Academic Self-Efficacy as a Predictor of Clinical Decision-Making Among Nursing Students: A Cross-Sectional Correlational Study Conducted in Palestine

Background The relationship between academic self-efficacy and clinical decision-making is crucial for nursing students’ professional development. Understanding this relationship contributes to nursing education literature globally, particularly regarding how psychological constructs influence clinical competence development across diverse cultural contexts. Methods A descriptive cross-sectional correlational design was employed, adhering to the STROBE checklist for cross-sectional studies. Using convenience sampling, 350 nursing students from the Faculty of Nursing, Arab American University, Palestine were approached for participation. The Clinical Decision-Making in Nursing Scale and Academic Self-Efficacy Scale were administered. Descriptive statistics, Pearson's correlation, and multiple linear regression were conducted for data analysis. Results Of 350 students approached, 321 completed the study. The results revealed a significant positive correlation between academic self-efficacy and clinical decision-making ( r = 0.538, P < .01). Multiple linear regression analysis identified academic self-efficacy (β = 0.389, P < .001), grade point average (β = 0.272, P < .001), and educational support (β = 0.162, P < .001) as factors significantly associated with clinical decision-making, collectively explaining 45.0% of the variance. Students scored highest in values-based decision-making (mean = 38.0, SD = 4.4) and lowest in information assimilation (mean = 31.9, SD = 7.2). No statistically significant gender differences were observed. Conclusion This study provides evidence of a significant association between academic self-efficacy and clinical decision-making among nursing students. While these findings contribute to understanding factors associated with decision-making skills, the cross-sectional design precludes causal conclusions. Nursing education programs may benefit from implementing pedagogical strategies that build self-efficacy, such as simulation and mentorship, with appropriate adaptation to local contexts. Further longitudinal and experimental research across diverse settings is needed to establish causality and inform evidence-based educational interventions.