title: Clinical Self-Efficacy in Senior Nursing Students: A Mixed- Methods Study.
abstract: BACKGROUND
  Clinical education has a basic role in nursing education, and effective clinical training establishes a sense of clinical self-efficacy in senior nursing students. Self-efficacy is a key component for acting independently in the nursing profession.
  
  
  OBJECTIVE
  This study was designed to outline senior nursing students' views about clinical self-efficacy and to determine its level in nursing students.
  
  
  METHODS
  A mixed-methods approach, including a quantitative cross-sectional study and qualitative content analysis,was used in this study. Participants were senior nursing students who were in their two last semesters. During the initial quantitative stage, all students in the 7th and 8th semesters of the nursing major were invited to participate. They were asked to complete the Nursing Clinical Self-Efficacy Scale (NCSES) and, during the subsequent qualitative stage, the 14 students in the 7th and 8th semesters were asked to participate in semi-structured interviews.
  
  
  RESULTS
  In the quantitative part, 58 students completed the self-efficacy questionnaire; the mean score was 219.28 ± 35.8, which showed moderate self-efficacy in students. Self-efficacy was different across skills. In the qualitative part, the 355 open codes that were extracted from the interviews were clustered to 12 categories and 3 themes. The main themes included the factors related to self-efficacy, outcomes of self-efficacy, and ways to improve self-efficacy.
  
  
  CONCLUSIONS
  Students had moderate self-efficacy. Several factors such as environment, nursing colleagues, and clinical educators could influence the creation of clinical self-efficacy in nursing students.
authors.affiliation: Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Abdal
authors.affiliation: Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Negin
authors.initials: N
authors.lastname: Masoudi Alavi
authors.affiliation: Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Adib-Hajbaghery
keywords: Education; Interview; Nursing Students; Questionnaires; Self-Efficacy