title: Understanding the influences on self-confidence among first-year undergraduate nursing students in Ireland.
abstract: OBJECTIVE
  To report a mixed-methods study of the development of self-confidence in Irish nursing students undertaking the first year of an undergraduate nursing programme.
  
  
  BACKGROUND
  Self-confidence underpins nurses' competence to carry out care effectively, yet there is little empirical evidence of how this attribute is fostered in pre-registration preparation. There is an assumption, however, that self-confidence develops independently and spontaneously.
  
  
  METHODS
  A sequential, mixed methods three-phase design was used.
  
  
  METHODS
  The design involved pretest and posttest measurements of self-confidence, focus group interviews, a student self-evaluation questionnaire and analysis of the relevant curriculum content. Data were collected between September 2007-April 2008 and sampling was from three cohorts of students at three different Institutes of Technology in Ireland. Data collection matched the nature of the data, including descriptive, non-inferential statistics and qualitative content analysis.
  
  
  RESULTS
  There was considerable variation in the amount and nature of theoretical preparation. Factors in clinical practice exerted the most influence. Self-confidence fluctuated during the first clinical placement and as students' self-confidence developed, simultaneously, motivation towards academic achievement increased. Conversely, self-confidence was quickly eroded by poor preceptor attitudes, lack of communication, and feeling undervalued.
  
  
  CONCLUSIONS
  The development of self-confidence is complex and multi-factorial. This study offers further understanding of facilitators and barriers that may be relevant elsewhere in promoting student nurses' developing self-confidence. The development of self-confidence must be recognized as a central tenet for the design and delivery of undergraduate programmes.
authors.affiliation: Waterford Institute of Technology, Waterford, Ireland. pchesser-smyth@wit.ie
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Chesser-Smyth
authors.forename: Tony
authors.initials: T
authors.lastname: Long
mesh_terms: D015331:Cohort Studies; D006801:Humans; D007494:Ireland; D012649:Self Concept; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires