The Effect of Internship Length on Self-Efficacy and Clinical Competence: Accelerating Entry Into the Nursing Workforce in Saudi Arabia

Abstract

Background: Limited studies have evaluated the impact of the length of internship training in relation to self-efficacy and clinical competence and the factors influencing these variables among nurse interns, particularly in Saudi Arabia. Aim: The threefold aim of this study was to (1) determine the self-efficacy and clinical competence of Saudi nursing interns, (2) assess the differences in their perceptions, and (3) evaluate the differences within the 1-year internship program in the self-efficacy and clinical competence of Saudi nursing interns. Design: The quantitative study employed a cross-sectional design and comparative and predictive research approaches. Methods: A total convenience sample of 206 Saudi nursing interns participated in the study. T-test and analysis of variance (ANOVA) were used to determine the differences in nursing interns’ perceptions. A multiple regression analysis was conducted to examine the extent to which various predictor variables accounted for variance in clinical competence among interns. Results/Findings: The nurse interns’ mean scores were 3.33/4 for self-efficacy and 4.42/5 for clinical competence. No significant correlation was found between demographics and either variable. However, self-efficacy correlated positively with clinical competence (r = 0.67,p < 0.001). A between-group ANOVA showed significant differences in self-efficacy (F(2, 203) = 19.00, p < 0.001) and clinical competence (F(2, 203) = 38.00, p < 0.001) across internship durations. Post hoc tests revealed significant increases in the 4- to 8-month groups, with no significant difference between 8- and 12-month groups. Implication: Given that no significant improvements were observed beyond the 8-month mark, it is recommended that internship programs consider reducing the overall duration to 8 months. This would preserve educational effectiveness while optimizing the use of institutional and human resources. More importantly, such a change could help address the persistent nursing shortage by accelerating the transition of qualified nursing graduates into the workforce by enabling earlier entry into professional roles without compromising competence or confidence. Conclusion: In conclusion, the present study has strengthened the relationship between self-efficacy and clinical competence. Higher self-efficacy corresponds to an increase in clinical competence. Additionally, the findings suggest that the duration of the internship program is important for enhancing the clinical skills of nursing interns; however, no significant differences were found between interns at the 8- and 12-month points in the program.