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Trajectories and Adaptive Recalibration of Self-Efficacy in Brazilian Medical Students: A Longitudinal Study With Implications for Educational Support

Clin Teach. 2026 Aug;23(4):e70448. doi: 10.1111/tct.70448.

ABSTRACT

INTRODUCTION: Self-efficacy, the belief in one’s capacity to execute actions necessary to achieve specific objectives, is a significant predictor of academic performance and well-being in medical training. Longitudinal studies examining the dynamic evolution of self-efficacy throughout undergraduate medical education remain scarce in the Brazilian context. This study prospectively evaluated perceived self-efficacy among medical students during critical curricular transitions.

METHODS: A prospective longitudinal study followed 50 medical students from a Brazilian public university at four time points: course entry (T1-2021), end of first year (T2-2022), midpoint of clinical cycle (T3-2023) and beginning of fifth year/internship (T4-2025). The Self-Efficacy Scale for Higher Education (SESHE), a validated 34-item instrument assessing five dimensions, was administered. Statistical analyses included repeated measures ANOVA, Wilcoxon test and effect size calculations (Cohen’s d).

RESULTS: The study observed a dynamic evolution in perceived self-efficacy, characterised by a notable shift in total self-efficacy from 2021 to 2023, followed by partial recovery by 2025. This pattern included significant reductions in several dimensions. Self-efficacy in proactive actions experienced the most pronounced change (d > 0.8), while self-efficacy in social interaction demonstrated relative stability. Baseline analyses revealed higher self-efficacy in social interaction among male students (d = 0.51).

CONCLUSION: These findings suggest that the observed changes in self-efficacy represent an adaptive recalibration, moving toward a more realistic self-assessment essential for professional development. Therefore, strategies that support this healthy recalibration are crucial. These interventions should aim to facilitate adaptive adjustment, fostering robust and accurate self-efficacy throughout medical training.

PMID:42246054 | DOI:10.1111/tct.70448

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