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Year : 2020  |  Volume : 23  |  Issue : 12  |  Page : 1721-1727

Investigating the Effect of Personality Traits and Academic Self-efficacies on Malpractice Tendencies in Health College Students

1 Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey
2 Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey

Date of Submission16-Dec-2019
Date of Acceptance20-May-2020
Date of Web Publication23-Dec-2020

Correspondence Address:
Dr. D Baykal
Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Vadi Campus, Anadolu Street, No:40 Kagithane, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_677_19

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Background: Prevention of malpractice is crucial for health care professionals since it could lead to morbidity and mortality. Personality traits of students, being health care professional candidates affect their academic self-efficacies and malpractice tendencies. Objective: To investigate the effect of personality traits and academic self-efficacies of midwifery and nursing students on their malpractice tendencies. Materials and Methods: The study was conducted with a total of 437 midwifery and nursing students studying at two universities between May and September 2019. The form of sociodemographic characteristics, Eysenck Personality Inventory, Academic Self-efficacy Scale, and Malpractice Tendency Scale were used to collect the data. Results: In the malpractice tendency scale, the students had the lowest score from patient monitoring and equipment safety subscale (x¯ = 40.59 ± 5.41) and the highest score from the communication subscale (x¯ = 22.78 ± 3.01). In the personality inventory, they were found to have the lowest score from the psychoticism subscale and the highest score from the extraversion subscale. Their academic self-efficacy mean score was 14.69 ± 3 0.49. Academic self-efficacy score was higher in the 1st year compared to the 4th year (P < 0.05). A negative correlation was found between neuroticism and extraversion subscales and academic self-efficacy (P < 0.01). A negative correlation was found between malpractice tendency and academic self-efficacy (P < 0.01). Conclusion: It was observed that neuroticism and extraversion personality traits in students were found to be associated with low academic self-efficacy and increasing malpractice tendencies. Investigation of academic self-efficacy and malpractice tendencies of the students in accordance with their personality traits would contribute to the improvement, arrangement, and updating of educational curricula.

Keywords: Academic self-efficacy, malpractice, personality traits, students

How to cite this article:
Baykal D, Yildirim D. Investigating the Effect of Personality Traits and Academic Self-efficacies on Malpractice Tendencies in Health College Students. Niger J Clin Pract 2020;23:1721-7

How to cite this URL:
Baykal D, Yildirim D. Investigating the Effect of Personality Traits and Academic Self-efficacies on Malpractice Tendencies in Health College Students. Niger J Clin Pract [serial online] 2020 [cited 2022 Nov 30];23:1721-7. Available from:

   Introduction Top

Midwifery and nursing education aims to combine practical and theoretical knowledge with clinical experiences and to reflect on professional life after graduation.[1] Midwives and nurses, constituting the majority of health care professionals, play an important role in the care, treatment, and rehabilitation of patients. While performing these functions, individuals take the first steps for acquiring the necessary knowledge during the university years, and their self-efficacy increases in the following years by self-improvement.

According to Bandura, academic self-efficacy is the belief that a person can accomplish an academic task or purpose at a certain level.[2] Individuals with low self-efficacy beliefs are unsuccessful in starting and maintaining correct behavior. The basis of motivation and success is related to one's belief in self-efficacy. Therefore, if an individual believes that he/she would have the results he/she wants from the planned actions, he/she can resist and solve the difficulties in professional life.[3] Similarly, students with high self-efficacy are more willing and successful in the activities they attend throughout their lives.[4],[5] It is reported that while positive self-efficacy increases desire and motivation in the individual and facilitates to cope with new and difficult tasks, negative self-efficacy causes easy quitting and not finishing the task.[6],[7] Academic self-efficacy is important in improving the student's personal skills in learning and performance. Providing academic competence in students helps them to comprehend the importance of the desire to learn and participating and learning in learning-related practices. Positive academic motivation not only helps students to succeed in their classes but also to realize the reward that comes with learning throughout their lives.[8] The studies have reported that high self-efficacy supports success.[9],[10],[11],[12] Learning strategies, as well as personality traits other than the previous performances, also affect academic self-efficacy.[13]

