Clinical Learning Environment quality and academic self-efficacy in nursing students: a cross-sectional study

BACKGROUND: Academic failure (AF) is common in nursing programmes, with significant consequences for healthcare systems. The clinical learning environment (CLE) may influence academic self-efficacy (ASE), a key determinant of motivation, resilience, and performance. However, its specific role remains unclear. AIM: This study examined whether CLE quality predicts ASE among first-year nursing students. METHODS: A cross-sectional study was conducted. CLE quality was assessed using the Clinical Learning Environment Quality Evaluation Index (CLEQI), and ASE with the Academic Nurse Self-Efficacy Scale (ANSEs). The relationship between CLE and ASE was analysed using linear regression. RESULTS: A total of 142 students participated. The mean CLEQI score was 45.4 (SD = 14.3), with the highest scores for tutorial strategies and the lowest for self-directed learning. The mean ANSEs score was 49.2 (SD = 9.0), with higher values for self-regulatory behaviour and lower for internal emotion management. CLEQI was the only significant predictor of ASE (β = 0.333, p < 0.001). CONCLUSIONS: CLE quality significantly predicted ASE. Strengthening tutorial strategies, learning opportunities, and emotional and self-directed learning support may promote academic success.