This study explored the relationship between third-year medical students' self-efficacy and their academic achievement on a third-year family medicine clerkship rotation. The sample size was 103 participants, and the mean age of the participants was 27 years (SD = 4.14). There were 68 male students and 35 female students who participated in the study. The self-efficacy questionnaire was administered prior to the rotation and again the last week of the rotation prior to performance assessments. Performance was measured by an oral examination, a written examination and a preceptor-assessed clinical evaluation.

In addition, a principal components analysis of the self-efficacy items (pre- and post-rotation) revealed a transformation in the clerkship students' knowledge structure of patient care. The influence of the family medicine clerkship experience on the different factor loadings (pre- and post-rotation) is discussed.

The results revealed moderate correlations between the pre-rotation self-efficacy scores and the oral exam scores (r=.22, p<.05) and the post-rotation self-efficacy scores and the clinical scores (r=.24, p<.02). There was a negative correlation found between the self-efficacy gain scores and the written exam scores (r=−.25, p<.05). Significant differences were found between the self-efficacy scores (pre- and post-rotation) of the students who completed the family medicine clerkship rotation during the first six months (early group) and those who completed the rotation during the last six months (late group) of the academic year, but no difference was found between the performance measures of the two groups. The self-efficacy measures and the performance measures of the males and females were compared and no gender differences were found.

The results of this study did not reflect as strong a relationship between the self-efficacy measures and the academic performance measures as was anticipated, but it may well be that the predictive power of the construct of self-efficacy, with regard to academic performance, flattens out beyond certain levels of efficacy and ability. Implications for further research of medical students' self-efficacy and its relationship to their academic performance are discussed.