Evaluating anxiety and self-confidence in nursing students: Adaptation and validation of the NASC-CDM scale for high-fidelity simulation training

•NASC-CDM scale is adapted for nursing students in high-fidelity simulation (HFS).•Exploratory factor analysis revealed constructs for anxiety and self-confidence.•Anxiety and self-confidence showed high internal consistency (α = 0.956 and α = 0.955).•The valid tool reliably measures nursing students anxiety and self-confidence in HFS. Anxiety and self-confidence impact performance and decision-making during high-fidelity simulation in nursing education. A validated tool to assess these factors is lacking. The Nursing Anxiety and Self-Confidence with Clinical Decision-Making© scale (NASC-CDM) was translated, adapted for high-fidelity simulation and validated using a five-step approach. This included a Content Validity Index review by experts and pilot-testing with first-year nursing students. Construct validity and internal consistency were evaluated using Exploratory Factor Analysis and Cronbach's alpha. A total of 187 first-year nursing students participated. Exploratory Factor Analysis identified constructs for anxiety (two factors, 60.72% variance) and self-confidence (three factors, 61.22% variance). The tool demonstrated high internal consistency, with Cronbach's alpha values of 0.956 for anxiety and 0.955 for self-confidence. The 19-item Dutch Nursing Anxiety and Self-Confidence with Clinical Decision-Making for High-Fidelity Simulation scale is a valid and reliable instrument measuring anxiety and self-confidence in nursing students during high-fidelity simulation.