Personality traits can affect the perception of emotions, thoughts, and events from person to person. One of the models revealing the basic structure of personality is Eysenck's personality model.[14]According to Eysenck's view, personality is based on one's showing similar reactions to similar situations over the years. He, therefore, argues that personality has biological and genetic characteristics. Eysenck deals with personality in three basic dimensions including introversion-extraversion, neuroticism, and psychoticism.[15]Introverted people are quiet, calm, gentle, mature people avoiding conflict and joining small social groups. People having extraversion personality are excited, outgoing, and social. Neuroticism shows a person's tendency to act emotionally. They give intense emotional reactions to the events, get excited, and get angry quickly. Psychotics are selfish, tough, and aggressive people who ignore others.[15]

Personal characteristics in academic success have been discussed further in recent years. Particularly, the determinants in increasing academic performance attract the attention of both researchers and educators. Personality traits are important determinants in academic achievement.[16],[17] It is stated that there is a relationship between personality traits and academic self-efficacy.[18] It has been reported that especially students having extraversion social personality traits also have high academic self-efficacies.[19] Personality traits of students studying in health programs may cause the possibility of malpractice in the clinical field.

Malpractice or medical error can occur due to many reasons. Among these reasons, human-related factors other than institutional and technical factors (fatigue, having insufficient knowledge, lack of precaution, wrong decision, timelessness, and controversial personality) are very important.[20]Malpractice can be seen in not only healthcare professionals but also students who are candidates of health care professionals. The care, diagnosis, and therapeutic interventions applied by health students in the stage of improving knowledge and skills in clinics under the supervision of advisory teachers are very risky and their malpractice risks are also high.[21]

Malpractice can be affected by personality traits such as argumentative personality as well as academic self-efficacy. Depending upon the scientific developments in the field of health, knowledge, and practices become invalid today. The health care professionals who do not have academic knowledge or do not follow current developments are more likely to make medical mistakes.[22] When the literature is examined, it is understood that personality traits, academic self-efficacy, and malpractice tendencies of the students were addressed separately.[19],[23],[24],[25],[26]

Investigating the personality traits in decreasing malpractice tendencies and increasing academic self-efficacies is thought to be important for students who are health care professional candidates. Accordingly, the aim of the study is to investigate the effect of personality traits and academic self-efficacies of the midwifery and nursing students on their malpractice tendencies.

   Methods Top

This study was designed as a descriptive cross-sectional study to assess and determine the relationship of personality traits and academic self-efficacies of midwifery and nursing students with malpractice.

The study was conducted with midwifery and nursing students studying in 2 foundation universities in Istanbul between May and September 2019. The population of the study was composed of a total of 490 students studying in 2 universities.

Without using sample selection, all students who agreed to participate in the study were included in the study. The sample of the study was composed of a total of 437 students i.e., 89% of the study population.

Before starting to collect data, ethics committee approval was obtained from the noninvasive clinical trials ethics committee (No: 12). In accordance with ethical principles, the purpose of the study was explained to the students and their written consents were obtained.

In the collection of data, information form for determining socio-demographic characteristics of the students, Revised Eysenck Personality Questionnaire (EPQR-A) for determining their personality traits, academic self-efficacy scale (ASE) for measuring academic self-efficacy, and malpractice tendency scale (MTS) for measuring their malpractice tendencies were applied.

An information form was used to collect personal data such as age and gender. Revised Eysenck personality questionnaire was prepared by Francis et al., (1992) by adapting the Eysenck personality inventory developed by Eysenck. Turkish validity and reliability study of the inventory was conducted by Karancı et al.[27]

The inventory assesses personality in 3 main factors (introversion-extroversion, neuroticism, and psychoticism). In addition, it is also aimed at lie subscale to prevent bias and check the validity of the questionnaire during the application. The inventory has a total of 24 items. The answers are scored as yes (1) and no (0).

Academic self-efficacy scale; Turkish adaptation of the scale, which contains a single subscale and was developed by Jarusalem and Schwarzer (1981) was conducted by Yilmaz et al.[28]The scale consisting of 7 items is a 4-point Likert type. A high score indicates high academic self-efficacy.

Malpractice tendency scale was developed by Özata and Altunkan to measure the malpractice tendency level of the healthcare professionals (nurse, midwife, etc.).[29] In the scale consisting of 55 items, there are items about the medicine and transfusion practices, falls, hospital infections, communication, and patient monitoring and equipment safety. The increase in total score taken in the 5-point Likert scale indicates low malpractice tendency of health care professionals while decrease in the score indicates high malpractice tendency.

