The effect of nursing students' physical examination self-efficacy on their clinical decision-making levels

Aim: This study was designed to determine the effect of nursing students' physical examination self-efficacy on their level of clinical decision-making. Material and Method: This descriptive and correlational study was conducted with 323 nursing students from all academic years at Ordu University during the 2023–2024 academic year.The data were collected by the researcher through face-to-face interviews between May and June 2024 using the "Descriptive Information Form," the " Physical Examination Perceived Self-Efficacy Instrument (PEPSEI)" and the "Clinical Decision-Making in Nursing Scale (CDMNS)." The data were analyzed using a suitable statistical software program, including descriptive tests, t-test, ANOVA, and correlation analyses, and were evaluated within a confidence interval of p˂0.05. Results: The students' mean age was 21.25±2.57; 76.2% were female, 64.4% chose nursing willingly, and the average GPA was 2.82±0.39. It was found that 81.4% of the students used physical examination methods in nursing practice; 80.8% used palpation, and 61.9% used inspection techniques. The majority reported feeling confident while performing physical examinations. The mean total score on the PSEPENS was 2.10±0.47, and the mean total score on the CDMNS was 144.49±14.87. Among the PEPSEI subdimensions, the highest scores were in the "Cardiovascular" domain, while the lowest were in the "Ear, Nose, and Throat" domain. In the CDMNS, the highest scores were in the "Evaluating Outcomes" domain, and the lowest in the "Searching for Alternatives or Options" domain. It was found that PSEPENS scores increased with age (r=0.119, p=0.032), male students had higher self-efficacy scores (t=2.471, p=0.015), and final-year students scored significantly higher (F=3.535, p=0.015). CDMNS scores were higher among female students (t=-4.243, p=0.000) and increased with GPA (r=0.164, p=0.003). Although no statistically significant overall effect was found between physical examination self-efficacy and clinical decision-making (R=0.089, R²adjusted=0.005, F(1,321)=2.571; p=0.110), a significant relationship was found between cardiovascular examination skills and CDMNS scores (r=0.202, p=0.000). Conclusions: Nursing students' perceived physical examination self-efficacy was at a moderate level, while their clinical decision-making skills were above average. These two constructs did not significantly influence each other overall; however, a significant relationship was identified between cardiovascular examination skills and clinical decision-making. Demographic variables such as age, gender, academic year, and GPA were found to have an impact on both physical examination self-efficacy and clinical decision-making. Keywords: Physical examination, physical examination self-efficacy, nursing students, clinical decision-making, clinical practice