEDICAL STUDENTS-AN

EXPERIMENTAL APPROACH

Objectives:
● To assess the level of confidence and competence among medical students.
● To point out the factors responsible for boosting up the confidence.
● To identify the causes leading to apprehensiveness and incompetence in medical
students.
● To investigate the effects of experience, health, motivation and support etc on amplifying
these abilities.

Rationale:
● To aid medical students in highlighting the factors enhancing or lowering their
confidence.
● To reinforce medical students in their career.

Study design:
Study design for this research will be a "descriptive study"

Methodology:
A medical college based research will be carried out among the students of all 5
academic years of Federal Medical And Dental College.A pre-designed and pre-tested
questionnaire will be used to assess the factors that reinforce the confidence in medical
students and those that diminish the abilities like competence.Results will b gathered and the
data will be analysed using statistical techniques.

Introduction:
'Confidence' comes from a Latin word 'Fidere' which means 'to trust'.Confidence is
a state of being certain that a hypothesis or prediction is correct or that a chosen course of
action is the best or most effective.Therefore,having a self-confidence is having trust in one's
self.The concept of self-confidence is commonly used as self-assurance in one's personal
judgemental ability,power etc.1
The term "competence" first appeared in an article authored by R.W. White in 1959 as a
concept for performance motivation.Competence is the set of demonstrable characteristics and
skills that enable and improve the efficiency of performance of a job.2Competence is also
defined as "action of seeking or endeavoring to gain what another is endeavoring to gain at the
same time,".3In other words "Competence is a combination of two topics of personal
competence and merit at work. Personal merit is a concept which refers to the dimensions of

1
Snyder, C. R.; Lopez, Shane J. (2009-01-01). Oxford Handbook of Positive Psychology. Oxford
University Press. ISBN 978-0-19-518724-3.
2
https://en.m.wikipedia.org/wiki/Competence_(human_resources)
3
https://www.etymonline.com/word/competition
artificial behavior in order to show the competence performance and merit at work depends on
the competences of the person in his field"(Woodruff 1991)4
Clinical confidence is the self-perceived ability to deal with clinical scenarios, and while it does
not necessarily correlate with competency, it is nevertheless a pre-requisite for students to be
able to fully participate in clinical activities.5Confidence and competence are the sole factors in
determining the success of medical students in their academic career as well as co-curricular
activities.This research is carried to highlight several factors that have been observed to have
profound effect on confidence and competence.
Academic achievements are considered an important factor.Students who perform better
receive more positive evaluations report and greater self-confidence.6In general, students who
perform well have increased confidence which likely in turn encourages students to take greater
responsibility to successfully complete tasks.7
Workshops and clinical experiences too have an important role.Most students reported
improved confidence after a surgical skills workshop.8Physicians’ knowledge, confidence, and
prior training will influence physical activity (PA) counselling in general practice.9Fine arts can be
used to teach technical skills, stimulate personal reflection, and prevent burnout. A meaningful
engagement with the arts can play an important role in developing physicians who are
observant, empathetic, and more well-rounded.10
Health-another factor.Self-reported depression, anxiety, sleep disturbance, memory impairment
and neck- and back pain most clearly discriminated burnout and exhausted groups from
disengaged and non-burnout groups.11
Family support helps students access a distinct position in their career.Perceived family support
plays a key role in establishing premedical students condence in their ability to cope with the
challenges of academic life.12The absence of health professionals within participants’ networks