While evaluating the results obtained in the study, IBM SPSS Statistics 22 (IBM SPSS, Turkey) program was used for statistical analyses. The compatibility of the variables to normal distribution was evaluated by Kolmogorov–Smirnov test, Q-Q graphs, and histograms. While evaluating the study data, descriptive statistical methods (mean, standard deviation, frequency, and percentage) as well as Student-t test were used to evaluate quantitative data between two groups. In the evaluation of quantitative data among more than two groups, one-way analysis of variance (ANOVA) was used. Levene's test was used to test the assumption of homogeneity of variances. In the determination of the groups causing the difference as a result of ANOVA test, those with homogeneous variances were assessed using Tukey Test, those without homogeneous variances were assessed using Tamhane T2 posthoc test. In the evaluation of the correlation between quantitative data, Pearson correlation analysis was used. In the evaluation of the reliability of the scales, the Cronbach's alpha and Kuder Richardson-20 reliability coefficients were used. Significance was evaluated at a level of P < 0.05.

   Results Top

Of the students, 11.9% (n = 52) were male and 88.1% (n = 385) were female. While the mean age of the female students was 21.63 ± 1.89 years, the mean age of the male students was 20.93 ± 1.96 years. 77.3% (n = 338) of the students were studying in nursing; whereas, 22.7% (n = 99) were studying in midwifery department [Table 1].
Table 1: Sociodemographic characteristics of the students

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Neuroticism subscale mean score of the students was 3.65 ± 1.61, their extraversion subscale mean score was 4.08 ± 1.86, their psychoticism subscale mean score was 1.34 ± 1.05, and their lie subscale mean score was 4.07 ± 1.59.

The mean scores of the students were 86.30 ± 6.15 for the subscale of medicine and transfusion practices, 22.77 ± 2.43 for the subscale of falls, 56.49 ± 5.00 for the subscale of hospital infections, 40.59 ± 5.41 for the subscale of patient monitoring and equipment safety, and 22.78 ± 3.01 for the subscale of communication. ASE total scores of the students varied between 7 and 28 and their mean score was 14.69 ± 3.49 [Table 2].
Table 2: EPQR-A, MTS and ASE scales score distributions of students

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Female students' medicine and transfusion practices (P = 0.003), falls (P = 0.001), and hospital infections (P = 0.001) average subscale scores have been found higher than male students' scores. Midwifery students' medicine and transfusion practices (P = 0.001), falls (P = 0.002), hospital infections (P = 0.025), and patient monitoring and equipment safety (P = 0.004) subcale scores were higher compared to nursery students' relevant scores. Also, it has been determined that male students' psychoticism subscale scores were statistically significantly higher than female students' scores (P = 0.001).

As a result of a post hoc analysis, 4th-grade students' average ASE total points have been found significantly higher than 1st-grade and 2nd-grade students' total points (P = 0.002 and P = 0.048, respectively) [Table 3].
Table 3: Comparison of personality traits, academic self-efficacies, and malpractice tendencies of the students on their sociodemographic characteristics

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A statistically significant and negative correlation was found among ASE total scores and the neuroticism (P = 0.002) and extraversion subscale scores (P < 0.01). A statistical significant and negative correlation was found between the ASE total scores and scores of medicine and transfusion practices (P = 0.001), falls (P = 0.001), hospital infections (P = 0.001), patient monitoring and equipment safety (P = 0.001), and communication (P = 0.001) subscales (P < 0.01).

A statistically significant and negative correlation was found between psychoticism subscale and scores of medicine and transfusion practices (P = 0.001), falls (P = 0.002), hospital infections (P = 0.002) subscales (P < 0.01).

A statistically significant and positive correlation was determined between the lie subscale and scores of medicine and transfusion practices (P = 0.001) and falls (P = 0.001) subscales (P < 0.01) [Table 4].
Table 4: Comparison of the effect of personality traits and academic self-efficacies of the students on their malpractice tendencies

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   Discussion Top

In this study, it was found that while the students having neuroticism and extraversion personality traits had low academic self-efficacies, the students having psychotic personality traits had high malpractice tendencies. In addition, the students with low academic self-efficacy had high malpractice tendencies in all subscales.

