• confidence-weighted testing;
  • feedback;
  • Japan;
  • self-confidence;
  • nursing skills


Nurses' lack of self-confidence in their own nursing skills is one of the main reasons that novice nurses leave the profession in Japan. Nursing education must help students gain self-confidence in their nursing skills in order to allow more novice nurses to stay in their profession. In this study, we evaluated whether confidence-weighted testing feedback actually improves students' self-confidence in their basic nursing skills. Confidence-weighted testing, which provides quantifiable results, might allow students to objectively assess their skill-related self-confidence. Sixty-seven first-year nursing students took two confidence-rating examinations on the knowledge and practical skills related to pulse and blood pressure measurement of immobile patients. Feedback was given to each participant after the first examination. After the first examination with confidence-weighted testing feedback, students showed higher levels of self-confidence in their practical skills, but not in knowledge. The improvement of self-confidence in practical skills suggests that there is still room for improvement in confidence-weighted testing feedback in knowledge. Further research is required to identify more effective feedback methods to improve students' self-confidence levels in knowledge using the results of confidence-weighted testing.