4
https://en.m.wikipedia.org/wiki/Competence_(human_resources)
5
Barnsley L, Lyon PM, Ralston SJ, Hibbert EJ, Cunningham I, Gordon FC, et al. Clinical skills in junior
medical officers: a comparison of self-reported confidence and observed competence. Med Educ.
2004;38(4):358–67.
6
62] Pajares, Frank; Johnson, Margaret J. (1996-04-01). "Self-efficacy beliefs and the writing performance
of entering high school students". Psychology in the Schools. 33 (2): 163–175.
doi:10.1002/(sici)1520-6807(199604)33:2<163::aid-pits10>3.0.co;2-c. ISSN 1520-6807.
7
Zimmerman, Barry J.; Kitsantas, Anastasia (2005-10-01). "Homework practices and academic
achievement: The mediating role of self-efficacy and perceived responsibility beliefs". Contemporary
Educational Psychology. 30 (4): 397–417. doi:10.1016/j.cedpsych.2005.05.003.
8
Clanton J, Gardner A, Cheung M, Mellert L, Evancho-Chapman M, George RL. The relationship between
confidence and competence in the development of surgical skills. Journal of surgical education. 2014 May
1;71(3):405-12.
9
Mandic S, Wilson H, Clark-Grill M, O’Neill D. A physical activity learning module improves medical
students’ skills and confidence for advising patients about physical activity. Montenegrin Journal of Sports
Science and Medicine. 2018 Mar 1;7(1):31.
10
He B, Prasad S, Higashi RT, Goff HW. The art of observation: a qualitative analysis of medical
students’ experiences. BMC medical education. 2019 Dec 1;19(1):234
11
Peterson U, Demerouti E, Bergström G, Samuelsson M, Åsberg M, Nygren Å. Burnout and physical and
mental health among Swedish healthcare workers. Journal of advanced nursing. 2008 Apr;62(1):84-95.
12
Klink JL, Byars-Winston A, Bakken LL. Coping efficacy and perceived family support: potential factors
for reducing stress in premedical students. Medical Education. 2008 Jun;42(6):572-9
(social capital) was experienced as a barrier to connecting with fellow students and accessing
placement.13
Healthy peer influence plays a key role.Implementing a peer-facilitated workshop led to
increased self-confidence in performing clinical skills.14
Motivation by teachers is what boosts the performance.Due to the unique characteristic of our
medical students’ educational background, This study shows that tutors’ autonomy support is
inconsistent with students’ academic achievement. However, both autonomous motivation and
support are essential to students’ academic achievement. Further study is needed to explore
students’ educational background and self-regulated learning competence to improve students’
academic achievement.15
There is evidence that students successful in knowing even one faculty member closely are
likely to feel more satisfied with their college life.16Therefore this too is a contributing factor.
Fear of failure is observed to be a cause of apprehensiveness among the
students.failure-relevant situations, dispositional fear of failure may lead to higher negative
affect depending on the dualistic regulatory effect of passion.17As pointed out by results, both
self confidence and fear of failure are determinants of are determinants of the EO of university
students. Self confidence has a positive and consistent effect on the three dimensions of EO,
whereas fear of failure has negative effect on EO.18
Confidence gap is noticed in gender difference.A research carried out at Northeastern
university,Boston indicates,despite performing equally to their male peers, female medical
students consistently report decreased self-confidence and increased anxiety, particularly over
issues related to their competence.19
Medical students have reported lack of credence and competency because of several
aforementioned causes.The goal of this research was to highlight all the main factors
contributing to their diminished confidence and incompetence.

13
Brosnan C, Southgate E, Outram S, Lempp H, Wright S, Saxby T, Harris G, Bennett A, Kelly B.
Experiences of medical students who are first in the family to attend university. Medical education. 2016
Aug;50(8):842-51.
14
Flynn, S., Williams, M., Colgan, R. et al. Improving Medical Student Confidence in Clinical Skills
through a Peer-Facilitated Workshop. Med.Sci.Educ. 27, 701–706 (2017).
https://doi.org/10.1007/s40670-017-0465-6
15
Int J Med Educ. 2016 Dec 29;7:417-423. doi: 10.5116/ijme.5843.1097
16
Komarraju M, Musulkin S, Bhattacharya G. Role of student–faculty interactions in developing college
students' academic self-concept, motivation, and achievement. Journal of college student development.
2010;51(3):332-42.
17
Stroe S, Sirén C, Shepherd D, Wincent J. The dualistic regulatory effect of passion on the relationship
between fear of failure and negative affect: Insights from facial expression analysis. Journal of Business
Venturing. 2019 Jul 19:105948
18
Martins, Izaias & Perez, Juan P. & Velasquez, Andres. (2018). Self-confidence and fear of failure
among university students and their relationship with entrepreneurial orientation: Evidence from
Colombia. Academia Revista Latinoamericana de Administración. 10.1108/ARLA-01-2018-0018.
19
Blanch DC, Hall JA, Roter DL, Frankel RM. Medical student gender and issues of confidence. Patient
education and counseling. 2008 Sep 1;72(3):374-81.