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Clinical Skill Anxiety and Its Determinants Among Clinical-Year Health Science Students in Ethiopia: An
Habtie Bantider Wubet1, Elelta Mulugeta Ayalew2, Temesgen Birlie Asmare1
1Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Background:
Clinical skill anxiety (CSA) is a common psychological challenge among health science students during their clinical years, potentially impacting clinical competence and patient safety. While previous Ethiopian studies have highlighted high levels of stress and anxiety among students, evidence on context-specific CSA and its determinants among clinical-year students remains limited.
Methods:
This institution-based cross-sectional study was conducted between 20 August and 25 October 2025. A total of 426 clinical-year health science students across medicine, nursing, midwifery, and anaesthesia programs at Debre Tabor Comprehensive Specialized Hospital (DTCSH) were invited to participate in a census. The study assessed clinical skill anxiety (CSA) and associated characteristics using an adapted Clinical Skill Anxiety Scale (CSAS). This scale was informed by established instruments (STAI, BAI, and PSS), modified through a literature review and expert consultation, and demonstrated acceptable internal consistency in this study population (Cronbach's α = 0.86). Predictors of CSA were identified using multivariable logistic regression (p < 0.05; 95% CI).
Results:
The overall prevalence of CSA among clinical-year health science students was 64.2% (95% CI: 59.5%-69.0%). Significant determinants included fear of making mistakes (AOR = 4.2; 95% CI: 2.80-6.30), limited instructor feedback (AOR = 3.6; 95% CI: 2.05-6.32), female sex (AOR = 2.2; 95% CI: 1.62-2.98), lack of prior clinical-skills exposure (AOR = 2.1; 95% CI: 1.35-3.26), and high academic stress (AOR = 1.8; 95% CI: 1.25-2.60).
Conclusion:
Nearly two-thirds (64.2%) of clinical-year students experienced CSA, which was associated with psychological, institutional, and instructional factors. Based on these cross-sectional findings, we suggest that strengthening mentorship, feedback systems, simulated skill practice, and stress-reduction strategies may be beneficial. Future research could explore interventions such as maintaining lower student-to-instructor ratios, bolstering structured feedback systems, increasing simulation-based learning opportunities, and integrating resilience training into health science courses. However, causal inferences cannot be drawn from this cross-sectional design; therefore, intervention studies are needed to evaluate the effectiveness of these approaches.
Patient Or Public Contribution:
No patients, caregivers, or public members participated in this study; the research focused exclusively on health science students in Ethiopia.
