Academic self-efficacy and perceived stressors for surgical practice in nursing students: A descriptive and correlational design

Academic self-efficacy and perceived stressors for surgical practice in nursing students: A descriptive and correlational design | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Academic self-efficacy and perceived stressors for surgical practice in nursing students: A descriptive and correlational design Esma Ozsaker, Zuleyha Aykut, Nihal Celikturk Doruker, Burcak Sahin Koze, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5235156/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 26 Feb, 2025 Read the published version in BMC Nursing → Version 1 posted 4 You are reading this latest preprint version Abstract Background: In high-stress surgical settings, it's crucial to recognize nursing students' academic self-confidence and the stressors they perceive. This understanding helps them effectively navigate their educational journey and cultivate a strong professional identity. Methods: This study aimed to determine the relationship between nursing students' academic self-efficacy and perceived stressors for professional practice in surgical clinics. The study design is descriptive and correlational. A total of 284 undergraduate nursing students practicing in surgical clinics at a university in Izmir province were recruited during the 2022-2023 academic year. A Personal Information Form, the Academic Nurse Self-Efficacy Scale (ANSES), and the Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR) were used to collect data. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis were used to analyze the data. Results: The mean age of the students included in the study was 21.02±1.52 years. The mean total score of the ANSES was 51.50±6.88 and the mean total score of the NSPCSS-TR was 82.98±15.58. There was no statistically significant relationship between the ANSES and NSPCSS-TR scores (r:-0.022, p:0.711). It was found that there was a statistically significant positive weak relationship between the ANSES sociability sub-dimension score and the NSPCSS-TR academic performance of the instructor sub-dimension score (r:0.190, p:0.001). It was found that there was a statistically significant negative weak relationship (r:-0.163, p:0.006) between ANSES external emotion management subscale score and NSPCSS-TR inappropriate situations in the clinical environment subscale score. Conclusions: This study found that nursing students' perceptions of academic self-efficacy and clinical stressors were high. It is recommended that programs aimed at improving the academic self-efficacy of nursing students should be implemented, that clinical practice should be emphasized as an important part of nursing education and that comprehensive studies should be conducted to reduce perceived stress in surgical clinics. Nursing education nursing student academic self-efficacy clinical stressor surgical clinic Introduction Nursing education is an applied and dynamic process that includes both theoretical and practical educational methods and requires observation and interpretation [ 1 ]. The clinical education and learning environment is an integral part of the educational program and constitutes almost half of the nursing curriculum [ 2 – 4 ]. During the clinical education process, students gain clinical competence by having the opportunity to transfer the theoretical knowledge they have learned into practice [ 5 ]. Clinical education provides students with the opportunity to put their knowledge into practice by improving their professional knowledge and skills as a result of facing practical realities that may affect their future professional practice [ 3 , 6 , 7 ]. Undergraduate nursing education in Turkey is a four-year program, and clinical practice plays an important role in nursing education. The clinical competence of undergraduate nursing students is necessary to provide quality care and high-standard nursing services [ 8 ]. To improve clinical competence, it is important to identify factors that may affect students' clinical competence. Since surgical clinics are clinics that include perioperative nursing care of patients, it is important for nursing students to plan and implement appropriate nursing care in the patient care process for appropriate clinical performance [ 5 ]. During clinical practice, students may face many difficulties or threats such as how to use high-technology medical equipment, how to carry out the application process in specialized units such as operating theatres, how to maintain good relationships with clinical staff and instructors, how to manage and cope with the demands of the patient's relatives, sudden changes in the patient's condition. These difficulties experienced in the clinical experience process can cause students to perceive stress [ 9 ]. The stress perceived by nursing students in a clinical setting is defined as the gap between the students' needs in a particular clinical situation and their resources or skills to cope with a task or situation [ 10 ]. It has been stated that nursing students who have negative clinical experiences and are exposed to clinical stress during the clinical practice process have decreased self-confidence, academic performance, motivation and interest in the profession, and their physical and mental health is affected [ 11 – 15 ]. The negative effects of stress on nursing students can be offset by personal and environmental support [ 16 ]. For example, high levels of self-efficacy contribute to the student's ability to effectively manage their academic responsibilities, whereas low levels of self-efficacy can lead to additional psychological distress [ 16 , 17 ]. Self-efficacy is also reported to have a positive and moderating effect on students' stress and ability to manage tasks and clinical responsibilities related to patient care [16, 18]. It is stated that students' perception of high academic self-efficacy (ASE) increases their level of motivation and strengthens their ability to cope with new or challenging tasks. It is stated that students' perception of low self-efficacy may lead them to leave their responsibilities unfinished and feel helpless [ 19 ]. In this direction, it is recommended to evaluate academic and clinical self-efficacy to assess and improve the clinical education process during the education of nursing students. For this reason, the assessment of ASE and its reflection on clinical practice is an issue that needs to be investigated. This study aimed to investigate the relationship between nursing students' ASE and their perceived stressors in surgical clinics. Research questions; What is the ASE of nursing students? What are the perceived stressors of nursing students in surgical clinics? Is there a relationship between nursing students' ASE and perceived stressors in surgical clinics? Aim The purpose of this study is to determine the relationship between nursing students' academic self-efficacy and perceived stressors for professional practice in surgical clinics. Methods Study design The study is descriptive and cross-sectional. Study setting and sample The population of this study consisted of 362 second-year students who were studying at the Faculty of Nursing of a university in Western Turkey in the spring semester of the 2022–2023 academic year and who were practicing in surgical clinics as part of the Diseases and Nursing Care I lesson. Students practiced in the clinics of general surgery, urology, brain and nerve surgery, cardiovascular surgery, eye surgery, orthopedics and traumatology, organ transplantation, plastic surgery, thoracic surgery, otolaryngology, and emergency department. The study aimed to reach the whole population without using the sample selection method, and 284 second-year students who practiced in surgical clinics as part of the Diseases and Nursing Care I course and accepted to participate in the study constituted the sample of the study. Data collection tools A Personal Information Form, the Academic Nurse Self-Efficacy Scale (ANSES), and the Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR) were used to collect data. Personal information form This form was developed by reviewing the literature [ 20 – 23 ] to determine the socio-demographic and diagnostic characteristics of the students. There are a total of 13 questions, nine multiple-choice questions, and four open-ended questions, including age, gender, marital status, academic achievement grade point average, perceived academic success, the surgical clinic where practice takes place, and emotions felt when going to practice, etc. Academic Nurse Self-Efficacy Scale (ANSES) : This scale was developed by Bulfone et al. and adapted into Turkish by Aktay & Korkmaz [ 24 – 25 ]. The scale has four sub-dimensions, namely internal emotion management, self-control/automatically controlled behavior, external emotion management, and sociability, and a total of 14 items. The scale is a 5-point Likert scale. The items in the scale are scored as follows: 'I do not trust myself at all' 1 point, 'I do not trust myself' 2 points, 'I neither trust myself nor resent myself' 3 points, 'I trust myself' 4 points, 'I trust myself a lot' 5 points. The maximum score that can be obtained from the scale is 70 and the minimum score is 14. There are no reverse-scored items on the scale. As the scores obtained from the scale increase, the students' ASE increases. The total Cronbach alpha value of the scale was 0.83 [ 24 ]. In this study, the Cronbach alpha value of the scale was found to be 0.81. Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR) This scale was developed by Rafati et al. The Turkish validity and reliability study was conducted by Aydin et al. [ 3 , 11 ]. The scale consists of the following six sub-dimensions and a total of 22 items. The scale has six sub-dimensions and 22 items, including inappropriate situations in the clinical environment (items 7, 8, 9, 10, 11 and 12), inappropriate behavior of the lecturer (items 16, 17, 18 and 19), academic performance of the lecturer (items 1, 2 and 3), attitude of the lecturer towards education (items 4, 5 and 6), inadequate knowledge and skills of the student (items 13, 14 and 15) and concerns about nursing care (items 20, 21 and 22). The scale is a 5-point Likert type and the items in the scale 'Never causes stress' 1 point, 'Rarely causes stress' 2 points, 'Sometimes causes stress' 3 points, 'Too often causes stress' 4 points, 'Always causes stress' are scored as 5 points. There are no reverse items on this scale. The highest score that can be obtained from the scale is 110 and the lowest score is 22. High scores indicate that students have a high perception of clinical stressors. The total Cronbach alpha value of the scale was 0.91 [ 11 ]. In this study, the Cronbach alpha value of the scale was 0.94. Data collection The study data were collected through face-to-face interviews with students practicing in surgical clinics as part of the Diseases and Nursing Care I course between April and June 2023. Students practice in surgical clinics three days a week on Tuesdays, Wednesdays, and Thursdays for three weeks. Data were collected on the last day of practice. First, the purpose of the study was explained to the students, and then written informed consent was obtained from the students. It took approximately 10 minutes for the students to complete the data collection form. Statistical analysis of data Statistical analyses were performed using IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). Data on socio-demographic characteristics and attitudes towards the nursing profession were analyzed using descriptive statistics (number, percentage, mean, standard deviation). The normality of the distribution of quantitative data was tested using the Kolmogrov-Smirnov test. (The values obtained by dividing the skewness value by its standard deviation value were found to be outside the values of -1.96 + 1.96). Since the data did not show normal distribution, continuous measurements were evaluated with nonparametric tests; the Mann-Whitney Test and the Kruskal-Wallis test were used. Correlation between quantitative data was assessed using Spearman's Rho correlation coefficient. The value of P < 0.05 was considered the statistical significance limit. Ethical considerations Ethical approval was obtained from the Ethics Committee for Scientific Research and Publication at Ege University (approval number: 23-1.1T/20, Date: 26.01.2023). Written approval was obtained from the institution where the research was conducted. All of the students were informed about the aim and procedure of the research, and written approval was obtained from those who agreed to participate. All participants were informed that data would be kept confidential and that their performances would in no way affect their lesson grades. Before starting the study, permission was obtained by e-mail from Aydin and Aktay who conducted the Turkish validity and reliability study of the Scale. Results The mean age of the nursing students participating in the study was 21.02 ± 1.52 (min: 19, max: 36) years and the mean academic achievement grade was 2.95 (out of 4.00 points). 85.6% (n: 243) of the students were female, 58.1% (n: 165) lived in a dormitory, 82% (n: 233) reason for choosing nursing was easy to find a job, 47.2% (n: 134) were satisfied with being a student nurse, 78.2% (n: 222) reported that they were curious, 78.5% (n: 223) reported their academic success as moderate (Table 1 ). The mean total ANSES and NSPCSS-TR scores of the nursing students were found as 51.50 ± 6.88 (min: 17, max: 70) and 82.98 ± 15.58 (min: 22, max: 110), respectively. The distributions of the mean scores of the sub-dimensions of the scales are shown in Table 2 (Table 2 ). Table 1 Descriptive characteristics of the students The mean age 21.02 ± 1.52 (min: 19, max: 36) The mean academic achievement grade 2.95 (out of 4.00 points) Characteristics n % Gender Female Male 243 41 85.6 14.4 Place of residence Home (alone) Home (with friend) Home (with family) Dormitory 18 44 57 165 6.3 15.5 20.1 58.1 Reason for choosing nursing*. I like the nursing profession It is the profession of the future My family's wishes and insistence Good salaries Easy to find a job Not having enough points for another department Other reasons 85 115 72 46 233 67 8 29.9 40.5 25.4 16.2 82.0 23.6 2.8 Satisfaction with being a student nurse Satisfied Not satisfied Undecided 134 28 122 47.2 9.9 43.0 Practice clinic Emergency Room General Surgery Clinic Urology Clinic Brain and Nerve Surgery Clinic Cardiovascular Surgery Clinic Eye Surgery Clinic Orthopedics Clinic Organ Transplantation Clinic Plastic Surgery Clinic Thoracic Surgery Clinic Otolaryngology Clinic 32 49 27 41 25 15 39 4 25 9 18 11.3 17.3 9.5 14.4 8.8 5.3 13.7 1.4 8.8 3.2 6.3 Emotions experienced in clinical practice Anxiety Stress Excitement Curiosity other 58 122 183 222 7 20.4 43.0 64.4 78.2 2.5 Perceived academic success Low Moderate High 26 223 35 9.2 78.5 12.3 * There was more than one answer to this question. Table 2 ANSES and NSPCSS-TR scores Scales X ± SD Median Min-Max ANSES Internal emotion management 10.63 ± 213 11.00 3.00–15.00 Self-control/automatically controlled behavior 15.17 ± 2.52 16.00 4.00–20.00 External emotion management 12.85 ± 3.32 13.00 4.00–20.00 Sociability 12.86 ± 1.95 13.00 3.00–15.00 Total Score 51.50 ± 6.88 52.00 17.00–70.00 NSPCSS-TR Academic performance of the lecturer 10.91 ± 2.52 11.00 3.00–15.00 Attitude of the lecturer towards education 10.29 ± 2.35 10.00 3.00–15.00 Inappropriate situations in the clinical environment 22.90 ± 4.80 24.00 6.00–30.00 Inadequate knowledge and skills of the student 11.67 ± 2.84 12.00 3.00–15.00 Inappropriate behavior of the lecturer 15.96 ± 3.46 16.00 4.00–20.00 Concerns about nursing care 11.26 ± 2.79 12.00 3.00–15.00 Total Score 82.98 ± 15.58 85.00 22.00-110.00 x: Mean, SD: Standard deviation, ANSES: Academic Nurse Self-Efficacy Scale, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale When the relationship between the scores of the nursing students' ANSES scores and the scores of the NSPCSS-TR was analyzed, it was found that there was no significant relationship between the two scales (r: -0.022, p:0.711). It was determined that there was a significant positive correlation between the sociability sub-dimension of the ANSES and the academic performance of the instructor sub-dimension of the NSPCSS-TR (r: 0.190, p: 0.001). It was found that there was a significant negative correlation between the external emotion management sub-dimension of the