The Mediating Role of Self-Confidence in Medical Students’ Attitudes and Clinical Performance Toward People with Disability

Vanda G Yazbeck Karam,1,2 Sandrella Bou Malhab,1,3 Sola Aoun Bahous,1 Pascale Salameh,1,3– 5 Myriam El Khoury-Malhame,6 Nadia Asmar1 1School of Medicine, Lebanese American University, Byblos, Lebanon; 2Department of Anesthesiology, Lebanese American University, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon; 3Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon; 4Faculty of Pharmacy, Lebanese University, Hadat, Lebanon; 5Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, 2417, Cyprus; 6Department of Psychology and Education, School of Arts and Science, Lebanese American University, Byblos, LebanonCorrespondence: Sandrella Bou Malhab, School of Medicine, Lebanese American University, Byblos, Lebanon, Email [email protected] Vanda G Yazbeck Karam, Department of Anesthesiology, Lebanese American University, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon, Email [email protected]: This study aimed to explore the mediating role of self-confidence in shaping the relationship between gender and year of enrollment, and medical students’ attitudes towards people with disability (PWD), and their clinical performance particularly in cultural contexts where stigma is prevalent.Methods: A cross-sectional study was conducted as part of an internal assessment at a private medical school in Lebanon, involving 143 medical students from all four years of the program. Mediation analysis with PROCESS macro, was used to explore the impact of self-confidence on students’ attitudes and clinical performance with PWD.Results: Students in higher years of medical training demonstrated more positive attitudes and better clinical performance with PWD, mediated by greater self-confidence. Conversely, female students reported lower self-confidence, negatively influencing their attitudes and clinical interactions with PWD.Discussion: This research highlights the critical role of self-confidence in mediating medical students’ attitudes and performance with PWD. Findings suggest the need for curriculum reforms to incorporate disability-focused training and additionally address gender-specific barriers to confidence-building.Keywords: medical student, self-confidence, mediation analysis, attitudes, patients with disability, medical education, clinical setting