Self-efficacy in pediatric resuscitation: Implications for education and performance

Objective. This article examines the relevance of self-efficacy-a cognitive process indicating people's confidence in their ability to effect a given behavior-to training and performance of pediatric resuscitation. The case is made that self-efficacy is likely to influence the development of and real-time access to cognitive, affective, psychomotor, and social aspects of resuscitation proficiency. Methods. Comprehensive literature reviews were conducted on relevant topic areas, including self-efficacy theory and empirical investigations of self-efficacy in clinical practice. Three case studies are used to illustrate the influence of self-efficacy on resuscitation practice. Results. The limited empirical evidence on the role of self-efficacy in clinical practice is consistent with self-efficacy theory: clinicians are less likely to initiate and sustain behaviors for which they lack confidence. This performance-based confidence can be distinguished from both knowledge and skills necessary to perform the behavior. Conclusions. Even clinicians who are knowledgeable and skilled in resuscitation techniques may fail to apply them successfully unless they have an adequately strong belief in their capability. General guidelines for promoting self-efficacy are presented, and specific recommendations are made for enhancing resuscitation self-efficacy during resuscitation training and postresuscitation procedures.