ANSES and the inappropriate situations in the clinical environment sub-dimension of the NSPCSS-TR (r: -0.163, p:0.006) (Table 3 ). Table 3 Relationship Between ANSES and NSPCSS-TR scores ANSES NSPCSS-TR Academic performance of the lecturer Attitude of the lecturer towards education Inappropriate situations in the clinical environment Inadequate knowledge and skills of the student Inappropriate behavior of the lecturer Concerns about nursing care Total Score İnternal emotion management r: -0.032 p: 0.589 r: -0.075 p: 0.208 r: -0.106 p: 0.074 r: -0.092 p: 0.123 r: -0.089 p: 0.132 r: -0.083 p: 0.162 r: -0.086 p: 0.148 Self-control/ automatically controlled behavior r: 0.114 p: 0.055 r: -0.021 p: 0.727 r: 0.054 p: 0.360 r: 0.108 p: 0.069 r: 0.110 p: 0.065 r: 0.034 p: 0.572 r: 0.091 p: 0.128 External emotion management r: -0.040 p: 0.505 r: -0.002 p: 0.970 r: -0.163** p: 0.006 r: -0.128* p: 0.032 r: -0.113 p: 0.058 r: -0.126* p: 0.034 r: -0.123* p: 0.039 Sociability r: 0.190** p: 0.001 r: 0.065 p: 0.278 r: 0.130* p: 0.028 r: 0.073 p: 0.220 r: 0.135* p: 0.023 r: 0.120* p: 0.044 r: 0.141* p: 0.017 Total Score r: 0.073 p: 0.222 r: -0.027 p: 0.656 r: -0.067 p: 0.262 r: -0.036 p: 0.546 r: -0.009 p: 0.877 r: -0.049 p: 0.410 r: -0.022 p: 0.711 r: Spearman Korelasyon Katsayısı, ANSES: Academic Nurse Self-Efficacy Scale, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale **Correlation is significant at the 0.01 level (2-tailed). *Correlation is significant at the 0.05 level (2-tailed). The distribution of the total score and sub-dimension mean scores of the scales according to the variables is shown in Table 4 . In the study, it was found that the mean total score of the Nursing Students Academic Self-Efficacy Scale of male student nurses was significantly higher than that of female student nurses (p:0,001). It was found that the mean total scores of the Nursing Students Academic Self-Efficacy Scale of the students who were satisfied with studying in the department of nursing were significantly higher than those of the students who were dissatisfied and undecided (p:0,004). It was found that the mean total scores of the Nursing Students Academic Self-Efficacy Scale of students with high perceived academic success were significantly higher than those of students with low and medium academic success (p:0,001). In the study, it was found that the mean total scores of female student nurses on the Clinical Stressor Perceptions of Nursing Students Scale were significantly higher than those of males (p:0,001) (Table 5 ). Table 4 Distribution of ANSES mean scores by independent variables Characteristics ANSES Total Score X±SD Internal emotion management X±SD Self-control/ automatically controlled behavior X±SD External emotion management X±SD Sociability X±SD Gender Female Male 50.91±6.80 54.98±6.38 U: 3262.000 p:0.001** 10.45±2.06 11.68±2.25 U: 3128.500 p:0.001** 15.18±2.58 15.07±2.17 U: 4632.000 p:0.466 12.42±3.21 15.32±2.88 U: 2307.000 p:0.001** 12.85±1.93 12.90±2.07 U: 4837.500 p:0.760 Satisfaction with being a student nurse Satisfied Not satisfied Undecided 52.72±6.53 48.57±8.90 50.83±6.48 X 2: 10.909 p: 0.004** 10.87±2.17 9.96±2.55 10.52±1.94 X 2 : 6.359 p: 0.042 15.71±2.22 14.04±3.10 14.83±2.56 X 2 : 14.402 p: 0.001** 12.78±3.39 13.21±2.94 12.83±3.33 X 2 : 0.204 p: 0.903 13.35±1.63 11.36±2.78 12.66±1.85 X 2 : 20.439 p: 0.001** Perceived academic success Low Moderate High 47.62±8.73 51.39±6.48 55.09±6.26 X 2 : 17.758 p: 0.001** 9.50±2.66 10.61±2.06 11.60±1.69 X 2 : 13.078 p: 0.001** 14.08±3.16 15.10±2.40 16.40±2.35 X 2 : 10.320 p: 0.006** 12.00±3.82 12.80±3.28 13.80±3.03 X 2 : 4.420 p: 0.110 12.04±2.63 12.89±1.87 13.29±1.76 X 2 : 4.278 p: 0.118 x: Mean, SD: Standard deviation, U: Mann-Whitney U test, X2: Kruskal-Wallis test, ANSES: Academic Nurse Self-Efficacy Scale, Table 5 Distribution of NSPCSS-TR mean scores by independent variables NSPCSS-TR Characteristics Total Score X±SD Academic performance of the lecturer X±SD Attitude of the lecturer towards education X±SD Inappropriate situations in the clinical environment X±SD Inadequate knowledge and skills of the student X±SD Inappropriate behavior of the lecturer X±SD Concerns about nursing care X±SD Gender Female Male 84.83±14.07 71.98±19.39 U: 3043.50 p: 0.001** 11.10±2.38 9.83±3.06 U: 3863.50 p: 0.020* 10.48±2.22 9.10±2.75 U: 3545.00 p: 0.003** 23.37±4.46 20.12±5.78 U: 3314.50 p: 0.001** 11.98±2.60 9.78±3.47 U: 3087.00 p: 0.001** 16.37±3.18 13.54±4.07 U: 2863.50 p: 0.001** 11.54±2.64 9.61±3.15 U: 3225.00 p: 0.001** Practice clinic Emergency General Surgery Urology Neurosurgery Cardiovascular Surgery Eye Surgery Orthopedics Transplantation Plastic Surgery Thoracic Surgery Otolaryngology 80.41±15.57 86.35±13.06 85.48±18.78 80.44±17.07 84.52±12.60 81.80±17.99 83.28±15.12 82.25±5.06 84.80±12.25 79.67±17.32 77.83±20.47 X 2 : 6.461 p: 0.775 10.34±2.44 11.20±2.051 11.96±2.95 10.51±2.76 10.76±1.83 10.73±2.81 10.92±2.76 11.75±0.50 11.12±2.54 10.44±2.07 10.50±296 X 2 : 12.946 p:0.0227 10.25±226 11.02±1.88735 10.15±3.08 9.71±2.32 9.88±2.33 9.93±2.66 10.33±2.24 10.00±1.41 11.12±1.54 9.56±3.54 9.83±2.62 X 2 : 14.780 p:0.140 22.31±4.93 23.78±4.66 23.52±5.22 22.24±4.83 23.56±3.98 22.13±5.89 23.44±4.63 22.75±1.71 22.84±3.45 21.89±6.07 21.28±6.14 X 2 : 5.791 p:0.832 11.56±3.10 12.24±2.37 11.89±2.87 11.44±3.03 12.24±2.55 12.13±2.90 11.36±2.86 11.50±1.29 11.56±2.50 11.33±3.08 10.28±3.75 X 2 : 6.264 p:0.793 15.31±3.50 16.59±3.17 16.11±4.15 15.49±3.88 16.32±2.97 15.20±4.04 16.31±3.30 16.25±1.71 16.32±3.36 15.89±3.02 15.06±3.35 X 2 : 6.704 p:0.753 10.63±2.85 11.51±2.72 11.85±2.88 11.05±3.00 11.76±1.85 11.67±2.53 10.92±2.51 10.00±1.83 11.84±2.98 10.56±4.33 10.89±3.25 X 2 : 9.034 p:0.529 Satisfaction with being a student nurse Satisfied Not satisfied Undecided 82.61±14.76 80.32±20.70 83.98±15.16 X 2 : 0.971 p: 0.615 11.05±2.42 10.39±3.10 10.87±2.49 X 2 : 1.283 p: 0.527 10.26±2.11 10.32±3.21 10.30±2.39 X 2 : 0.439 p: 0.803 22.50±4.75 22.29±6.32 23.48±4.42 X 2 : 3.588 p: 0.166 11.53±2.70 11.21±3.72 11.92±2.76 X 2 : 1.740 p: 0.419 16.10±3.42 15.29±4.05 15.96±3.37 X 2 : 0.818 p: 0.664 11.17±2.74 10.82±3.33 11.47±2.72 X 2 : 1.145 p: 0.564 Perceived academic success Low Moderate High 85.77±17.92 82.69±15.49 82.74±14.56 X 2 : 2.038 p: 0.361 11.08±2.70 10.81±2.53 11.40±2.30 X 2 : 1.378 p: 0.502 10.54±2.60 10.24±2.35 10.34±2.20 X 2 : 0.834 p: 0.659 24.19±5.31 22.73±4.79 23.03±4.42 X 2 : 3.034 p: 0.219 12.15±3.59 11.60±2.74 11.77±2.90 X 2 : 3.231 p: 0.199 16.31±4.31 15.96±3.43 15.65±3.00 X 2 : 2.313 p: 0.315 11.50±3.41 11.35±2.69 10.54±2.93 X 2 : 2.936 p: 0.230 x: Mean, SD: Standard deviation, U: Mann-Whitney U test, X2: Kruskal-Wallis test, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale, *p<0.05, ** p<0.01 Discussion Nursing students’ ASE levels ASE is defined as students' assessment of their abilities to achieve educational goals [ 26 ] and their confidence in themselves to successfully complete academic tasks [ 27 ]. It is emphasized that special attention should be paid to the monitoring and development of the ASE in the nursing education process [ 26 ]. In this study, when the total mean scores and sub-dimension scores of ASE of nursing students were examined, it was found to be above average. Similar to the findings of this study, it was found that self-efficacy scores were above average in studies that examined self-efficacy levels in nursing students [ 28 – 31 ]. Self-efficacy levels can increase the independence of nursing students, allowing them to exert more effort to overcome difficulties and achieve goals [ 8 ] and increase professional job satisfaction [ 32 ]. Interventions to promote self-efficacy should be structured together with the mentor and the clinical nurse during lectures and clinical practice [ 26 ]. When the total and sub-dimensional mean scores of the nursing students' ANSES were analyzed according to the gender variable, it was found that the total and sub-dimensional mean scores of the male students' ANSES were higher than those of the female students (p:0.001). The high scores of male nursing students on the ASE suggest that this group of students has a high level of confidence in their academic abilities, performance, and learning process. In the study, it was found that the self-efficacy perceptions of the students who were satisfied with studying in the nursing department were significantly higher (p: 0.004) than those who were dissatisfied and undecided. Similarly, as a result of some studies [ 30 – 33 ], it is highlighted that the ASE of the students who willingly chose the nursing department was higher and significantly affected their academic success. The high ASE scores of students with high satisfaction suggest that this group of students has high confidence in their abilities and belief in their success and that students with high self-efficacy also can manage their academic responsibilities positively and regularly [16,18]. The results of the study found that students with high academic achievement perceptions had significantly higher total scores on the ANSES (p: 0.001) than students with low and medium achievement perceptions. Bulfone et al (2022) found that high levels of self-efficacy significantly increased the likelihood of academic success [ 26 ]. This relationship is consistent with the literature, as many studies have shown that students with high levels of self-efficacy are more likely to achieve academic success [ 34 , 35 ]. It can be assumed that high academic achievement perceptions may influence students' intrinsic motivation and self-efficacy perceptions, and these students may be more likely to achieve higher levels of success by feeling confident in their abilities. In addition, it is thought that these students with high academic achievement perceptions may be more motivated because they have a positive perception of success, and with this motivation, they may put in more work and effort. This finding overlaps with the definition of ASE in the literature. It also supports the findings that students' self-efficacy perceptions positively affect their learning speed and increase their academic success [ 5 , 19 , 26 ]. One of the current strategies to counteract the academic failure of nursing students is the development of students' ASE [ 26 ]. Nursing students' clinical stressors levels Nurse educators need to identify areas for improvement to help students achieve high levels of clinical competence and to ensure the quality of the educational process [ 36 ]. To this end, it is important to assess students' perceptions of the clinical learning environment [ 37 ]. In this study, nursing students' perceptions of clinical stressors were found to be high. Karaca et al. (2017) also showed that the stress levels of Turkish nursing students in clinical practice were higher than the stress levels reached in studies conducted in other countries using the same scales [ 38 ]. The clinical learning environment can be an important source of stress for nursing students [ 39 ]. It has been stated that the most stressful factors for students in clinical practice are clinical stressors (e.g. lack of professional knowledge and skills, communication with patients and clinical staff, difficulties in hospital adaptation) and academic stressors (e.g. clinical examinations, communication with lecturers) [ 29 ]. In addition, problems may be caused by the high number of students in clinical practice, the presence of students from other faculties in the same clinical practice environment, the lack of appropriate practice areas, and the neglect of students by the existing healthcare team [ 40 ]. Students' inadequate knowledge and skills for practice, mistakes, unclear expectations from the instructor, thoughts such as encountering negative reactions, and low self-confidence may be the cause of clinical stress [ 29 ]. Negative clinical education experiences may lead to a decrease in students' self-confidence, academic performance, motivation, and interest in the profession, which may affect their physical and mental health [ 11 ]. The stress experienced by students in clinical education is an important factor that reduces the effectiveness of education [ 29 ]. Nursing students with high-stress levels have been found to have low academic performance and clinical competence [16,41]. Therefore, clinical stressors should be effectively managed, and the clinical practice environment should be considered as the best learning environment opportunity [ 3 , 42 ]. Identifying students' sources of clinical stress and providing them with adequate support to cope with it can reduce students' exposure to the negative effects of stress and improve the quality of professional care. The study found that the mean total score of the NSPCSS-TR was significantly higher in female nursing students than in male nursing students (p: 0.001). Gender may affect on an individual's perception of stress. This may suggest that female students experience more stress during the nursing education process. It is thought that the higher perceptions of clinical stress in female nursing students compared to male nursing students may be due to occupational stressors, for example, gender role expectations or gender-related difficulties within the profession may influence these differences. In the literature, no relationship was found between gender and perceived stress [ 43 , 44 , 45 ]. Although this study result does not support the literature in this regard, in another study that investigated the relationship between educational stress and professional self-esteem among nursing students, the mean scores of female students were higher than male students, which is similar to our study result [ 46 ]. Correlations between self-efficacy and clinical stressors Evaluating students' views and self-efficacy perceptions about clinical practice will contribute to the development of effective clinical teaching strategies by assessing the effectiveness of strategies adopted in nursing education for clinical teaching [ 47 ]. In this study, which aimed to examine the relationship between ASE and perceptions of clinical stressors among nursing students who were practicing in surgical clinics for the first time, no significant relationship was found between nursing students' ASE and perceptions of clinical stressors (p > 0.05). In the study conducted by Aciksoz et al. (2016) on nursing students, in which they investigated the relationship between self-efficacy perception and anxiety and stress toward clinical practice, it was found that the level of anxiety toward clinical skills decreased with the increase in students' self-efficacy perception; however, no significant relationship was found between self-efficacy perception and perceived stress toward clinical skills (p > 0.05) [ 29 ]. Ozvurmaz and Mandıracıoglu (2018) found a moderately significant relationship between ASE perception and clinical teaching perception in nursing students [ 48 ]. Göger and Cevirme (2018) found that the level of self-efficacy of nursing students was affected by educational stress [ 30 ]. Yu et al. (2021) found that self-efficacy mediated the relationship between clinical learning environment and clinical competence [ 8 ]. In another study, it was reported that students who came to the nursing department willingly were more determined to cope with the problems they encountered and that individuals with high levels of self-efficacy were more determined to succeed [ 49 ]. Understanding students' perceptions of self-efficacy and the factors that may affect their learning, such as stress in the clinical environment, has been reported to enable the planning of activities to improve the effectiveness of nursing education and have important implications for the future of education [ 29 ]. It was found that there was a significant positive correlation between the ANSES sociability sub-dimension of nursing students and the NSPCSS-TR academic performance of the instructor sub-dimension (r: 0.190, p: 0.001). This indicates that as nursing students' social skills (sociability sub-dimension) increase, so do their perceptions of the academic performance of the instructor. This can be interpreted as students with social skills perceiving their academic performance positively. It can be interpreted that improving social skills or increasing interaction with lecturers can positively affect students' perceptions of academic performance. It is thought that educational programs and social support services can have a positive effect on students' academic performance perceptions by focusing on improving nursing students' social skills. The significant negative