Self-Efficacy in Clinical Decision-Making Under Stress Among Senior Nursing Students

BACKGROUND: Clinical decision-making under stress is a critical competency for senior nursing students, as it influences their ability to manage complex patient needs and contributes to both patient safety and professional preparedness. PURPOSE: The aim was to examine the contribution of empowering clinical instruction, resilience, trait anxiety, and clinical satisfaction to senior nursing students' self-efficacy in clinical decision-making under stress. METHODS: This was a cross-sectional study and included 216 final-year students. RESULTS: Regression analysis identified empowerment ( β = .473), satisfaction ( β = .343), and resilience ( β = .130) as significant positive predictors of self-efficacy. The final model explained 70.9% of the variance in self-efficacy (adjusted R2 = 0.698). CONCLUSIONS: Educators should prioritize empowering behaviors, including autonomy, feedback, and decision-making opportunities, to enhance students' confidence in stressful situations and prepare competent nurses for safe, independent, high-quality care.