The sociodemographic characteristics of the students participating in the study (mean age, marital status, etc.) were similar to the studies conducted with university students.[30],[31] When the subscale mean scores of the students in malpractice tendency scale were examined, their malpractice tendencies were found to be low. It was determined that they got the lowest score from the patient monitoring and equipment safety subscale among the subscale mean scores. Their scores from the other subscales were high and positive. When the studies conducted with the students are examined, it is reported that their medical error or malpractice tendencies are high. When the malpractices of the students in the practice field are examined, it is reported that they have difficulties in the identification of the patients and they do not comply with the sterility/asepsis rules.[25],[32] In the study, it was determined that the malpractice tendencies of female students were lower than the male students. Midwifery and nursing is one of the oldest professions in history and is often known as the women's profession. Although men began to be accepted in nursing schools in Turkey in recent years, it is reported that women behave more attentive in patient care due to their naturally naive, emotional, and motherly characteristics.[33] The reason for lower malpractice tendencies of the students in this study unlike the results of the studies conducted with students in Turkey was thought to be caused by the high academic self-efficacies of the students.

Midwives may be involved in more malpractice cases throughout their careers compared with nurses since midwives have a responsibility for both pregnant women and fetuses. Gundogmus et al. reported that as high as 52% of midwives were exposed to malpractice liability.[34] Whereas in our study, midwifery students' malpractice tendencies were found to be lower than nursery students, in all subscales, except for communication scale. We think this might be because midwifery students observe more malpractice results during their clinical practice trainings.

It was observed that the academic self-efficacies of the students participating in the study were generally high (x¯ = 14.69 ± 3.49). Academic self-efficacy ensures the correct use of knowledge in theoretical and practical fields. Midwifery and nursing students define and analyze their knowledge and clinical experiences under theoretical guidelines and increase their self-efficacy by researching.[35] It is reported that while individuals with high academic self-efficacy are confident in areas such as planning, organizing, and conducting their academic studies[36] the individuals with low academic self-efficacy are unsuccessful.[37]

Academic self-efficacy also provides the opportunity to have sufficient knowledge. In the studies, it was reported that some of the students did not know that the things they did was an error while some did not report even though they do know that they were wrong.[21] It was also found in the study that the academic self-efficacies of the 1st year students were higher than the 4th year students. The reason for low academic self-efficacy levels in the 4th year is thought to be due to the fact that these students experience anxiety in the last year such as finding a job and stepping into a new life. It is important to increase academic self-efficacy in reducing malpractice in clinical practices of health care professional candidates. In parallel with the literature, the study results confirmed that academic self-efficacy decreased malpractice tendency.

Self-efficacy is also related to personality traits. It was found in this study that the students having neuroticism and extraversion personality traits had low academic self-efficacies. Male subjects' psychoticism scores were higher than females. In a study conducted in 37 countries, it was reported that males had higher psychoticism scores compared with women; because of this gender differences may have a genetic basis. Also, students with neuroticism and extrovert personality traits were found to be academically less self-efficacious.[38]

It is believed that low self-perception, excessively emotional, and irrational behaviors of the students with neuroticism personality decrease their academic self-efficacies. In parallel with the study results, it is stated that neuroticism reduces academic self-efficacy.[39] Extraversion personality trait represents sociality, communication, and assertiveness.[15] Similarly, in studies conducted with university students, it is also reported that the young age group shows extraversion personality trait.[40],[41]

The extraversion personality trait in students in the field of health will contribute to maintain the effective communication when they start in their professional career.[42] On the other hand, extraverted people find it difficult to pursue tasks that require a process such as focusing and following attention for a long time.[43]It is believed that with similar reasons, the academic self-efficacies of the students participating in the study were lower than the other students since they showed extraversion personality traits. The studies support the results of the present study.

We found that the personality traits of midwifery and nursing students affected their academic self-efficacies and malpractice tendencies. The obtained results support the literature results, and it is also believed that it is important to find that personality traits are associated with malpractice and academic self-efficacy.


The present study was conducted with midwifery and nursing students of two universities located in Istanbul province. Although these universities have a high number of quotas, the application of the study in two universities constitutes the limitation of the study.

   Conclusions Top

It is important for midwifery and nursing students to have sufficient academic competence during the process of entering professional life. Acquiring academic self-efficacy is essential in not only gaining adequate medical knowledge but also decreasing malpractice tendency. In addition, personality traits that affect the individual's behaviors should not be ignored. Therefore, it is believed that the students should be supported in accordance with personality traits in increasing their academic self-efficacies and reducing malpractice tendencies. It is recommended for academicians to plan their education in theory and practice fields by taking into account the personality traits of their students.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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  [Table 1], [Table 2], [Table 3], [Table 4]


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