correlation between nursing students' ANSES external emotion management sub-dimension and the NSPCSS-TR inappropriate situations in the clinical environment sub-dimension suggests that as nursing students' external emotion management skills increase (i.e. how they respond to stress and emotional reactions), their perception of inappropriate situations in the clinical environment decreases. Increased external emotion management skills may help student nurses cope more effectively with clinical stressors and reduce the tendency to perceive these stressors negatively. Contrary to the findings of this study, the literature indicates that nursing students who are exposed to clinical stressors or who have negative clinical experiences are less interested in the profession, their self-confidence, motivation, and academic performance decrease, and their physical and mental health is negatively affected [ 11 – 15 ], and students with high-stress levels have lower academic and clinical competencies [16,41]. As more effective management of clinical stressors by student nurses can have a positive impact on both their emotional well-being and academic performance, there is a need to increase the number of training and activities that can help student nurses cope with stress and improve their emotional management skills [ 3 , 38 , 50 ]. Conclusions and Implications The study found that nursing students' ASE and perceptions of clinical stress were high, and there was no significant relationship between nursing students' ASE and perceptions of clinical stress. It is recommended that programs aimed at improving nursing students' ASE should be implemented, that clinical practice, which is of great importance in nursing education, should be emphasized, and that comprehensive studies should be conducted to reduce perceived stress in surgical clinics. This study underscores the significance of addressing academic self-efficacy and stressors among nursing students, particularly those preparing for surgical practice. As nurses play crucial roles in surgical teams, their self-efficacy and stress management directly impact patient care outcomes. Therefore, nursing education should include interventions to boost students' self-efficacy and equip them with stress coping strategies for surgical settings. By investing in students' self-efficacy and stress management, healthcare systems can improve surgical care quality and patient safety. Declarations Ethics approval and consent to participate; Ethical approval for the study was taken from the ethics review committee of the institution where the research was carried out (approval number: 23-1.1T/20, Date: 26.01.2023). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Consent for publication: Not applicable. Availability of data and materials: The data that support the findings of this study are available from the authors upon reasonable request. Competing interests: The authors declare no competing interests. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors' contributions: All the authors have contributed to the study on conception and design, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published. All authors agree with the content of the manuscript. Study design: EO, ZA, NCD, BSK, SG Data collection: ZA, NCD, BSK, SG Data analysis: ZA, NCD, BSK, SG Study supervision: EO, ZA, NCD, BSK, SG Manuscript writing: ZA, NCD, BSK, SG Critical revisions for important intellectual content: EO Acknowledgements: We would like to thank all the students who agreed to participate in the study. Clinical trial number: not applicable. References Uzdil N, Gunaydin Y. The effect of sense of coherence on mindful attention awareness and academic self-efficacy in nursing students. Nurse Educ Pract. 2022;64:1–7. https://doi.org/10.1016/j.nepr.2022.103429 . Poorheidari M, Delvarzian ZM, Yahyaee S, Montazeri AS. Study of the stressful experiences of midwifery students during clinical education in the labor room. Res Med Educ. 2018;9(4):58–66. http://rme.gums.ac.ir/article-1-408-en.html . Rafati F, Nia SH, Khoshnood Z, Allen KA. Development and psychometric testing of nursing students’ perceptions of clinical stressors scale: an instrument design study. BMJ Psychiatry. 2021;21(1):1–10. 10.1186/s12888-020-02964-8 . https://link.springer.com/article/ . Sajadi SK. Evaluation of laboratory sciences students’ attitude toward their field of study and future career in Kurdistan University of Medical Sciences. Zanko J Med Sci. 2016;16:52–60. http://zanko.muk.ac.ir/article-1-104-en.html . Karahan Okuroglu G. The Relationship between nursing students' self-efficacy regarding their clinical performance with their academic self-efficacy and academic achievement: descriptive study. Turkiye Klinikleri J Nurs Sci. 2022;14(1):125–31. https://doi.org/10.5336/nurses.2021-83326 . Egan T, Jaye C. Communities of clinical practice: the social organization of clinical learning. Health. 2009;13(1):107–25. https://doi.org/10.1177/136345930809736 . Lee JJ, Clarke CL, Carson MN. Nursing students’ learning dynamics and influencing factors in clinical contexts. Nurse Educ Pract. 2018;29:103–9. https://doi.org/10.1016/j.nepr.2017.12.003 . Yu M, Tong H, Li S, Wu XV, Hong J, Wang W. Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. Nurse Educ Pract. 2021;53:103055. https://doi.org/10.1016/j.nepr.2021.103055 . Chan KLC, So KWW, Fong YTD. Hong Kong baccalaureate nursing students’ stress and their coping strategies in clinical practice. J Prof Nurs. 2009;25(5):307–13. https://doi.org/10.1016/j.profnurs.2009.01.018 . Admi H, Moshe-Eilon Y, Sharon D, Mann M. Nursing students’ stress and satisfaction in clinical practice along different stages: a cross-sectional study. Nurse Educ Today. 2018;68:86–92. https://doi.org/10.1016/j.nedt.2018.05.027 . Aydin M, Erdol H, Gorgoz M, Aksu FE. Turkish validity and reliability study of ‘nursing students’ perception of clinical stressors scale. Nurse Educ Pract. 2022;64:1–7. https://doi.org/10.1016/j.nepr.2022.103440 . Cornine A. Reducing nursing student anxiety in the clinical setting: An integrative review. Nurs Educ Perspect. 2020;41(4):229–34. https://doi.org/10.1097/01.NEP.0000000000000633 . Flott EA, Linden L. The clinical learning environment in nursing education: a concept analysis. J Adv Nurs. 2016;72(3):501–13. https://doi.org/10.1111/jan.12861 . Norouzi N, Imani B. Clinical education stressors in operating room students: A qualitative study. Invest Educ Enferm. 2021;39(1):1–12. https://doi.org/10.17533/udea.iee.v39n1e08 . Sharifipour F, Heydarpour S, Salari N. Nursing and midwifery students’ viewpoints of clinical learning environment: a cross-sectional study. Adv Med Educ Pract. 2020;11:447–54. https://doi.org/10.2147/AMEP.S253782 . Shehadeh J, Hamdan-Mansour MA, Halasa NM, Bani Hani HM, Nabolsi MM, Thultee I, et al. Academic and self-efficacy as predictors of academic satisfaction among nursing students. Open Nurs J. 2020;14:92–9. https://doi.org/10.2174/1874434602014010092 . Conner M, Self-Efficacy S, Social Support in Retention of Student Registered Nurse Anesthetists. AANA Journal, Matthews P, Coyne A. I. Stress and stressors in the clinical environment: A comparative study of fourth-year student nurses and newly qualified general nurses in Ireland. J Clin Nurs. 2013;22(5–6),770-9. https://doi.org/10.1111/j.1365-2702.2012.04145.x Aktas D, Sancar B. The relationship between the nursing students’ attitudes towards scientific research and their levels of academic self-efficacy. Manisa Celal Bayar Univ J Institue Health Sci. 2021;8(1):17–22. https://doi.org/10.34087/cbusbed.748244 . Buyukbayra Z, Ayik DB. Determination of nursing students’ stress levels related to nursing education. J Adnan Menderes Univ Health Sci Fac. 2020;4(2):90–9. Https://Doi.Org/10.46237/Amusbfd.562097 . (Original Study Published in Turkish). Demirbag BC, Bulut HK, Calık KY. Evaluation of Nursing Students' Educational Stress. J DU Health Sci Inst. 2021;11(2):159–64. https://doi.org/10.33631/duzcesbed.749779 . (Original Study Published in Turkish). Ma H, Zou JM, Zhong Y, Li J, He JQ. Perceived stress, coping style and burnout of Chinese nursing students in late-stage clinical practice: A cross-sectional study. Nurse Educ Pract. 2022;62:103385. https://doi.org/10.1016/j.nepr.2022.103385 . Pawlak ND, Serafin L, Czarkowska-Pączek B. Female sex and living in a large city moderate the relationships between nursing students’ stress level, perception of their studies, and intention to practice professionally: a cross-sectional study. Int J Environ Res Public Health. 2022;19(9):5740. https://doi.org/10.3390/ijerph19095740 . Aktay G, Cicek Korkmaz A. Exploring Psychometric Properties of the Turkish Version of the Academic Nurse Self-Efficacy Scale. Int J Scholars Educ. 2023;6(1):69–81. https://doi.org/10.52134/ueader.1270141 . Bulfone G, Vellone E, Maurici M, Macale L, Alvaro R. Academic self-efficacy in Bachelor-level nursing students: Development and validation of a new instrument. J Adv Nurs. 2020;76(1):398–408. https://doi.org/10.1111/jan.14226 . Bulfone G, Iovino P, Mazzotta R, Sebastian M, Macale L, Sili A, et al. Self-efficacy, burnout and academic success in nursing students: A counterfactual mediation analysis. J Adv Nurs. 2022;78(10):3217–24. https://doi.org/10.1111/jan.15231 . Warshawski S, Bar-Lew O, Barnoy S. Role of academic self-efficacy and social support on nursing students’ test anxiety. Nurse Educ. 2019;44(1):6–10. https://doi.org/10.1097/NNE.0000000000000552 . Abdal M, Alavi NM, Adib-Hajbaghery M. Clinical self-efficacy in senior nursing students: A mixed- methods study. Nurs Midwifery Stud. 2015;4(3):e29143. https://doi.org/10.17795/nmsjournal29143 . Aciksoz S, Uzun Ş, Arslan F. Assessment of relationship between nursing students’ self-efficacy and levels of their anxiety and stress about clinical practice. Gülhane Med J. 2016;58:129–35. https://doi.org/10.5455/gulhane . 169643 (Original Study Published in Turkish). Goger S, Cevirme A. The Effect of Nursing Students’ Self-Efficacy Levels on Education Stress. J Educ Res Nurs. 2019;16(4):306–12. https://doi.org/10.5222/HEAD.2019.306 . (Original Study Published in Turkish). Yuzer Alsac S, Oztas G. The factors affecting the academic self-efficacy levels of nursing students. J Health Nurs Manage. 2023;10(3):301–9. https://doi.org/10.54304/SHYD.2023.55477 . (Original Study Published in Turkish). De Simone S, Planta A, Cicotto G. The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction. Appl Nurs Res. 2018;39:130–40. https://doi.org/10.1016/j.apnr.2017.11.004 . Ozveren H, Gulnar E, Ozden D. Determination of the factors that affect the choice of career of the nursing students. Turkish J Clin Lab. 2017;8(2):57–64. https://doi.org/10.18663/tjcl.320040 . (Original Study Published in Turkish). Bouih A, Nadif B, Benattabou D. Assessing the effect of general self-efficacy on academic achievement using path analysis: A preliminary study. J Engl Lang Teach Appl Linguistics. 2021;3:18–24. https://doi.org/10.32996/jeltal.2021.3.4.3 . Schneider M, Preckel F. Variables associated with achievement in higher education: A systematic review of meta-analyses. Psychol Bull. 2017;143(6):565–600. https://doi.org/10.1037/bul0000098 . Albagawi B, Hussein FM, Alotaibi JS, Albougami AS, Amer FM, Alsharari AF. Self-efficacy and clinical competence of fourth-year nursing students: A self-reported study. Int J Adv Appl Sci. 2019;6(8):65–70. https://doi.org/10.21833/ijaas.2019.08.009 . Cochran KL, Moss M, Mealer M. Prevalence of coping strategy training in nursing school curricula. J Crit Care. 2020;29:104–10. https://doi.org/10.4037/ajcc2020287 . Karaca A, Yildirim N, Ankarali H, Acikgoz F, Akkus D. Nursing students' perceived levels of clinical stress, stress responses and coping behaviors. J Psychiatric Nurs. 2017;8(1):32–9. https://doi.org/10.14744/phd.2017.22590 . Mazalová L, Gurková E, Štureková L. Nursing students’ perceived stress and clinical learning experience. Nurse Educ Pract. 2022. https://doi.org/10.1016/j.nepr.2022.103457 . 64,103457. Camlibel M, Uludag E. Investigating the Psychometric Characteristics of the Nursing Students’ Perceptions of Clinical Stressors Scale. Journal of Nursing Effect., Shaban IA, Khater WA, Akhu-Zaheya LM. Undergraduate nursing students’ stress sources and coping behaviours during their initial period of clinical training: A Jordanian perspective. Nurse Educ Pract. 2012;12(4),204-9. https://doi.org/10.1016/j.nepr.2012.01.005. Jayasekara R, Smith C, Hall C, Rankin E, Smith M, Visvanathan V, et al. The effectiveness of clinical education models for undergraduate nursing programs: a systematic review. Nurse Educ Pract. 2018;29:116–26. https://doi.org/10.1016/j.nepr.2017.12.006 . Hweidi IM, Nizamli FM. Stressors in intensive care units in Syria: patients' perceptions. J Res Nurs. 2015;20(2):114–26. https://doi.org/10.1177/1744987114524202 . Pang PS, Suen LK. Stressors in the intensive care unit: comparing the perceptions of Chinese patients and their family. Stress Health. 2009;25(2):151–9. https://doi.org/10.1002/smi.1232 . Yava A, Tosun N, Unver V, Cicek H. Patient and nurse perceptions of stressors in the intensive care unit. Stress Health. 2011;27(2). https://doi.org/10.1002/smi.1333 . Kılıc HF. The relationship between nursing students’ educational stress and professional self-esteem. J Hacettepe Univ Fac Nurs. 2018;5(1):49–59. https://doi.org/10.31125/hunhemsire.431130 . (Original Study Published in Turkish). Pozam M, Zaybak A. Examination of nursing students’ self efficacy regarding their clinical performance. E-J Dokuz Eylul Univ Nurs Fac. 2022;15(1):22–9. https://doi.org/10.46483/deuhfed.928683 . Ozvurmaz S, Mandıracıoglu A. Evaluation of students’ perceptions of clinicaleducation environment andacademic self-sufficiency: a cross-sectionalstudy. Tıp Eğitimi Dünyası. 2018;17(53):51–9. https://doi.org/10.25282/ted.433398 . Yigitbas C, Yetkin A. Evaluating of self-efficacy-sufficiency levels of students in the health college. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2003;7(1):6–13. (Original Study Published in Turkish). Chapman R, Orb A. Coping strategies in clinical practice: The nursing students’ lived experience. Contemp Nurse. 