Academic self-efficacy of paramedical students over a 4-year follow-up

BACKGROUND: Academic self-efficacy is essential for student motivation, emotional regulation, and academic achievement, particularly in paramedical education. It is shaped by personal beliefs, environmental support, and demographic factors, and can fluctuate throughout the educational journey due to various stressors. This study examines the longitudinal changes in academic self-efficacy among paramedical students in Qom over four years. METHOD: This longitudinal survey study (2021-2024) assessed academic self-efficacy among 76 paramedical students at Qom University using census sampling. Participants completed a validated 27-item questionnaire across four semesters, measuring confidence in academic tasks and responsibilities. Data was collected anonymously with informed consent. Non-parametric statistical analyses, including the Friedman test, were conducted using SPSS v23, with significance set at p < 0.05 RESULTS: Out of 81 initial participants, 76 paramedical students completed the study. Academic self-efficacy scores varied across semesters, with the lowest in semester 5 and the highest in semester 8, showing significant changes over time (p < 0.001). Post-hoc analysis revealed that classroom confidence decreased in Semester 5 and increased in interpersonal and out-of-class performance by Semester 8. Students in semester 8 also showed greater ability to manage academic, work, and family responsibilities compared to earlier semesters. CONCLUSIONS: This study highlights the mid-phase decline in academic self-efficacy among paramedical students, underscoring the need for targeted educational support. Strengthening self-efficacy through structured interventions is crucial to increasing academic performance, resilience, and long-term professional satisfaction.