Self-efficacy beliefs facilitate the learning and development of medical students. Although research on the self-efficacy beliefs of medical students is of great interest in medical education, no attempts have been made to systematically review the research and examine the validity of the measurement tools used in the research. The findings from this review suggest that research on medical students self-efficacy is growing rapidly and is becoming increasingly international, but that much research is not aligned with the conceptual underpinnings of the construct, thus reducing the validity of its measurement
Bandura’s social cognitive theory suggests that self-efficacy – defined as the confidence to carry out the courses of action necessary to accomplish desired goals – plays an important role in influencing achievement outcomes through its dynamic interplay with environmental and behavioural determinants. Although skills and knowledge provide the raw materials for student success in medical education, beliefs about personal capabilities to use these raw materials can spell the difference between success and failure. Self-efficacy beliefs provide the underpinning for motivation, well-being and achievement and ‘are rooted in the core belief that one has the power to effect changes by one’s actions’ (P. 622).
According to self-efficacy theory, the factors that influence behaviour are embedded in the belief that one has the capability to accomplish that behaviour. In most cases, people will choose to engage in activities in which they are confident of success, and avoid those in which they are not.
In Bandura’s social cognitive theory of human agency, self-efficacy reflects internal personal beliefs that interact bi-directionally with behavioural and environmental determinants, illustrated in a model of triadic reciprocal causation. Self-efficacy operates as an intra-personal motivation variable that captures the core aspects of human agency, namely people’s beliefs that they are contributors, but not sole determiners, of what happens to them. According to Bandura’s conceptualization, self-efficacy is characterized by: (a) beliefs about future actions, not past performance; (b) beliefs about capabilities, not outcome expectations; and (c) domain specificity, not assessment of generalized traits. Other constructs bear conceptual similarity to self-efficacy. For example, self-efficacy is conceptually separable from confidence. Although the two constructs are sometimes used interchangeably by researchers, confidence is a ‘catchword rather than a construct embedded in a theoretical system’ (P. 382) . Self-confidence has been the attention of research but with a relatively modest conceptual foundation. Self-confidence reflects strength of belief (She is a self-confident person), but not the target or specific domain for that belief. Research on self-efficacy offers the advantage of building on a strong theoretical foundation that provides a deeper understanding of human agency. Self-efficacy is separable from other constructs such as self-concept, which refers to multidimensional self-perceptions that are past-oriented, aggregated, and normative; self-esteem, which refers to personal judgments of self-worth; or locus of control, which refers to generalized beliefs that actions affect outcomes
In contrast, self-efficacy beliefs are goal-oriented, context-specific, and future-oriented judgments of capabilities that change according to the task involved. Self-efficacy refers to beliefs about capabilities rather than an evaluation of past success or judgments about outcome expectations that flow from self-efficacy.
Operationally, self-efficacy measures typically include words indicating assessment of capability, such as can and confident: ‘I am confident that I can solve this problem.’ Finally, self-efficacy is domain-specific, not a generalized trait of self-confidence that does not specify a particular task or domain. People differ in their efficacy across different domains of functioning; the construction of valid self-efficacy scales requires attention to specific domains of functioning, rather than overall well-being