2001;11(1):95–102. https://doi.org/10.5172/conu.11.1.95 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 26 Feb, 2025 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 30 Oct, 2024 Editor assigned by journal 30 Oct, 2024 Submission checks completed at journal 30 Oct, 2024 First submitted to journal 09 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5235156","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":372105902,"identity":"5b1592c1-a249-462f-b982-fd4d671e5699","order_by":0,"name":"Esma Ozsaker","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Esma","middleName":"","lastName":"Ozsaker","suffix":""},{"id":372105905,"identity":"de19ac5a-7be1-4b4f-9072-be4aff48f8f4","order_by":1,"name":"Zuleyha Aykut","email":"","orcid":"","institution":"Bandırma Onyedi Eylül University","correspondingAuthor":false,"prefix":"","firstName":"Zuleyha","middleName":"","lastName":"Aykut","suffix":""},{"id":372105906,"identity":"a7d82a94-acb7-43e9-a2cb-ab8eb7383b75","order_by":2,"name":"Nihal Celikturk Doruker","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Nihal","middleName":"Celikturk","lastName":"Doruker","suffix":""},{"id":372105907,"identity":"8ea5464b-e408-4405-bf9f-de2fefb2d29d","order_by":3,"name":"Burcak Sahin Koze","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYBACAzB5AMhgZmAGMeXA/AekaDEG8xOI0sIA0ZLYACLxaTGXyH344ceZOnlzdt7DBh/+2KTPDzv8EGiLnZxuA3YtljPSjSV7bhw23NnMl5w4gyctd+PtNAOglmRjswM4HHYjjY2B58MBxg2HeYwP80gczt04OwGk5UDiNjxaGP98qLOHaDH4n244O/0DQS3MPDeYE0FaknkSDiTIS+fgt8Wy5xmztMyZw8kgLYYzDiQbbpDOKTiQYIDbL+bsaYwf3xyrs91w/oyxxIc/dvLys9M3f/hQYSeHSwsWp4JVGhCrHATkG0hRPQpGwSgYBSMBAADUnGM/vmGtaAAAAABJRU5ErkJggg==","orcid":"","institution":"Ege University","correspondingAuthor":true,"prefix":"","firstName":"Burcak","middleName":"Sahin","lastName":"Koze","suffix":""},{"id":372105908,"identity":"e34cc87a-c8e3-4c33-a6b5-e8e03ad5842a","order_by":4,"name":"Sinem Gecit","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Sinem","middleName":"","lastName":"Gecit","suffix":""}],"badges":[],"createdAt":"2024-10-09 22:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5235156/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5235156/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-025-02836-0","type":"published","date":"2025-02-26T15:58:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":77622588,"identity":"2e5bc7aa-6162-4840-b7f1-10e3ee69b372","added_by":"auto","created_at":"2025-03-03 16:08:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1450658,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5235156/v1/4aab75b2-1631-4f8a-8ddd-d8f2d06739c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Academic self-efficacy and perceived stressors for surgical practice in nursing students: A descriptive and correlational design","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNursing education is an applied and dynamic process that includes both theoretical and practical educational methods and requires observation and interpretation [\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e]. The clinical education and learning environment is an integral part of the educational program and constitutes almost half of the nursing curriculum [\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e]. During the clinical education process, students gain clinical competence by having the opportunity to transfer the theoretical knowledge they have learned into practice [\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e]. Clinical education provides students with the opportunity to put their knowledge into practice by improving their professional knowledge and skills as a result of facing practical realities that may affect their future professional practice [\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e]. Undergraduate nursing education in Turkey is a four-year program, and clinical practice plays an important role in nursing education. The clinical competence of undergraduate nursing students is necessary to provide quality care and high-standard nursing services [\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e]. To improve clinical competence, it is important to identify factors that may affect students' clinical competence. Since surgical clinics are clinics that include perioperative nursing care of patients, it is important for nursing students to plan and implement appropriate nursing care in the patient care process for appropriate clinical performance [\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e]. During clinical practice, students may face many difficulties or threats such as how to use high-technology medical equipment, how to carry out the application process in specialized units such as operating theatres, how to maintain good relationships with clinical staff and instructors, how to manage and cope with the demands of the patient's relatives, sudden changes in the patient's condition. These difficulties experienced in the clinical experience process can cause students to perceive stress [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e]. The stress perceived by nursing students in a clinical setting is defined as the gap between the students' needs in a particular clinical situation and their resources or skills to cope with a task or situation [\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e]. It has been stated that nursing students who have negative clinical experiences and are exposed to clinical stress during the clinical practice process have decreased self-confidence, academic performance, motivation and interest in the profession, and their physical and mental health is affected [\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eThe negative effects of stress on nursing students can be offset by personal and environmental support [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eFor example, high levels of self-efficacy contribute to the student's ability to effectively manage their academic responsibilities, whereas low levels of self-efficacy can lead to additional psychological distress [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e]. Self-efficacy is also reported to have a positive and moderating effect on students' stress and ability to manage tasks and clinical responsibilities related to patient care [16, 18]. It is stated that students' perception of high academic self-efficacy (ASE) increases their level of motivation and strengthens their ability to cope with new or challenging tasks. It is stated that students' perception of low self-efficacy may lead them to leave their responsibilities unfinished and feel helpless [\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e]. In this direction, it is recommended to evaluate academic and clinical self-efficacy to assess and improve the clinical education process during the education of nursing students. For this reason, the assessment of ASE and its reflection on clinical practice is an issue that needs to be investigated. This study aimed to investigate the relationship between nursing students' ASE and their perceived stressors in surgical clinics.\u003c/p\u003e\n\u003cp\u003eResearch questions;\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003e\n\u003cp\u003eWhat is the ASE of nursing students?\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eWhat are the perceived stressors of nursing students in surgical clinics?\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eIs there a relationship between nursing students' ASE and perceived stressors in surgical clinics?\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch3\u003eAim\u003c/h3\u003e\n\u003cp\u003eThe purpose of this study is to determine the relationship between nursing students' academic self-efficacy and perceived stressors for professional practice in surgical clinics.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u0026nbsp;\u003c/div\u003e"},{"header":"Methods","content":"\u003ch2\u003eStudy design\u003c/h2\u003e\n\u003cp\u003eThe study is descriptive and cross-sectional.\u003c/p\u003e\n\u003ch3\u003eStudy setting and sample\u003c/h3\u003e\n\u003cp\u003eThe population of this study consisted of 362 second-year students who were studying at the Faculty of Nursing of a university in Western Turkey in the spring semester of the 2022\u0026ndash;2023 academic year and who were practicing in surgical clinics as part of the Diseases and Nursing Care I lesson. Students practiced in the clinics of general surgery, urology, brain and nerve surgery, cardiovascular surgery, eye surgery, orthopedics and traumatology, organ transplantation, plastic surgery, thoracic surgery, otolaryngology, and emergency department. The study aimed to reach the whole population without using the sample selection method, and 284 second-year students who practiced in surgical clinics as part of the Diseases and Nursing Care I course and accepted to participate in the study constituted the sample of the study.\u003c/p\u003e\n\u003ch3\u003eData collection tools\u003c/h3\u003e\n\u003cp\u003eA Personal Information Form, the Academic Nurse Self-Efficacy Scale (ANSES), and the Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR) were used to collect data.\u003c/p\u003e\n\u003ch3\u003ePersonal information form\u003c/h3\u003e\n\u003cp\u003eThis form was developed by reviewing the literature [\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e] to determine the socio-demographic and diagnostic characteristics of the students. There are a total of 13 questions, nine multiple-choice questions, and four open-ended questions, including age, gender, marital status, academic achievement grade point average, perceived academic success, the surgical clinic where practice takes place, and emotions felt when going to practice, etc.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcademic Nurse Self-Efficacy Scale (ANSES)\u003c/strong\u003e: This scale was developed by Bulfone et al. and adapted into Turkish by Aktay \u0026amp; Korkmaz [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]. The scale has four sub-dimensions, namely internal emotion management, self-control/automatically controlled behavior, external emotion management, and sociability, and a total of 14 items. The scale is a 5-point Likert scale. The items in the scale are scored as follows: 'I do not trust myself at all' 1 point, 'I do not trust myself' 2 points, 'I neither trust myself nor resent myself' 3 points, 'I trust myself' 4 points, 'I trust myself a lot' 5 points. The maximum score that can be obtained from the scale is 70 and the minimum score is 14. There are no reverse-scored items on the scale. As the scores obtained from the scale increase, the students' ASE increases. The total Cronbach alpha value of the scale was 0.83 [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e]. In this study, the Cronbach alpha value of the scale was found to be 0.81.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis scale was developed by Rafati et al. The Turkish validity and reliability study was conducted by Aydin et al. [\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e]. The scale consists of the following six sub-dimensions and a total of 22 items. The scale has six sub-dimensions and 22 items, including inappropriate situations in the clinical environment (items 7, 8, 9, 10, 11 and 12), inappropriate behavior of the lecturer (items 16, 17, 18 and 19), academic performance of the lecturer (items 1, 2 and 3), attitude of the lecturer towards education (items 4, 5 and 6), inadequate knowledge and skills of the student (items 13, 14 and 15) and concerns about nursing care (items 20, 21 and 22). The scale is a 5-point Likert type and the items in the scale 'Never causes stress' 1 point, 'Rarely causes stress' 2 points, 'Sometimes causes stress' 3 points, 'Too often causes stress' 4 points, 'Always causes stress' are scored as 5 points. There are no reverse items on this scale. The highest score that can be obtained from the scale is 110 and the lowest score is 22. High scores indicate that students have a high perception of clinical stressors. The total Cronbach alpha value of the scale was 0.91 [\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e]. In this study, the Cronbach alpha value of the scale was 0.94.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003eData collection\u003c/h2\u003e\n\u003cp\u003eThe study data were collected through face-to-face interviews with students practicing in surgical clinics as part of the Diseases and Nursing Care I course between April and June 2023. Students practice in surgical clinics three days a week on Tuesdays, Wednesdays, and Thursdays for three weeks. Data were collected on the last day of practice. First, the purpose of the study was explained to the students, and then written informed consent was obtained from the students. It took approximately 10 minutes for the students to complete the data collection form.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStatistical analysis of data\u003c/h3\u003e\n\u003cp\u003eStatistical analyses were performed using IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). Data on socio-demographic characteristics and attitudes towards the nursing profession were analyzed using descriptive statistics (number, percentage, mean, standard deviation). The normality of the distribution of quantitative data was tested using the Kolmogrov-Smirnov test. (The values obtained by dividing the skewness value by its standard deviation value were found to be outside the values of -1.96\u0026thinsp;+\u0026thinsp;1.96). Since the data did not show normal distribution, continuous measurements were evaluated with nonparametric tests; the Mann-Whitney Test and the Kruskal-Wallis test were used. Correlation between quantitative data was assessed using Spearman's Rho correlation coefficient. The value of P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered the statistical significance limit.\u003c/p\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eEthical approval\u0026nbsp;was obtained from the Ethics Committee for Scientific Research and Publication at Ege University (approval number: 23-1.1T/20, Date: 26.01.2023). Written approval was obtained from the institution where the research was conducted. All of the students were informed about the aim and procedure of the research, and written approval was obtained from those who agreed to participate. All participants were informed that data would be kept confidential and that their performances would in no way affect their lesson grades. Before starting the study, permission was obtained by e-mail from Aydin and Aktay who conducted the Turkish validity and reliability study of the Scale.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe mean age of the nursing students participating in the study was 21.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.52 (min: 19, max: 36) years and the mean academic achievement grade was 2.95 (out of 4.00 points). 85.6% (n: 243) of the students were female, 58.1% (n: 165) lived in a dormitory, 82% (n: 233) reason for choosing nursing was easy to find a job, 47.2% (n: 134) were satisfied with being a student nurse, 78.2% (n: 222) reported that they were curious, 78.5% (n: 223) reported their academic success as moderate (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). The mean total ANSES and NSPCSS-TR scores of the nursing students were found as 51.50\u0026thinsp;\u0026plusmn;\u0026thinsp;6.88 (min: 17, max: 70) and 82.98\u0026thinsp;\u0026plusmn;\u0026thinsp;15.58 (min: 22, max: 110), respectively. The distributions of the mean scores of the sub-dimensions of the scales are shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDescriptive characteristics of the students\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eThe mean age 21.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.52 (min: 19, max: 36)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eThe mean academic achievement grade\u003c/strong\u003e 2.95 (out of 4.00 points)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e243\u003c/p\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e85.6\u003c/p\u003e\n\u003cp\u003e14.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHome (alone)\u003c/p\u003e\n\u003cp\u003eHome (with friend)\u003c/p\u003e\n\u003cp\u003eHome (with family)\u003c/p\u003e\n\u003cp\u003eDormitory\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003cp\u003e44\u003c/p\u003e\n\u003cp\u003e57\u003c/p\u003e\n\u003cp\u003e165\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e6.3\u003c/p\u003e\n\u003cp\u003e15.5\u003c/p\u003e\n\u003cp\u003e20.1\u003c/p\u003e\n\u003cp\u003e58.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReason for choosing nursing*.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI like the nursing profession\u003c/p\u003e\n\u003cp\u003eIt is the profession of the future\u003c/p\u003e\n\u003cp\u003eMy family's wishes and insistence\u003c/p\u003e\n\u003cp\u003eGood salaries\u003c/p\u003e\n\u003cp\u003eEasy to find a job\u003c/p\u003e\n\u003cp\u003eNot having enough points for another department\u003c/p\u003e\n\u003cp\u003eOther reasons\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e85\u003c/p\u003e\n\u003cp\u003e115\u003c/p\u003e\n\u003cp\u003e72\u003c/p\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003cp\u003e233\u003c/p\u003e\n\u003cp\u003e67\u003c/p\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e29.9\u003c/p\u003e\n\u003cp\u003e40.5\u003c/p\u003e\n\u003cp\u003e25.4\u003c/p\u003e\n\u003cp\u003e16.2\u003c/p\u003e\n\u003cp\u003e82.0\u003c/p\u003e\n\u003cp\u003e23.6\u003c/p\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction with being a student nurse\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSatisfied\u003c/p\u003e\n\u003cp\u003eNot satisfied\u003c/p\u003e\n\u003cp\u003eUndecided\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e134\u003c/p\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003cp\u003e122\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e47.2\u003c/p\u003e\n\u003cp\u003e9.9\u003c/p\u003e\n\u003cp\u003e43.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePractice clinic\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEmergency Room\u003c/p\u003e\n\u003cp\u003eGeneral Surgery Clinic\u003c/p\u003e\n\u003cp\u003eUrology Clinic\u003c/p\u003e\n\u003cp\u003eBrain and Nerve Surgery Clinic\u003c/p\u003e\n\u003cp\u003eCardiovascular Surgery Clinic\u003c/p\u003e\n\u003cp\u003eEye Surgery Clinic\u003c/p\u003e\n\u003cp\u003eOrthopedics Clinic\u003c/p\u003e\n\u003cp\u003eOrgan Transplantation Clinic\u003c/p\u003e\n\u003cp\u003ePlastic Surgery Clinic\u003c/p\u003e\n\u003cp\u003eThoracic Surgery Clinic\u003c/p\u003e\n\u003cp\u003eOtolaryngology Clinic\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003cp\u003e49\u003c/p\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.3\u003c/p\u003e\n\u003cp\u003e17.3\u003c/p\u003e\n\u003cp\u003e9.5\u003c/p\u003e\n\u003cp\u003e14.4\u003c/p\u003e\n\u003cp\u003e8.8\u003c/p\u003e\n\u003cp\u003e5.3\u003c/p\u003e\n\u003cp\u003e13.7\u003c/p\u003e\n\u003cp\u003e1.4\u003c/p\u003e\n\u003cp\u003e8.8\u003c/p\u003e\n\u003cp\u003e3.2\u003c/p\u003e\n\u003cp\u003e6.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEmotions experienced in clinical practice\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAnxiety\u003c/p\u003e\n\u003cp\u003eStress\u003c/p\u003e\n\u003cp\u003eExcitement\u003c/p\u003e\n\u003cp\u003eCuriosity\u003c/p\u003e\n\u003cp\u003eother\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003cp\u003e122\u003c/p\u003e\n\u003cp\u003e183\u003c/p\u003e\n\u003cp\u003e222\u003c/p\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e20.4\u003c/p\u003e\n\u003cp\u003e43.0\u003c/p\u003e\n\u003cp\u003e64.4\u003c/p\u003e\n\u003cp\u003e78.2\u003c/p\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePerceived academic success\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003cp\u003e223\u003c/p\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9.2\u003c/p\u003e\n\u003cp\u003e78.5\u003c/p\u003e\n\u003cp\u003e12.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\"\u003e* There was more than one answer to this question.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eANSES and NSPCSS-TR scores\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eScales\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eX\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMedian\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMin-Max\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eANSES\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInternal emotion management\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e10.63\u0026thinsp;\u0026plusmn;\u0026thinsp;213\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSelf-control/automatically controlled behavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e15.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.00\u0026ndash;20.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eExternal emotion management\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e12.85\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.00\u0026ndash;20.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSociability\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e12.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal Score\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e51.50\u0026thinsp;\u0026plusmn;\u0026thinsp;6.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17.00\u0026ndash;70.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eNSPCSS-TR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAcademic performance of the lecturer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e10.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAttitude of the lecturer towards education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e10.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInappropriate situations in the clinical environment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e22.90\u0026thinsp;\u0026plusmn;\u0026thinsp;4.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.00\u0026ndash;30.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInadequate knowledge and skills of the student\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e11.67\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInappropriate behavior of the lecturer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e15.96\u0026thinsp;\u0026plusmn;\u0026thinsp;3.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.00\u0026ndash;20.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eConcerns about nursing care\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e11.26\u0026thinsp;\u0026plusmn;\u0026thinsp;2.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.00\u0026ndash;15.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal Score\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\"\u0026plusmn;\"\u003e\n\u003cp\u003e82.98\u0026thinsp;\u0026plusmn;\u0026thinsp;15.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e85.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22.00-110.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003ex: Mean, SD: Standard deviation, ANSES: Academic Nurse Self-Efficacy Scale, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eWhen the relationship between the scores of the nursing students' ANSES scores and the scores of the NSPCSS-TR was analyzed, it was found that there was no significant relationship between the two scales (r: -0.022, p:0.711). It was determined that there was a significant positive correlation between the sociability sub-dimension of the ANSES and the academic performance of the instructor sub-dimension of the NSPCSS-TR (r: 0.190, p: 0.001). It was found that there was a significant negative correlation between the external emotion management sub-dimension of the ANSES and the inappropriate situations in the clinical environment sub-dimension of the NSPCSS-TR (r: -0.163, p:0.006) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eRelationship Between ANSES and NSPCSS-TR scores\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"7\" align=\"left\"\u003e\n\u003cp\u003eANSES\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003eNSPCSS-TR\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAcademic performance of the lecturer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAttitude of the lecturer towards education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInappropriate situations in the clinical environment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInadequate knowledge and skills of the student\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInappropriate behavior of the lecturer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eConcerns about nursing care\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal Score\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eİnternal emotion management\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.032\u003c/p\u003e\n\u003cp\u003ep: 0.589\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.075\u003c/p\u003e\n\u003cp\u003ep: 0.208\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.106\u003c/p\u003e\n\u003cp\u003ep: 0.074\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.092\u003c/p\u003e\n\u003cp\u003ep: 0.123\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.089\u003c/p\u003e\n\u003cp\u003ep: 0.132\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.083\u003c/p\u003e\n\u003cp\u003ep: 0.162\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.086\u003c/p\u003e\n\u003cp\u003ep: 0.148\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSelf-control/ automatically controlled behavior\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.114\u003c/p\u003e\n\u003cp\u003ep: 0.055\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.021\u003c/p\u003e\n\u003cp\u003ep: 0.727\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.054\u003c/p\u003e\n\u003cp\u003ep: 0.360\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.108\u003c/p\u003e\n\u003cp\u003ep: 0.069\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.110\u003c/p\u003e\n\u003cp\u003ep: 0.065\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.034\u003c/p\u003e\n\u003cp\u003ep: 0.572\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.091\u003c/p\u003e\n\u003cp\u003ep: 0.128\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eExternal emotion management\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.040\u003c/p\u003e\n\u003cp\u003ep: 0.505\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.002\u003c/p\u003e\n\u003cp\u003ep: 0.970\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.163**\u003c/p\u003e\n\u003cp\u003ep: 0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.128*\u003c/p\u003e\n\u003cp\u003ep: 0.032\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.113\u003c/p\u003e\n\u003cp\u003ep: 0.058\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.126*\u003c/p\u003e\n\u003cp\u003ep: 0.034\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.123*\u003c/p\u003e\n\u003cp\u003ep: 0.039\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSociability\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.190**\u003c/p\u003e\n\u003cp\u003ep: 0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.065\u003c/p\u003e\n\u003cp\u003ep: 0.278\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.130*\u003c/p\u003e\n\u003cp\u003ep: 0.028\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.073\u003c/p\u003e\n\u003cp\u003ep: 0.220\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.135*\u003c/p\u003e\n\u003cp\u003ep: 0.023\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.120*\u003c/p\u003e\n\u003cp\u003ep: 0.044\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.141*\u003c/p\u003e\n\u003cp\u003ep: 0.017\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: 0.073\u003c/p\u003e\n\u003cp\u003ep: 0.222\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.027\u003c/p\u003e\n\u003cp\u003ep: 0.656\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.067\u003c/p\u003e\n\u003cp\u003ep: 0.262\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.036\u003c/p\u003e\n\u003cp\u003ep: 0.546\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.009\u003c/p\u003e\n\u003cp\u003ep: 0.877\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.049\u003c/p\u003e\n\u003cp\u003ep: 0.410\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er: -0.022\u003c/p\u003e\n\u003cp\u003ep: 0.711\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003er: Spearman Korelasyon Katsayısı, ANSES: Academic Nurse Self-Efficacy Scale, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003cspan class=\"Underline\"\u003e**Correlation is significant at the 0.01 level (2-tailed).\u003c/span\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003cspan class=\"Underline\"\u003e*Correlation is significant at the 0.05 level (2-tailed).\u003c/span\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe distribution of the total score and sub-dimension mean scores of the scales according to the variables is shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e. In the study, it was found that the mean total score of the Nursing Students Academic Self-Efficacy Scale of male student nurses was significantly higher than that of female student nurses (p:0,001). It was found that the mean total scores of the Nursing Students Academic Self-Efficacy Scale of the students who were satisfied with studying in the department of nursing were significantly higher than those of the students who were dissatisfied and undecided (p:0,004). It was found that the mean total scores of the Nursing Students Academic Self-Efficacy Scale of students with high perceived academic success were significantly higher than those of students with low and medium academic success (p:0,001). In the study, it was found that the mean total scores of female student nurses on the Clinical Stressor Perceptions of Nursing Students Scale were significantly higher than those of males (p:0,001) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDistribution of ANSES mean scores by independent variables\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 217px;\" rowspan=\"2\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 618px;\" colspan=\"5\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eANSES\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eScore\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eX\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eInternal emotion management X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eSelf-control/ automatically controlled behavior X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eExternal emotion management \u0026nbsp;X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eSociability X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 217px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e50.91\u0026plusmn;6.80\u003c/p\u003e\n\u003cp\u003e54.98\u0026plusmn;6.38\u003c/p\u003e\n\u003cp\u003eU: 3262.000\u003c/p\u003e\n\u003cp\u003ep:0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.45\u0026plusmn;2.06\u003c/p\u003e\n\u003cp\u003e11.68\u0026plusmn;2.25\u003c/p\u003e\n\u003cp\u003eU: 3128.500\u003c/p\u003e\n\u003cp\u003ep:0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15.18\u0026plusmn;2.58\u003c/p\u003e\n\u003cp\u003e15.07\u0026plusmn;2.17\u003c/p\u003e\n\u003cp\u003eU: 4632.000\u003c/p\u003e\n\u003cp\u003ep:0.466\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.42\u0026plusmn;3.21\u003c/p\u003e\n\u003cp\u003e15.32\u0026plusmn;2.88\u003c/p\u003e\n\u003cp\u003eU: 2307.000\u003c/p\u003e\n\u003cp\u003ep:0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.85\u0026plusmn;1.93\u003c/p\u003e\n\u003cp\u003e12.90\u0026plusmn;2.07\u003c/p\u003e\n\u003cp\u003eU: 4837.500\u003c/p\u003e\n\u003cp\u003ep:0.760\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 217px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction with being a student nurse\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSatisfied\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot satisfied\u003c/p\u003e\n\u003cp\u003eUndecided\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e52.72\u0026plusmn;6.53\u003c/p\u003e\n\u003cp\u003e48.57\u0026plusmn;8.90\u003c/p\u003e\n\u003cp\u003e50.83\u0026plusmn;6.48\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2:\u003c/sup\u003e 10.909\u003c/p\u003e\n\u003cp\u003ep: 0.004**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.87\u0026plusmn;2.17\u003c/p\u003e\n\u003cp\u003e9.96\u0026plusmn;2.55\u003c/p\u003e\n\u003cp\u003e10.52\u0026plusmn;1.94\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 6.359\u003c/p\u003e\n\u003cp\u003ep: 0.042\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15.71\u0026plusmn;2.22\u003c/p\u003e\n\u003cp\u003e14.04\u0026plusmn;3.10\u003c/p\u003e\n\u003cp\u003e14.83\u0026plusmn;2.56\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 14.402\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.78\u0026plusmn;3.39\u003c/p\u003e\n\u003cp\u003e13.21\u0026plusmn;2.94\u003c/p\u003e\n\u003cp\u003e12.83\u0026plusmn;3.33\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 0.204\u003c/p\u003e\n\u003cp\u003ep: 0.903\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e13.35\u0026plusmn;1.63\u003c/p\u003e\n\u003cp\u003e11.36\u0026plusmn;2.78\u003c/p\u003e\n\u003cp\u003e12.66\u0026plusmn;1.85\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 20.439\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 217px;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003ePerceived academic success\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e47.62\u0026plusmn;8.73\u003c/p\u003e\n\u003cp\u003e51.39\u0026plusmn;6.48\u003c/p\u003e\n\u003cp\u003e55.09\u0026plusmn;6.26\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 17.758\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9.50\u0026plusmn;2.66\u003c/p\u003e\n\u003cp\u003e10.61\u0026plusmn;2.06\u003c/p\u003e\n\u003cp\u003e11.60\u0026plusmn;1.69\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 13.078\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e14.08\u0026plusmn;3.16\u003c/p\u003e\n\u003cp\u003e15.10\u0026plusmn;2.40\u003c/p\u003e\n\u003cp\u003e16.40\u0026plusmn;2.35\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 10.320\u003c/p\u003e\n\u003cp\u003ep: 0.006**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.00\u0026plusmn;3.82\u003c/p\u003e\n\u003cp\u003e12.80\u0026plusmn;3.28\u003c/p\u003e\n\u003cp\u003e13.80\u0026plusmn;3.03\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 4.420\u003c/p\u003e\n\u003cp\u003ep: 0.110\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 115px;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.04\u0026plusmn;2.63\u003c/p\u003e\n\u003cp\u003e12.89\u0026plusmn;1.87\u003c/p\u003e\n\u003cp\u003e13.29\u0026plusmn;1.76\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 4.278\u003c/p\u003e\n\u003cp\u003ep: 0.118\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ex: Mean, SD: Standard deviation, U: Mann-Whitney U test, X2: Kruskal-Wallis test, ANSES: Academic Nurse Self-Efficacy Scale,\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp; \u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDistribution of NSPCSS-TR mean scores by independent variables\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 100%;\" colspan=\"8\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eNSPCSS-TR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 16.1844%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eX\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.2894%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eAcademic performance of the lecturer X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eAttitude of the lecturer towards education X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eInappropriate situations in the clinical environment X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.1115%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eInadequate knowledge and skills of the student\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eX\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eInappropriate behavior of the lecturer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eConcerns about nursing care X\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 16.1844%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e84.83\u0026plusmn;14.07\u003c/p\u003e\n\u003cp\u003e71.98\u0026plusmn;19.39\u003c/p\u003e\n\u003cp\u003eU: 3043.50\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.2894%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.10\u0026plusmn;2.38\u003c/p\u003e\n\u003cp\u003e9.83\u0026plusmn;3.06\u003c/p\u003e\n\u003cp\u003eU: 3863.50\u003c/p\u003e\n\u003cp\u003ep: 0.020*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.48\u0026plusmn;2.22\u003c/p\u003e\n\u003cp\u003e9.10\u0026plusmn;2.75\u003c/p\u003e\n\u003cp\u003eU: 3545.00\u003c/p\u003e\n\u003cp\u003ep: 0.003**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e23.37\u0026plusmn;4.46\u003c/p\u003e\n\u003cp\u003e20.12\u0026plusmn;5.78\u003c/p\u003e\n\u003cp\u003eU: 3314.50\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.1115%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.98\u0026plusmn;2.60\u003c/p\u003e\n\u003cp\u003e9.78\u0026plusmn;3.47\u003c/p\u003e\n\u003cp\u003eU: 3087.00\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e16.37\u0026plusmn;3.18\u003c/p\u003e\n\u003cp\u003e13.54\u0026plusmn;4.07\u003c/p\u003e\n\u003cp\u003eU: 2863.50\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.54\u0026plusmn;2.64\u003c/p\u003e\n\u003cp\u003e9.61\u0026plusmn;3.15\u003c/p\u003e\n\u003cp\u003eU: 3225.00\u003c/p\u003e\n\u003cp\u003ep: 0.001**\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 16.1844%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003ePractice clinic\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEmergency\u003c/p\u003e\n\u003cp\u003eGeneral Surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUrology\u003c/p\u003e\n\u003cp\u003eNeurosurgery Cardiovascular Surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEye Surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOrthopedics\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTransplantation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePlastic Surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThoracic Surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOtolaryngology\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e80.41\u0026plusmn;15.57\u003c/p\u003e\n\u003cp\u003e86.35\u0026plusmn;13.06\u003c/p\u003e\n\u003cp\u003e85.48\u0026plusmn;18.78\u003c/p\u003e\n\u003cp\u003e80.44\u0026plusmn;17.07\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e84.52\u0026plusmn;12.60\u003c/p\u003e\n\u003cp\u003e81.80\u0026plusmn;17.99\u003c/p\u003e\n\u003cp\u003e83.28\u0026plusmn;15.12\u003c/p\u003e\n\u003cp\u003e82.25\u0026plusmn;5.06\u003c/p\u003e\n\u003cp\u003e84.80\u0026plusmn;12.25\u003c/p\u003e\n\u003cp\u003e79.67\u0026plusmn;17.32\u003c/p\u003e\n\u003cp\u003e77.83\u0026plusmn;20.47\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 6.461\u003c/p\u003e\n\u003cp\u003ep: 0.775\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.2894%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.34\u0026plusmn;2.44\u003c/p\u003e\n\u003cp\u003e11.20\u0026plusmn;2.051\u003c/p\u003e\n\u003cp\u003e11.96\u0026plusmn;2.95\u003c/p\u003e\n\u003cp\u003e10.51\u0026plusmn;2.76\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.76\u0026plusmn;1.83\u003c/p\u003e\n\u003cp\u003e10.73\u0026plusmn;2.81\u003c/p\u003e\n\u003cp\u003e10.92\u0026plusmn;2.76\u003c/p\u003e\n\u003cp\u003e11.75\u0026plusmn;0.50\u003c/p\u003e\n\u003cp\u003e11.12\u0026plusmn;2.54\u003c/p\u003e\n\u003cp\u003e10.44\u0026plusmn;2.07\u003c/p\u003e\n\u003cp\u003e10.50\u0026plusmn;296\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 12.946\u003c/p\u003e\n\u003cp\u003ep:0.0227\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.25\u0026plusmn;226\u003c/p\u003e\n\u003cp\u003e11.02\u0026plusmn;1.88735\u003c/p\u003e\n\u003cp\u003e10.15\u0026plusmn;3.08\u003c/p\u003e\n\u003cp\u003e9.71\u0026plusmn;2.32\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9.88\u0026plusmn;2.33\u003c/p\u003e\n\u003cp\u003e9.93\u0026plusmn;2.66\u003c/p\u003e\n\u003cp\u003e10.33\u0026plusmn;2.24\u003c/p\u003e\n\u003cp\u003e10.00\u0026plusmn;1.41\u003c/p\u003e\n\u003cp\u003e11.12\u0026plusmn;1.54\u003c/p\u003e\n\u003cp\u003e9.56\u0026plusmn;3.54\u003c/p\u003e\n\u003cp\u003e9.83\u0026plusmn;2.62\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 14.780\u003c/p\u003e\n\u003cp\u003ep:0.140\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e22.31\u0026plusmn;4.93\u003c/p\u003e\n\u003cp\u003e23.78\u0026plusmn;4.66\u003c/p\u003e\n\u003cp\u003e23.52\u0026plusmn;5.22\u003c/p\u003e\n\u003cp\u003e22.24\u0026plusmn;4.83\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e23.56\u0026plusmn;3.98\u003c/p\u003e\n\u003cp\u003e22.13\u0026plusmn;5.89\u003c/p\u003e\n\u003cp\u003e23.44\u0026plusmn;4.63\u003c/p\u003e\n\u003cp\u003e22.75\u0026plusmn;1.71\u003c/p\u003e\n\u003cp\u003e22.84\u0026plusmn;3.45\u003c/p\u003e\n\u003cp\u003e21.89\u0026plusmn;6.07\u003c/p\u003e\n\u003cp\u003e21.28\u0026plusmn;6.14\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 5.791\u003c/p\u003e\n\u003cp\u003ep:0.832\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.1115%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.56\u0026plusmn;3.10\u003c/p\u003e\n\u003cp\u003e12.24\u0026plusmn;2.37\u003c/p\u003e\n\u003cp\u003e11.89\u0026plusmn;2.87\u003c/p\u003e\n\u003cp\u003e11.44\u0026plusmn;3.03\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.24\u0026plusmn;2.55\u003c/p\u003e\n\u003cp\u003e12.13\u0026plusmn;2.90\u003c/p\u003e\n\u003cp\u003e11.36\u0026plusmn;2.86\u003c/p\u003e\n\u003cp\u003e11.50\u0026plusmn;1.29\u003c/p\u003e\n\u003cp\u003e11.56\u0026plusmn;2.50\u003c/p\u003e\n\u003cp\u003e11.33\u0026plusmn;3.08\u003c/p\u003e\n\u003cp\u003e10.28\u0026plusmn;3.75\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 6.264\u003c/p\u003e\n\u003cp\u003ep:0.793\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15.31\u0026plusmn;3.50\u003c/p\u003e\n\u003cp\u003e16.59\u0026plusmn;3.17\u003c/p\u003e\n\u003cp\u003e16.11\u0026plusmn;4.15\u003c/p\u003e\n\u003cp\u003e15.49\u0026plusmn;3.88\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e16.32\u0026plusmn;2.97\u003c/p\u003e\n\u003cp\u003e15.20\u0026plusmn;4.04\u003c/p\u003e\n\u003cp\u003e16.31\u0026plusmn;3.30\u003c/p\u003e\n\u003cp\u003e16.25\u0026plusmn;1.71\u003c/p\u003e\n\u003cp\u003e16.32\u0026plusmn;3.36\u003c/p\u003e\n\u003cp\u003e15.89\u0026plusmn;3.02\u003c/p\u003e\n\u003cp\u003e15.06\u0026plusmn;3.35\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 6.704\u003c/p\u003e\n\u003cp\u003ep:0.753\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.63\u0026plusmn;2.85\u003c/p\u003e\n\u003cp\u003e11.51\u0026plusmn;2.72\u003c/p\u003e\n\u003cp\u003e11.85\u0026plusmn;2.88\u003c/p\u003e\n\u003cp\u003e11.05\u0026plusmn;3.00\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.76\u0026plusmn;1.85\u003c/p\u003e\n\u003cp\u003e11.67\u0026plusmn;2.53\u003c/p\u003e\n\u003cp\u003e10.92\u0026plusmn;2.51\u003c/p\u003e\n\u003cp\u003e10.00\u0026plusmn;1.83\u003c/p\u003e\n\u003cp\u003e11.84\u0026plusmn;2.98\u003c/p\u003e\n\u003cp\u003e10.56\u0026plusmn;4.33\u003c/p\u003e\n\u003cp\u003e10.89\u0026plusmn;3.25\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 9.034\u003c/p\u003e\n\u003cp\u003ep:0.529\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 16.1844%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction with being a student nurse\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSatisfied\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot satisfied\u003c/p\u003e\n\u003cp\u003eUndecided\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e82.61\u0026plusmn;14.76\u003c/p\u003e\n\u003cp\u003e80.32\u0026plusmn;20.70\u003c/p\u003e\n\u003cp\u003e83.98\u0026plusmn;15.16\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 0.971\u003c/p\u003e\n\u003cp\u003ep: 0.615\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.2894%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.05\u0026plusmn;2.42\u003c/p\u003e\n\u003cp\u003e10.39\u0026plusmn;3.10\u003c/p\u003e\n\u003cp\u003e10.87\u0026plusmn;2.49\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 1.283\u003c/p\u003e\n\u003cp\u003ep: 0.527\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.26\u0026plusmn;2.11\u003c/p\u003e\n\u003cp\u003e10.32\u0026plusmn;3.21\u003c/p\u003e\n\u003cp\u003e10.30\u0026plusmn;2.39\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 0.439\u003c/p\u003e\n\u003cp\u003ep: 0.803\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e22.50\u0026plusmn;4.75\u003c/p\u003e\n\u003cp\u003e22.29\u0026plusmn;6.32\u003c/p\u003e\n\u003cp\u003e23.48\u0026plusmn;4.42\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 3.588\u003c/p\u003e\n\u003cp\u003ep: 0.166\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.1115%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.53\u0026plusmn;2.70\u003c/p\u003e\n\u003cp\u003e11.21\u0026plusmn;3.72\u003c/p\u003e\n\u003cp\u003e11.92\u0026plusmn;2.76\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 1.740\u003c/p\u003e\n\u003cp\u003ep: 0.419\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e16.10\u0026plusmn;3.42\u003c/p\u003e\n\u003cp\u003e15.29\u0026plusmn;4.05\u003c/p\u003e\n\u003cp\u003e15.96\u0026plusmn;3.37\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 0.818\u003c/p\u003e\n\u003cp\u003ep: 0.664\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.17\u0026plusmn;2.74\u003c/p\u003e\n\u003cp\u003e10.82\u0026plusmn;3.33\u003c/p\u003e\n\u003cp\u003e11.47\u0026plusmn;2.72\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 1.145\u003c/p\u003e\n\u003cp\u003ep: 0.564\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 16.1844%;\" valign=\"top\"\u003e\n\u003cp\u003e\u003cstrong\u003ePerceived academic success\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e85.77\u0026plusmn;17.92\u003c/p\u003e\n\u003cp\u003e82.69\u0026plusmn;15.49\u003c/p\u003e\n\u003cp\u003e82.74\u0026plusmn;14.56\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 2.038\u003c/p\u003e\n\u003cp\u003ep: 0.361\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.2894%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.08\u0026plusmn;2.70\u003c/p\u003e\n\u003cp\u003e10.81\u0026plusmn;2.53\u003c/p\u003e\n\u003cp\u003e11.40\u0026plusmn;2.30\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 1.378\u003c/p\u003e\n\u003cp\u003ep: 0.502\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e10.54\u0026plusmn;2.60\u003c/p\u003e\n\u003cp\u003e10.24\u0026plusmn;2.35\u003c/p\u003e\n\u003cp\u003e10.34\u0026plusmn;2.20\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 0.834\u003c/p\u003e\n\u003cp\u003ep: 0.659\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e24.19\u0026plusmn;5.31\u003c/p\u003e\n\u003cp\u003e22.73\u0026plusmn;4.79\u003c/p\u003e\n\u003cp\u003e23.03\u0026plusmn;4.42\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 3.034\u003c/p\u003e\n\u003cp\u003ep: 0.219\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 12.1115%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12.15\u0026plusmn;3.59\u003c/p\u003e\n\u003cp\u003e11.60\u0026plusmn;2.74\u003c/p\u003e\n\u003cp\u003e11.77\u0026plusmn;2.90\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 3.231\u003c/p\u003e\n\u003cp\u003ep: 0.199\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 13.1833%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e16.31\u0026plusmn;4.31\u003c/p\u003e\n\u003cp\u003e15.96\u0026plusmn;3.43\u003c/p\u003e\n\u003cp\u003e15.65\u0026plusmn;3.00\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 2.313\u003c/p\u003e\n\u003cp\u003ep: 0.315\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 10.9325%;\" valign=\"top\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11.50\u0026plusmn;3.41\u003c/p\u003e\n\u003cp\u003e11.35\u0026plusmn;2.69\u003c/p\u003e\n\u003cp\u003e10.54\u0026plusmn;2.93\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 2.936\u003c/p\u003e\n\u003cp\u003ep: 0.230\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ex: Mean, SD: Standard deviation, U: Mann-Whitney U test, X2: Kruskal-Wallis test, NSPCSS-TR: Nursing Students' Perceptions of Clinical Stressors Scale, *p\u0026lt;0.05, ** p\u0026lt;0.01\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eNursing students\u0026rsquo; ASE levels\u003c/h2\u003e \u003cp\u003eASE is defined as students' assessment of their abilities to achieve educational goals [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and their confidence in themselves to successfully complete academic tasks [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. It is emphasized that special attention should be paid to the monitoring and development of the ASE in the nursing education process [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In this study, when the total mean scores and sub-dimension scores of ASE of nursing students were examined, it was found to be above average. Similar to the findings of this study, it was found that self-efficacy scores were above average in studies that examined self-efficacy levels in nursing students [\u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR27\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Self-efficacy levels can increase the independence of nursing students, allowing them to exert more effort to overcome difficulties and achieve goals [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and increase professional job satisfaction [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Interventions to promote self-efficacy should be structured together with the mentor and the clinical nurse during lectures and clinical practice [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen the total and sub-dimensional mean scores of the nursing students' ANSES were analyzed according to the gender variable, it was found that the total and sub-dimensional mean scores of the male students' ANSES were higher than those of the female students (p:0.001). The high scores of male nursing students on the ASE suggest that this group of students has a high level of confidence in their academic abilities, performance, and learning process.