Self-efficacy, burnout and academic success in nursing students: A counterfactual mediation analysis

Aim: To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students. Design: This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students. Methods: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed. Results: The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout. Conclusion: The mechanism by which self-efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification. Impact: Nurses' professors should be engaged in strategies to promote self-efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse.