Situation: The nurse at the clinic of a public high school t… | 마이메르시 MyMerci
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Nursing Practice II — Maternal and Child Health Nursing
문제

Situation: The nurse at the clinic of a public high school talks with students who come in for consultation. The nurse is training a 16-year-old student to give a short talk on hand washing to younger pupils. He says he is too nervous to speak in front of a class. According to Bandura's social cognitive theory, which strategy will MOST strengthen his belief that he can do it?

해설
All four options are sources of self-efficacy in Bandura's theory: mastery experience, vicarious experience, verbal persuasion, and physiological and emotional states. Mastery experience, succeeding at the task oneself, is the strongest source. Starting with a small group gives him an early success that builds confidence for the larger class.
같은 주제 다음 문제Situation: A 20-month-old boy is admitted to the pediatric ward of a district hospital for…이 문제가 수록된 문제집PLNE Question Bank 150014,000원 · 무료 체험 가능

심화 해설

Core concept: Bandura’s four sources of self-efficacy

Self-efficacy is the belief that one can successfully perform a specific behavior in a specific situation. In Bandura’s social cognitive theory, that belief is built and strengthened through four distinct sources of information: performance accomplishments (mastery experience), vicarious experience (modeling), verbal persuasion, and physiological and emotional states [1][2]. All four options in this question represent one of those sources, but they are not equal in strength.

OptionSource of self-efficacyStrength
1. Telling him often that she is sure he can do itVerbal persuasionWeakest; effect fades without actual success
2. Having him first give the talk to a small groupPerformance accomplishment (mastery)Strongest source
3. Teaching slow breathing to calm himselfPhysiological/emotional stateIndirect; helps interpretation of arousal
4. Watching a classmate deliver the same talk wellVicarious experienceModerate; depends on perceived similarity


Performance accomplishments—actually succeeding at the task—are the most powerful and durable source of self-efficacy because they provide direct, personal evidence of capability. When the student gives the talk to a small group and succeeds, he experiences mastery. That success becomes a reference point: “I did it once; I can do it again.” The meta-analytic evidence confirms that performance accomplishments show the strongest cumulative association with self-efficacy compared with the other three sources [4].

Watch out! Verbal persuasion (option 1) feels supportive, but telling someone “you can do it” without any actual success behind it produces only weak, short-lived changes in belief. It is the least reliable source on its own [1][4].

Key point! The reason a small group works is not that it is easier content—it is that it creates a mastery experience. The student performs the actual behavior, succeeds, and internalizes that success. This is why option 2 is the strongest strategy.

Vicarious experience (option 4) can help, but its effect depends on how similar the model is to the observer. A classmate who is already confident may not feel comparable to a nervous student, which limits the boost [1][4]. Physiological strategies such as slow breathing (option 3) address the emotional state that can lower self-efficacy, but they do not by themselves create evidence of competence. They may reduce anxiety, yet the belief that he can actually deliver the talk still has not been tested or proven.

Self-efficacy is the bridge between knowledge and action: the belief that one can perform a behavior usually must precede the actual attempt. The student already knows the hand-washing content. What he lacks is not information but the conviction that he can present it. A small-group success directly supplies that conviction [2].

In clinical and school health settings, this principle applies broadly. When preparing a patient or student for a new behavior—whether it is giving a talk, self-injecting insulin, or performing hand hygiene—the most effective intervention is to arrange a graded mastery opportunity: start with a smaller, achievable version of the task, let the person succeed, and then build toward the full target behavior. This is the practical translation of Bandura’s hierarchy of self-efficacy sources.
References (research sources)
  • [1]
    The theory and measurement of the self-efficacy construct.Research articlevan der Bijl JJ, Shortridge-Baggett LM (2001)
  • [2]
    Self-efficacy and health education.Research articleLawrance L, McLeroy KR (1986) · DOI: 10.1111/j.1746-1561.1986.tb05761.x
  • [4]
    Unique effects and moderators of effects of sources on self-efficacy: A model-based meta-analysis.Meta-analysis/systematic reviewByars-Winston A, Diestelmann J, Savoy JN, Hoyt WT (2017) · DOI: 10.1037/cou0000219

임상 시나리오

Building Self-Efficacy in a Nervous StudentBandura's strongest source: mastery experience

The most powerful way to strengthen self-efficacy is performance accomplishment: having the student actually succeed at the task. Start with a small group rather than a full class so the first attempt is manageable and likely to succeed.

The other sources are weaker: verbal persuasion fades without real success, vicarious experience depends on similarity to the model, and calming physiological state only changes how arousal is interpreted.

Caution

Do not rely on praise alone. A failed first attempt in front of a large class can lower self-efficacy, so arrange a small, low-pressure mastery opportunity first.

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