Objective: The objectives of the present study were to evaluate the academic self-efficacy, content knowledge and confidence in these responses, as well as attitudes of students in an undergraduate biostatistics course. Design: The study was a cross-sectional analytical design. Setting: The study was carried out in Masinde Muliro University of science and technology Sample: Sampling frame consisting of 114 students who had at least taken a biostatistics course. Probability sampling technique of purposive sampling method was applied to select the students. ( n = 114 ) Analysis: Data were analyzed through path analysis and confirmatory factor analysis. Main measures: Self-efficacy, confidence, attitude and knowledge Results: The estimation of this hypothesized structural model yielded an acceptable fit to the data, χ2 =45.9, df = 2; χ 2 /df ratio =22.123 (good), CFI = .933; RMSEA = .071, with 90% C.I. = .044 - .083, SRMR = .078. Attitude was a direct predictor of self-efficacy (β = .490, p < .001), confidence was a direct predictor of self-efficacy (β = .400, p < .001), self-efficacy was a direct predictor of knowledge (β = .515, p < .001). Conclusion: The study concludes that academic self-efficacy and optimism were strongly related to performance. Therefore, this study supports previous literature that found academic self-efficacy affects the success of students in the sciences. Recommendation: Educators should be aware of students' personality antecedents in order to improve their students' beliefs about their capabilities to master different areas of coursework. Article visualizations: