From Uncertainty to Competence: A Longitudinal Study of Confidence Development in Occupational Therapy Education.

Everyone was a second-year occupational therapy doctoral student at one university in California, so these results may not describe students in other programs or regions. Confidence was self-reported. Students may have answered in ways that looked good to their instructors, and feeling confident is not the same as being competent, which this study did not measure. The survey was reviewed by experts but never formally tested for reliability or validity, so it is not clear how well these four questions capture confidence. Surveys were voluntary and anonymous, so the researchers could not follow individual students over time or link confidence to grades or performance. Not everyone completed the surveys: 37 students enrolled in 2023 but only 34 had both a first and a last survey, and the authors note that students who kept responding may have differed from those who stopped. There was no comparison group. Every student took the same course with the same mix of teaching methods, so nothing here shows which teaching method, or anything else, caused the change in confidence. The course instructors were the study authors. They took real steps to reduce bias, but students knew their teachers were studying the course. Detailed competency-by-competency confidence results are shown only in supporting information figures rather than in the article text.

The authors declare no conflicts of interest and report that no funding was received. The course instructors were the study authors, and they describe the steps taken to protect students: voluntary and anonymous surveys, no instructor access to individual responses until grades were submitted, and a research assistant not involved in teaching helping with data collection.

Do not read this as evidence that any particular teaching method builds confidence. Every student received the same mix of lectures, labs, case-based learning and quizzes with no comparison group, so the study cannot show which ingredient, if any, caused the change. It also measured how confident students felt, not whether they could actually apply the material clinically.