The 21st century has issued in resurgence in the need to reform public education, much of which focuses on teacher preparation and performance. However, more than 12% of new teachers have any significant training upon entering the classroom and almost 50% of teachers resign within their first 5 years. One reason for this is inadequate preparation and an expectation that new hires perform at the same level as experienced teachers. To significantly impact the preparation of health education teachers so that they are successful, professional preparation programs should determine how well their candidates have the essential elements of knowledge and skill development coupled with self-efficacy training. This suggests that candidates become competent as health educators when they balance an accurate perception of their health knowledge and skills with a belief in their ability to perform these competencies. Likewise, health education candidates at different levels of training require different sets of knowledge, skills, and sense of efficacy in order to achieve maximum success. A paucity of research exists on the evaluation and development of teacher efficacy associated with the ability to effectively teach health education. The purpose of this exploratory study was to examine differences in generations of current health education candidates' and graduates' sense of efficacy. The goal of this project was to determine if in perceived teacher efficacy differed among four generations of health education candidates (n=110) and teachers (n=60) at 4 different levels of preparation (entry-level, intermediate-level, internship candidates, graduates/teachers). Two Likert-type instruments were used; one measured health teaching efficacy and the second measured general teacher efficacy. Both measures were broken into sub-scales according to the 7 responsibilities of a health educator as well as two other sub-scales, performing skills/comprehending content and classroom management. Analyses of variance showed a significant difference in efficacy among the 4 levels as related to the 9 sub-scales. The most pronounced result was that candidates completing the internship were more efficacious in all areas except coordinating school health services and classroom management. Results from the study provide preliminary guidance about meeting training needs of candidates as well as experienced teachers. Some implications include the need for early classroom experience for candidates, preparation in becoming an independent teacher, and mentorship programs benefiting new and tenured teachers. Developing training strategies based on these findings would allow entry-level and experienced health educators to teach students more effectively and ensure maximum teacher success and retention.Keyword(s): college level issues, curriculum development, professional preparation