Abstract
BACKGROUND AND AIM: Self-efficacy is a key component in developing professional readiness among nursing students. It plays a crucial role in enhancing clinical performance, decision-making quality, and self-confidence. Therefore, identifying and applying effective educational methods to improve this capability is one of the major challenges in nursing education systems. This study aimed to compare the effectiveness of three teaching approaches—role-playing, small group discussion, and traditional instruction—on the self-efficacy of nursing students. METHODS: This Quasi-experimental study with three groups was conducted on 90 nursing students at Zahedan University of Medical sciences, Iran. Participants were randomly assigned to groups by drawing a card: red card (role-playing), yellow card (group discussion), and green card (traditional teaching). In the traditional teaching group, the educational content was delivered through lecture and PowerPoint presentation. In the group discussion method, students were divided into subgroups of six, and each subgroup was provided with a clinical scenario related to the topic. With the guidance of a facilitator, the subgroups engaged in discussion and exchange of ideas about the scenario. In the role-playing method, students were divided into groups of four, and each member assumed one of the roles: nurse, parent, child, or observer. Each group received a structured clinical scenario related to the subject, and the students enacted the assigned roles and performed the scenarios. Data were collected using the Clinical Self-Efficacy Questionnaire, completed by all students before and three months after the intervention. RESULTS: The present study demonstrated the clear superiority of active learning methods, particularly role-playing, over traditional teaching in enhancing nursing students’ self-efficacy. Role-playing, by providing a safe environment for practice, led to a 55.7% improvement in self-efficacy (p < 0.001, d = 1.55) and enhanced students’ professional confidence. Group discussion was also effective, resulting in a 50.9% improvement (p = 0.02), whereas traditional teaching yielded only a negligible 0.8% increase (p = 0.78). CONCLUSION: The findings suggest that using active and interactive teaching methods—especially role-playing—can effectively enhance nursing students’ self-efficacy. These results can be utilized in designing student-centered and participatory educational programs.