Trajectories and Adaptive Recalibration of Self‐Efficacy in Brazilian Medical Students: A Longitudinal Study With Implications for Educational Support

INTRODUCTION: Self-efficacy, the belief in one's capacity to execute actions necessary to achieve specific objectives, is a significant predictor of academic performance and well-being in medical training. Longitudinal studies examining the dynamic evolution of self-efficacy throughout undergraduate medical education remain scarce in the Brazilian context. This study prospectively evaluated perceived self-efficacy among medical students during critical curricular transitions. METHODS: A prospective longitudinal study followed 50 medical students from a Brazilian public university at four time points: course entry (T1-2021), end of first year (T2-2022), midpoint of clinical cycle (T3-2023) and beginning of fifth year/internship (T4-2025). The Self-Efficacy Scale for Higher Education (SESHE), a validated 34-item instrument assessing five dimensions, was administered. Statistical analyses included repeated measures ANOVA, Wilcoxon test and effect size calculations (Cohen's d). RESULTS: The study observed a dynamic evolution in perceived self-efficacy, characterised by a notable shift in total self-efficacy from 2021 to 2023, followed by partial recovery by 2025. This pattern included significant reductions in several dimensions. Self-efficacy in proactive actions experienced the most pronounced change (d > 0.8), while self-efficacy in social interaction demonstrated relative stability. Baseline analyses revealed higher self-efficacy in social interaction among male students (d = 0.51). CONCLUSION: These findings suggest that the observed changes in self-efficacy represent an adaptive recalibration, moving toward a more realistic self-assessment essential for professional development. Therefore, strategies that support this healthy recalibration are crucial. These interventions should aim to facilitate adaptive adjustment, fostering robust and accurate self-efficacy throughout medical training.