The Nursing Student Self-Efficacy in Clinical Skills Scale (NSSE-CS): A development and psychometric validation study

Abstract

Aim: Develop and validate a scale that measures nursing students’ self-efficacy (SE) in performing core clinical skills typically acquired during undergraduate clinical placements. Background: Student perceptions of SE can enhance motivation, foster improvement and serve as a robust predictor of academic achievement. For nursing students, success relies not only on theoretical knowledge but also on performing core clinical skills, usually acquired during undergraduate clinical placements. Therefore, it is necessary to assess students’ SE in clinical skills. Design: A multicenter, cross-sectional, descriptive, validation study. Methods: We developed the Nursing Student Self-Efficacy in Clinical Skills Scale (NSSE-CS) and conducted an Exploratory Factor Analysis (EFA) to evaluate its construct validity. An online survey was administered to third-year nursing students at the end of their final clinical placements in October 2024. Results: Overall, 393 nursing students from five universities across Italy completed the survey. EFA revealed four factors for the 48-item NSSE-CS: “Fundamental care”, “Assessment and planning”, “Low-complexity care” and “High-complexity care”. SE scores were positively correlated with the frequency of practicing core skills during placements. SE was also significantly associated with gender, nationality, university affiliation and completion of the clinical placement examination. The omega composite reliability was good (ω =.98). Conclusion: The NSSE-CS is a valid and reliable instrument for assessing third-year nursing students’ SE in clinical skills. By encouraging students to reflect on their own SE, nurse educators can provide more targeted support and tailored learning opportunities, helping students effectively master core clinical skills.