\u003c/p\u003e \u003cp\u003eIn the study, it was found that the self-efficacy perceptions of the students who were satisfied with studying in the nursing department were significantly higher (p: 0.004) than those who were dissatisfied and undecided. Similarly, as a result of some studies [\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR29\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e33\u003c/span\u003e], it is highlighted that the ASE of the students who willingly chose the nursing department was higher and significantly affected their academic success. The high ASE scores of students with high satisfaction suggest that this group of students has high confidence in their abilities and belief in their success and that students with high self-efficacy also can manage their academic responsibilities positively and regularly [16,18]. The results of the study found that students with high academic achievement perceptions had significantly higher total scores on the ANSES (p: 0.001) than students with low and medium achievement perceptions. Bulfone et al (2022) found that high levels of self-efficacy significantly increased the likelihood of academic success [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This relationship is consistent with the literature, as many studies have shown that students with high levels of self-efficacy are more likely to achieve academic success [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. It can be assumed that high academic achievement perceptions may influence students' intrinsic motivation and self-efficacy perceptions, and these students may be more likely to achieve higher levels of success by feeling confident in their abilities. In addition, it is thought that these students with high academic achievement perceptions may be more motivated because they have a positive perception of success, and with this motivation, they may put in more work and effort. This finding overlaps with the definition of ASE in the literature. It also supports the findings that students' self-efficacy perceptions positively affect their learning speed and increase their academic success [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. One of the current strategies to counteract the academic failure of nursing students is the development of students' ASE [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eNursing students' clinical stressors levels\u003c/h2\u003e \u003cp\u003eNurse educators need to identify areas for improvement to help students achieve high levels of clinical competence and to ensure the quality of the educational process [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. To this end, it is important to assess students' perceptions of the clinical learning environment [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. In this study, nursing students' perceptions of clinical stressors were found to be high. Karaca et al. (2017) also showed that the stress levels of Turkish nursing students in clinical practice were higher than the stress levels reached in studies conducted in other countries using the same scales [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The clinical learning environment can be an important source of stress for nursing students [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. It has been stated that the most stressful factors for students in clinical practice are clinical stressors (e.g. lack of professional knowledge and skills, communication with patients and clinical staff, difficulties in hospital adaptation) and academic stressors (e.g. clinical examinations, communication with lecturers) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In addition, problems may be caused by the high number of students in clinical practice, the presence of students from other faculties in the same clinical practice environment, the lack of appropriate practice areas, and the neglect of students by the existing healthcare team [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Students' inadequate knowledge and skills for practice, mistakes, unclear expectations from the instructor, thoughts such as encountering negative reactions, and low self-confidence may be the cause of clinical stress [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Negative clinical education experiences may lead to a decrease in students' self-confidence, academic performance, motivation, and interest in the profession, which may affect their physical and mental health [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The stress experienced by students in clinical education is an important factor that reduces the effectiveness of education [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Nursing students with high-stress levels have been found to have low academic performance and clinical competence [16,41]. Therefore, clinical stressors should be effectively managed, and the clinical practice environment should be considered as the best learning environment opportunity [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Identifying students' sources of clinical stress and providing them with adequate support to cope with it can reduce students' exposure to the negative effects of stress and improve the quality of professional care.\u003c/p\u003e \u003cp\u003eThe study found that the mean total score of the NSPCSS-TR was significantly higher in female nursing students than in male nursing students (p: 0.001). Gender may affect on an individual's perception of stress. This may suggest that female students experience more stress during the nursing education process. It is thought that the higher perceptions of clinical stress in female nursing students compared to male nursing students may be due to occupational stressors, for example, gender role expectations or gender-related difficulties within the profession may influence these differences. In the literature, no relationship was found between gender and perceived stress [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Although this study result does not support the literature in this regard, in another study that investigated the relationship between educational stress and professional self-esteem among nursing students, the mean scores of female students were higher than male students, which is similar to our study result [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eCorrelations between self-efficacy and clinical stressors\u003c/h2\u003e \u003cp\u003eEvaluating students' views and self-efficacy perceptions about clinical practice will contribute to the development of effective clinical teaching strategies by assessing the effectiveness of strategies adopted in nursing education for clinical teaching [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. In this study, which aimed to examine the relationship between ASE and perceptions of clinical stressors among nursing students who were practicing in surgical clinics for the first time, no significant relationship was found between nursing students' ASE and perceptions of clinical stressors (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). In the study conducted by Aciksoz et al. (2016) on nursing students, in which they investigated the relationship between self-efficacy perception and anxiety and stress toward clinical practice, it was found that the level of anxiety toward clinical skills decreased with the increase in students' self-efficacy perception; however, no significant relationship was found between self-efficacy perception and perceived stress toward clinical skills (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Ozvurmaz and Mandıracıoglu (2018) found a moderately significant relationship between ASE perception and clinical teaching perception in nursing students [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. G\u0026ouml;ger and Cevirme (2018) found that the level of self-efficacy of nursing students was affected by educational stress [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Yu et al. (2021) found that self-efficacy mediated the relationship between clinical learning environment and clinical competence [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In another study, it was reported that students who came to the nursing department willingly were more determined to cope with the problems they encountered and that individuals with high levels of self-efficacy were more determined to succeed [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Understanding students' perceptions of self-efficacy and the factors that may affect their learning, such as stress in the clinical environment, has been reported to enable the planning of activities to improve the effectiveness of nursing education and have important implications for the future of education [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. It was found that there was a significant positive correlation between the ANSES sociability sub-dimension of nursing students and the NSPCSS-TR academic performance of the instructor sub-dimension (r: 0.190, p: 0.001). This indicates that as nursing students' social skills (sociability sub-dimension) increase, so do their perceptions of the academic performance of the instructor. This can be interpreted as students with social skills perceiving their academic performance positively. It can be interpreted that improving social skills or increasing interaction with lecturers can positively affect students' perceptions of academic performance. It is thought that educational programs and social support services can have a positive effect on students' academic performance perceptions by focusing on improving nursing students' social skills.\u003c/p\u003e \u003cp\u003eThe significant negative correlation between nursing students' ANSES external emotion management sub-dimension and the NSPCSS-TR inappropriate situations in the clinical environment sub-dimension suggests that as nursing students' external emotion management skills increase (i.e. how they respond to stress and emotional reactions), their perception of inappropriate situations in the clinical environment decreases. Increased external emotion management skills may help student nurses cope more effectively with clinical stressors and reduce the tendency to perceive these stressors negatively. Contrary to the findings of this study, the literature indicates that nursing students who are exposed to clinical stressors or who have negative clinical experiences are less interested in the profession, their self-confidence, motivation, and academic performance decrease, and their physical and mental health is negatively affected [\u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], and students with high-stress levels have lower academic and clinical competencies [16,41]. As more effective management of clinical stressors by student nurses can have a positive impact on both their emotional well-being and academic performance, there is a need to increase the number of training and activities that can help student nurses cope with stress and improve their emotional management skills [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e "},{"header":"Conclusions and Implications","content":"\u003cp\u003eThe study found that nursing students' ASE and perceptions of clinical stress were high, and there was no significant relationship between nursing students' ASE and perceptions of clinical stress. It is recommended that programs aimed at improving nursing students' ASE should be implemented, that clinical practice, which is of great importance in nursing education, should be emphasized, and that comprehensive studies should be conducted to reduce perceived stress in surgical clinics. This study underscores the significance of addressing academic self-efficacy and stressors among nursing students, particularly those preparing for surgical practice. As nurses play crucial roles in surgical teams, their self-efficacy and stress management directly impact patient care outcomes. Therefore, nursing education should include interventions to boost students' self-efficacy and equip them with stress coping strategies for surgical settings. By investing in students' self-efficacy and stress management, healthcare systems can improve surgical care quality and patient safety.\u003c/p\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate;\u0026nbsp;\u003c/strong\u003eEthical approval for the study was taken from the ethics review committee of the institution where the research was carried out (approval number: 23-1.1T/20, Date: 26.01.2023). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eThe data that support the findings of this study are available from the authors upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eAll the authors have contributed to the study on conception and design, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published. All authors agree with the content of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudy design: EO, ZA, NCD, BSK, SG\u003cbr\u003eData collection: ZA, NCD, BSK, SG\u003cbr\u003eData analysis: ZA, NCD, BSK, SG\u003cbr\u003eStudy supervision: EO, ZA, NCD, BSK, SG\u003cbr\u003eManuscript writing: ZA, NCD, BSK, SG\u003cbr\u003eCritical revisions for important intellectual content: EO\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eWe would like to thank all the students who agreed to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003enot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUzdil N, Gunaydin Y. The effect of sense of coherence on mindful attention awareness and academic self-efficacy in nursing students. Nurse Educ Pract. 2022;64:1\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2022.103429\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2022.103429\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoorheidari M, Delvarzian ZM, Yahyaee S, Montazeri AS. Study of the stressful experiences of midwifery students during clinical education in the labor room. Res Med Educ. 2018;9(4):58\u0026ndash;66. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://rme.gums.ac.ir/article-1-408-en.html\u003c/span\u003e\u003cspan address=\"http://rme.gums.ac.ir/article-1-408-en.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRafati F, Nia SH, Khoshnood Z, Allen KA. Development and psychometric testing of nursing students\u0026rsquo; perceptions of clinical stressors scale: an instrument design study. BMJ Psychiatry. 2021;21(1):1\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12888-020-02964-8\u003c/span\u003e\u003cspan address=\"10.1186/s12888-020-02964-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://link.springer.com/article/\u003c/span\u003e\u003cspan address=\"https://link.springer.com/article/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSajadi SK. Evaluation of laboratory sciences students\u0026rsquo; attitude toward their field of study and future career in Kurdistan University of Medical Sciences. Zanko J Med Sci. 2016;16:52\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://zanko.muk.ac.ir/article-1-104-en.html\u003c/span\u003e\u003cspan address=\"http://zanko.muk.ac.ir/article-1-104-en.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKarahan Okuroglu G. The Relationship between nursing students' self-efficacy regarding their clinical performance with their academic self-efficacy and academic achievement: descriptive study. Turkiye Klinikleri J Nurs Sci. 2022;14(1):125\u0026ndash;31. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5336/nurses.2021-83326\u003c/span\u003e\u003cspan address=\"10.5336/nurses.2021-83326\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEgan T, Jaye C. Communities of clinical practice: the social organization of clinical learning. Health. 2009;13(1):107\u0026ndash;25. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/136345930809736\u003c/span\u003e\u003cspan address=\"10.1177/136345930809736\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee JJ, Clarke CL, Carson MN. Nursing students\u0026rsquo; learning dynamics and influencing factors in clinical contexts. Nurse Educ Pract. 2018;29:103\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2017.12.003\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2017.12.003\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu M, Tong H, Li S, Wu XV, Hong J, Wang W. Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. Nurse Educ Pract. 2021;53:103055. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2021.103055\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2021.103055\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChan KLC, So KWW, Fong YTD. Hong Kong baccalaureate nursing students\u0026rsquo; stress and their coping strategies in clinical practice. J Prof Nurs. 2009;25(5):307\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.profnurs.2009.01.018\u003c/span\u003e\u003cspan address=\"10.1016/j.profnurs.2009.01.018\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdmi H, Moshe-Eilon Y, Sharon D, Mann M. Nursing students\u0026rsquo; stress and satisfaction in clinical practice along different stages: a cross-sectional study. Nurse Educ Today. 2018;68:86\u0026ndash;92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nedt.2018.05.027\u003c/span\u003e\u003cspan address=\"10.1016/j.nedt.2018.05.027\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAydin M, Erdol H, Gorgoz M, Aksu FE. Turkish validity and reliability study of \u0026lsquo;nursing students\u0026rsquo; perception of clinical stressors scale. Nurse Educ Pract. 2022;64:1\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2022.103440\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2022.103440\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCornine A. Reducing nursing student anxiety in the clinical setting: An integrative review. Nurs Educ Perspect. 2020;41(4):229\u0026ndash;34. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/01.NEP.0000000000000633\u003c/span\u003e\u003cspan address=\"10.1097/01.NEP.0000000000000633\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFlott EA, Linden L. The clinical learning environment in nursing education: a concept analysis. J Adv Nurs. 2016;72(3):501\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jan.12861\u003c/span\u003e\u003cspan address=\"10.1111/jan.12861\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorouzi N, Imani B. Clinical education stressors in operating room students: A qualitative study. Invest Educ Enferm. 