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Clinical competency is underpinned by the self-confidence of nurses to act. Confidence may be critical to the understanding of how practice choices are made and not made by nurses in extended practice roles. The aim of this study was to explore how emergency nurses perceived (i) self-confidence in undertaking an extended practice role; and (ii) the factors associated with confidence within clinical practice.

A multicentred qualitative exploratory study. Fifty two participants were included in the study. Across three sites 36 (28 females, 8 males) face to face interviews and 16 non-participant observations (13 females, 3 males) were conducted.

The study generated new knowledge about self-confidence, self-efficacy and the role that contextual factors have in regulating behaviour. It shows that self-confidence is an important resource that sustains a nurse's ability to problem solve and to …