Educating Entrepreneurs Without Intentions: Graduate Self-Efficacy and Entrepreneurship Education in Low and Middle-Income Countries (LMICs)

Emmanuel Ahimbisibwe, Burani Aluonzi, Ezra Francis Munyambonera, Kaaya Siraje
Kabale University, P.O. Box 317, Kabale, Uganda
https://orcid.org/0009-0003-9421-771X
Email: ahimbisibweemmanuel@yahoo.com

Abstract: Entrepreneurship education (EE) has been widely integrated into higher education in low- and middle-income countries (LMICs) as a policy response to graduate unemployment, including within nursing education. However, evidence suggests that exposure to EE does not consistently translate into entrepreneurial intentions (EIs) among graduates. This narrative literature review examines the relationship between entrepreneurship education, self-efficacy, and entrepreneurial intentions among nursing students and graduates in LMICs, with particular attention to the moderating role of self-efficacy. The review synthesises empirical, conceptual, and policy-oriented studies published between 1997 and 2025 and is guided by intention-based theories, particularly the Theory of Planned Behaviour. Findings indicate that while entrepreneurship education consistently improves entrepreneurial awareness and knowledge, its direct effect on entrepreneurial intentions is weak and inconsistent. In contrast, entrepreneurship education demonstrates a more reliable influence on entrepreneurial self-efficacy, especially when implemented through experiential and practice-oriented pedagogies. Crucially, the review shows that self-efficacy conditions the effectiveness of entrepreneurship education, such that EE is more likely to translate into entrepreneurial intentions when graduates perceive themselves as capable of entrepreneurial action. In contexts characterised by structural constraints, weak ecosystems, and risk-averse professional norms, low self-efficacy can suppress intention formation despite EE exposure. The study concludes that entrepreneurship education in LMIC nursing contexts must be designed and evaluated as a psychologically mediated and context-sensitive intervention. Strengthening self-efficacy is central to closing the persistent gap between entrepreneurship education and entrepreneurial intention outcomes in LMICs.