2021;39(1):1\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17533/udea.iee.v39n1e08\u003c/span\u003e\u003cspan address=\"10.17533/udea.iee.v39n1e08\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharifipour F, Heydarpour S, Salari N. Nursing and midwifery students\u0026rsquo; viewpoints of clinical learning environment: a cross-sectional study. Adv Med Educ Pract. 2020;11:447\u0026ndash;54. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2147/AMEP.S253782\u003c/span\u003e\u003cspan address=\"10.2147/AMEP.S253782\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShehadeh J, Hamdan-Mansour MA, Halasa NM, Bani Hani HM, Nabolsi MM, Thultee I, et al. Academic and self-efficacy as predictors of academic satisfaction among nursing students. Open Nurs J. 2020;14:92\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2174/1874434602014010092\u003c/span\u003e\u003cspan address=\"10.2174/1874434602014010092\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConner M, Self-Efficacy S, Social Support in Retention of Student Registered Nurse Anesthetists. AANA Journal, Matthews P, Coyne A. I. Stress and stressors in the clinical environment: A comparative study of fourth-year student nurses and newly qualified general nurses in Ireland. J Clin Nurs. 2013;22(5\u0026ndash;6),770-9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1365-2702.2012.04145.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2702.2012.04145.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAktas D, Sancar B. The relationship between the nursing students\u0026rsquo; attitudes towards scientific research and their levels of academic self-efficacy. Manisa Celal Bayar Univ J Institue Health Sci. 2021;8(1):17\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.34087/cbusbed.748244\u003c/span\u003e\u003cspan address=\"10.34087/cbusbed.748244\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBuyukbayra Z, Ayik DB. Determination of nursing students\u0026rsquo; stress levels related to nursing education. J Adnan Menderes Univ Health Sci Fac. 2020;4(2):90\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003eHttps://Doi.Org/10.46237/Amusbfd.562097\u003c/span\u003e\u003cspan address=\"Https://Doi.Org/10.46237/Amusbfd.562097\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemirbag BC, Bulut HK, Calık KY. Evaluation of Nursing Students' Educational Stress. J DU Health Sci Inst. 2021;11(2):159\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.33631/duzcesbed.749779\u003c/span\u003e\u003cspan address=\"10.33631/duzcesbed.749779\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMa H, Zou JM, Zhong Y, Li J, He JQ. Perceived stress, coping style and burnout of Chinese nursing students in late-stage clinical practice: A cross-sectional study. Nurse Educ Pract. 2022;62:103385. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2022.103385\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2022.103385\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePawlak ND, Serafin L, Czarkowska-Pączek B. Female sex and living in a large city moderate the relationships between nursing students\u0026rsquo; stress level, perception of their studies, and intention to practice professionally: a cross-sectional study. Int J Environ Res Public Health. 2022;19(9):5740. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijerph19095740\u003c/span\u003e\u003cspan address=\"10.3390/ijerph19095740\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAktay G, Cicek Korkmaz A. Exploring Psychometric Properties of the Turkish Version of the Academic Nurse Self-Efficacy Scale. Int J Scholars Educ. 2023;6(1):69\u0026ndash;81. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.52134/ueader.1270141\u003c/span\u003e\u003cspan address=\"10.52134/ueader.1270141\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBulfone G, Vellone E, Maurici M, Macale L, Alvaro R. Academic self-efficacy in Bachelor-level nursing students: Development and validation of a new instrument. J Adv Nurs. 2020;76(1):398\u0026ndash;408. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jan.14226\u003c/span\u003e\u003cspan address=\"10.1111/jan.14226\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBulfone G, Iovino P, Mazzotta R, Sebastian M, Macale L, Sili A, et al. Self-efficacy, burnout and academic success in nursing students: A counterfactual mediation analysis. J Adv Nurs. 2022;78(10):3217\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jan.15231\u003c/span\u003e\u003cspan address=\"10.1111/jan.15231\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWarshawski S, Bar-Lew O, Barnoy S. Role of academic self-efficacy and social support on nursing students\u0026rsquo; test anxiety. Nurse Educ. 2019;44(1):6\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/NNE.0000000000000552\u003c/span\u003e\u003cspan address=\"10.1097/NNE.0000000000000552\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdal M, Alavi NM, Adib-Hajbaghery M. Clinical self-efficacy in senior nursing students: A mixed- methods study. Nurs Midwifery Stud. 2015;4(3):e29143. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17795/nmsjournal29143\u003c/span\u003e\u003cspan address=\"10.17795/nmsjournal29143\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAciksoz S, Uzun Ş, Arslan F. Assessment of relationship between nursing students\u0026rsquo; self-efficacy and levels of their anxiety and stress about clinical practice. G\u0026uuml;lhane Med J. 2016;58:129\u0026ndash;35. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5455/gulhane\u003c/span\u003e\u003cspan address=\"10.5455/gulhane\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 169643 (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoger S, Cevirme A. The Effect of Nursing Students\u0026rsquo; Self-Efficacy Levels on Education Stress. J Educ Res Nurs. 2019;16(4):306\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5222/HEAD.2019.306\u003c/span\u003e\u003cspan address=\"10.5222/HEAD.2019.306\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYuzer Alsac S, Oztas G. The factors affecting the academic self-efficacy levels of nursing students. J Health Nurs Manage. 2023;10(3):301\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.54304/SHYD.2023.55477\u003c/span\u003e\u003cspan address=\"10.54304/SHYD.2023.55477\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Simone S, Planta A, Cicotto G. The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction. Appl Nurs Res. 2018;39:130\u0026ndash;40. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.apnr.2017.11.004\u003c/span\u003e\u003cspan address=\"10.1016/j.apnr.2017.11.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOzveren H, Gulnar E, Ozden D. Determination of the factors that affect the choice of career of the nursing students. Turkish J Clin Lab. 2017;8(2):57\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.18663/tjcl.320040\u003c/span\u003e\u003cspan address=\"10.18663/tjcl.320040\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBouih A, Nadif B, Benattabou D. Assessing the effect of general self-efficacy on academic achievement using path analysis: A preliminary study. J Engl Lang Teach Appl Linguistics. 2021;3:18\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.32996/jeltal.2021.3.4.3\u003c/span\u003e\u003cspan address=\"10.32996/jeltal.2021.3.4.3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchneider M, Preckel F. Variables associated with achievement in higher education: A systematic review of meta-analyses. Psychol Bull. 2017;143(6):565\u0026ndash;600. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/bul0000098\u003c/span\u003e\u003cspan address=\"10.1037/bul0000098\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlbagawi B, Hussein FM, Alotaibi JS, Albougami AS, Amer FM, Alsharari AF. Self-efficacy and clinical competence of fourth-year nursing students: A self-reported study. Int J Adv Appl Sci. 2019;6(8):65\u0026ndash;70. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.21833/ijaas.2019.08.009\u003c/span\u003e\u003cspan address=\"10.21833/ijaas.2019.08.009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCochran KL, Moss M, Mealer M. Prevalence of coping strategy training in nursing school curricula. J Crit Care. 2020;29:104\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4037/ajcc2020287\u003c/span\u003e\u003cspan address=\"10.4037/ajcc2020287\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaraca A, Yildirim N, Ankarali H, Acikgoz F, Akkus D. Nursing students' perceived levels of clinical stress, stress responses and coping behaviors. J Psychiatric Nurs. 2017;8(1):32\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.14744/phd.2017.22590\u003c/span\u003e\u003cspan address=\"10.14744/phd.2017.22590\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMazalov\u0026aacute; L, Gurkov\u0026aacute; E, Šturekov\u0026aacute; L. Nursing students\u0026rsquo; perceived stress and clinical learning experience. Nurse Educ Pract. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2022.103457\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2022.103457\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 64,103457.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCamlibel M, Uludag E. Investigating the Psychometric Characteristics of the Nursing Students\u0026rsquo; Perceptions of Clinical Stressors Scale. Journal of Nursing Effect., Shaban IA, Khater WA, Akhu-Zaheya LM. Undergraduate nursing students\u0026rsquo; stress sources and coping behaviours during their initial period of clinical training: A Jordanian perspective. Nurse Educ Pract. 2012;12(4),204-9. https://doi.org/10.1016/j.nepr.2012.01.005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJayasekara R, Smith C, Hall C, Rankin E, Smith M, Visvanathan V, et al. The effectiveness of clinical education models for undergraduate nursing programs: a systematic review. Nurse Educ Pract. 2018;29:116\u0026ndash;26. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nepr.2017.12.006\u003c/span\u003e\u003cspan address=\"10.1016/j.nepr.2017.12.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHweidi IM, Nizamli FM. Stressors in intensive care units in Syria: patients' perceptions. J Res Nurs. 2015;20(2):114\u0026ndash;26. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/1744987114524202\u003c/span\u003e\u003cspan address=\"10.1177/1744987114524202\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePang PS, Suen LK. Stressors in the intensive care unit: comparing the perceptions of Chinese patients and their family. Stress Health. 2009;25(2):151\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/smi.1232\u003c/span\u003e\u003cspan address=\"10.1002/smi.1232\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYava A, Tosun N, Unver V, Cicek H. Patient and nurse perceptions of stressors in the intensive care unit. Stress Health. 2011;27(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/smi.1333\u003c/span\u003e\u003cspan address=\"10.1002/smi.1333\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKılıc HF. The relationship between nursing students\u0026rsquo; educational stress and professional self-esteem. J Hacettepe Univ Fac Nurs. 2018;5(1):49\u0026ndash;59. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.31125/hunhemsire.431130\u003c/span\u003e\u003cspan address=\"10.31125/hunhemsire.431130\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePozam M, Zaybak A. Examination of nursing students\u0026rsquo; self efficacy regarding their clinical performance. E-J Dokuz Eylul Univ Nurs Fac. 2022;15(1):22\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.46483/deuhfed.928683\u003c/span\u003e\u003cspan address=\"10.46483/deuhfed.928683\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOzvurmaz S, Mandıracıoglu A. Evaluation of students\u0026rsquo; perceptions of clinicaleducation environment andacademic self-sufficiency: a cross-sectionalstudy. Tıp Eğitimi D\u0026uuml;nyası. 2018;17(53):51\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.25282/ted.433398\u003c/span\u003e\u003cspan address=\"10.25282/ted.433398\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYigitbas C, Yetkin A. Evaluating of self-efficacy-sufficiency levels of students in the health college. Cumhuriyet \u0026Uuml;niversitesi Hemşirelik Y\u0026uuml;ksek Okulu Dergisi. 2003;7(1):6\u0026ndash;13. (Original Study Published in Turkish).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChapman R, Orb A. Coping strategies in clinical practice: The nursing students\u0026rsquo; lived experience. Contemp Nurse. 2001;11(1):95\u0026ndash;102. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5172/conu.11.1.95\u003c/span\u003e\u003cspan address=\"10.5172/conu.11.1.95\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Nursing education, nursing student, academic self-efficacy, clinical stressor, surgical clinic","lastPublishedDoi":"10.21203/rs.3.rs-5235156/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5235156/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e In high-stress surgical settings, it's crucial to recognize nursing students' academic self-confidence and the stressors they perceive. This understanding helps them effectively navigate their educational journey and cultivate a strong professional identity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This study aimed\u003cstrong\u003e \u003c/strong\u003eto determine the relationship between nursing students' academic self-efficacy and perceived stressors for professional practice in surgical clinics. The study design is descriptive and correlational. A total of 284 undergraduate nursing students practicing in surgical clinics at a university in Izmir province were recruited during the 2022-2023 academic year. A Personal Information Form, the Academic Nurse Self-Efficacy Scale (ANSES), and the Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS-TR) were used to collect data. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis were used to analyze the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The mean age of the students included in the study was 21.02±1.52 years. The mean total score of the ANSES was 51.50±6.88 and the mean total score of the NSPCSS-TR was 82.98±15.58. There was no statistically significant relationship between the ANSES and NSPCSS-TR scores (r:-0.022, p:0.711). It was found that there was a statistically significant positive weak relationship between the ANSES sociability sub-dimension score and the NSPCSS-TR academic performance of the instructor sub-dimension score (r:0.190, p:0.001). It was found that there was a statistically significant negative weak relationship (r:-0.163, p:0.006) between ANSES external emotion management subscale score and NSPCSS-TR inappropriate situations in the clinical environment subscale score.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e This study found that nursing students' perceptions of academic self-efficacy and clinical stressors were high. It is recommended that programs aimed at improving the academic self-efficacy of nursing students should be implemented, that clinical practice should be emphasized as an important part of nursing education and that comprehensive studies should be conducted to reduce perceived stress in surgical clinics.\u003c/p\u003e","manuscriptTitle":"Academic self-efficacy and perceived stressors for surgical practice in nursing students: A descriptive and correlational design","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-11 14:47:48","doi":"10.21203/rs.3.rs-5235156/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-30T07:55:52+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-30T07:44:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-30T07:43:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-10-09T21:55:31+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5b66ee8e-dd88-4346-b19f-41f54721e15f","owner":[],"postedDate":"November 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-03T16:03:13+00:00","versionOfRecord":{"articleIdentity":"rs-5235156","link":"https://doi.org/10.1186/s12912-025-02836-0","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2025-02-26 15:58:16","publishedOnDateReadable":"February 26th, 2025"},"versionCreatedAt":"2024-11-11 14:47:48","video":"","vorDoi":"10.1186/s12912-025-02836-0","vorDoiUrl":"https://doi.org/10.1186/s12912-025-02836-0","workflowStages":[]},"version":"v1","identity":"rs-5235156","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5235156","identity":"rs-5235156","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}