Self-efficacy in the context of nursing education and transition to practice as a registered practitioner: A systematic review.
Mousa Abusubhiah, Nuala Walshe, Rena Creedon and 2 others
PMID 37421389WHAT IT FOUND
Educational programmes for nursing students and registered nurses generally increased self-efficacy, with most studies showing improvement.
However, the evidence is weak: it relies mostly on small, non-randomised groups without control comparisons, and different studies used incompatible measurement tools.
Key findings
01Of 47 included studies, 35 reported significant improvements in self-efficacy levels after educational interventions.
02The evidence base is limited by heterogeneity, with 47 individual tools used to measure self-efficacy, preventing a meta-analysis.
03Only eight of the 47 studies were randomised controlled trials; the majority were quasi-experimental pre-test/post-test designs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence is primarily non-randomised, with only 8 RCTs among 47 studies. Most studies were single-group pre-test/post-test designs with no control group, making it difficult to attribute changes to the intervention. There was extreme heterogeneity in measurement tools (47 different scales), preventing direct comparison or pooling of results. Sample sizes were often small, and follow-up periods were short, with only one study including longitudinal data. Over 60% of included studies lacked a theoretical underpinning for the intervention.
Declared interests
The authors report no conflicts of interest. There was no external funding.
The easy way to misread this
Do not interpret the reported increases in self-efficacy as proof that specific teaching methods work better than others. The majority of evidence comes from uncontrolled single-group studies where natural maturation or testing effects could explain the improvement, and the lack of a standardised measurement tool means results cannot be compared across studies.