The relationship between clinical reasoning and self-efficacy in clinical performance among nursing students

A primary objective of nursing education is to foster clinical reasoning skills among students. One of the most critical student characteristics that potentially shapes the development of cognitive skills is self-efficacy in clinical performance. This study aimed to determine the relationship between clinical reasoning and self-efficacy in clinical performance among nursing students. This analytical cross-sectional study was conducted at the Schools of Nursing of Guilan University of Medical Sciences in 2023. Participants included all sixth-, seventh-, and eighth-semester undergraduate nursing students, selected through census sampling. Data were collected using a demographic information questionnaire, the Nurses’ Clinical Reasoning Scale, and the Clinical Performance Self-Efficacy Scale. Multiple regression analysis was employed to examine relationships between demographic factors, self-efficacy, and clinical reasoning. The mean total clinical reasoning score was 55.71 ± 8.26. The mean total clinical performance self-efficacy score was 134.59 ± 21.89. Significant correlations were found between clinical reasoning scores and age (p = 0.061), academic semester (p < 0.001), grade point average (p < 0.001), clinical work experience (p = 0.011), and clinical performance self-efficacy (p < 0.001). Multiple regression analysis revealed that only clinical performance self-efficacy (β = 0.78, p < 0.001) was a significant predictor of clinical reasoning competence. The study demonstrated that one of the most critical student characteristics shaping clinical reasoning competence is clinical performance self-efficacy. Given that a primary goal of nursing education is to develop high-level cognitive skills in nurses for effective decision-making in clinical situations, nursing education programs should focus on enhancing self-efficacy through active teaching methods to improve clinical reasoning competence.