EXAMINATION STRESS AND COPING AMONG UNDERGRADUATE NURSING STUDENTS DURING COMPUTER-BASED EXAMINATIONS IN SWABI, PAKISTAN: A DESCRIPTIVE CROSS-SECTIONAL STUDY

Abstract

Background: Computer-based examinations are now common in nursing education, and they bring technical demands that paper tests do not. Local evidence on how nursing students experience stress and cope during these examinations is limited.

Objective: To assess the level and frequency of stress and the coping scores of undergraduate nursing students during computer-based examinations in Swabi, Pakistan, and to describe their attitude toward these examinations.

Methodology: We conducted a descriptive cross-sectional study in nursing colleges in Swabi. The sample size was calculated as 299 with Open-Epi 95% confidence interval and 5% margin of error. (359 after allowing for 20% non-response or incomplete data), and students were selected by stratified random sampling according to academic year. Stress was measured with the Westside Test Anxiety Scale and coping with the Brief COPE. Attitude toward computer-based examinations was also recorded. Data were analyzed in SPSS using frequencies, percentages, means and standard deviations.

Results: Of the 299 students analyzed (mean age 22.64 years, SD 1.362; 68.2% male; 56.2% in the eighth semester), 260 (87.0%) had moderate stress, 31 (10.4%) mild stress and 8 (2.7%) severe stress (mean score 3.13, SD 0.406). Coping scores were moderate in 256 students (85.6%), poor in 37 (12.4%), and good in 6 (2.0%) (mean 2.42, SD 0.355). Attitude toward computer-based examinations was neutral in 247 students (82.6%), and negative and positive in 26 students each (8.7%) (mean 3.28, SD 0.440).

Conclusion: Most nursing students in this sample had moderate stress during computer-based examinations, and very few had good coping scores. Colleges may consider stress-management and examination-familiarization sessions before examination periods. Associations with age, gender and semester need to be tested in larger studies.