Self-efficacy can be seen as a link between knowledge, skill and performance. This study compared the self-efficacy score and clinical score for physiotherapy students following their pre-clinical training and those students who received 8 h of additional simulation training. Thus it may be that self-efficacy can be an outcome of education and plays an important role in how students perform on clinical placements. Correlations between self-efficacy score and weekly clinical scores were undertaken for the control and intervention groups. Significant positive correlations for the control group occurred between the total self-efficacy score and total clinical score at weeks 2 and 5 with a Spearman rho of 0.59 and 0.69, respectively. For the participants who received simulation training (intervention), negative correlations were found for the total self-efficacy score and total clinical score at week 1 with a Spearman rho of -0.72. Those students who received simulation training appeared to overestimate their performance, as determined by their self-efficacy questionnaire results. For those students who did not receive additional training, their self-efficacy tended to match their clinical ability.