Self-Efficacy in Clinical Decision-Making Under Stress Among Senior Nursing Students
Elizabeta Kadosh1, Rita Alfasi Okounev1,2, Dana Darienko1,2
1Schonbrunn School of Nursing, Sourasky (Ichilov) Medical Center, Tel Aviv, Israel (Ms Kadosh, Ms Alfasi Okounev, Ms Darienko, Ms Luxman Balasanov, Ms Mostafa Asali, Ms Naser, and Ms Taki Fdely).
Background:
Clinical decision-making under stress is a critical competency for senior nursing students, as it influences their ability to manage complex patient needs and contributes to both patient safety and professional preparedness.
Purpose:
The aim was to examine the contribution of empowering clinical instruction, resilience, trait anxiety, and clinical satisfaction to senior nursing students' self-efficacy in clinical decision-making under stress.
Methods:
This was a cross-sectional study and included 216 final-year students.
Results:
Regression analysis identified empowerment ( β = .473), satisfaction ( β = .343), and resilience ( β = .130) as significant positive predictors of self-efficacy. The final model explained 70.9% of the variance in self-efficacy (adjusted R2 = 0.698).
Conclusions:
Educators should prioritize empowering behaviors, including autonomy, feedback, and decision-making opportunities, to enhance students' confidence in stressful situations and prepare competent nurses for safe, independent, high-quality care.
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