VIRTUAL GALLERY In Undergraduate Students in a Nursing Program...

Abstract

Undergraduate nursing education is both academically demanding and emotionally intense, often contributing to high levels of anxiety, stress, and reduced quality of life among students. These pressures are most evident during high-stakes assessments, such as exams and clinical skill evaluations, which can impair concentration, decision-making, and academic performance. The PICO question guiding this review was: In undergraduate students in a nursing program, how does intervention, compared with no intervention, affect stress and academic success?

A CINAHL search of peer-reviewed articles published within the past five years was conducted using keywords including nursing students, undergraduate nursing students, exam anxiety, test anxiety, stress prevention, student role adaptation, academic achievement, NCLEX success, interventions, and study skills. The review identified a range of interventions aimed at reducing stress and improving outcomes for nursing students.

Evidence demonstrates that targeted strategies can positively influence student well-being. Mindfulness exercises (Bultas, Boyd, & McGroarty, 2021), music listening (Aksoy & Ozturk, 2023), and aromatherapy (Guler et al., 2023) were found to reduce anxiety levels and promote calm during both classroom and clinical learning experiences. While these approaches did not always translate directly into improved exam scores, they consistently enhanced emotional stability and preparedness. Test accommodations, such as extended exam time (Janes et al., 2022), created a more supportive environment but did not significantly improve performance, suggesting that environmental adjustments alone may be insufficient.

Institutional supports, including resilience-building courses and structured coping interventions, showed mixed quantitative outcomes but yielded valuable qualitative benefits. Students reported improved sleep, enhanced study focus, and a greater ability to manage stress (Moore, Montgomery, & Cobbs, 2021). Large-scale surveys, such as Brown et al. (2021), revealed that poor study habits and test anxiety remain key predictors of academic struggles, particularly among first-year students. These findings underscore the importance of early intervention and proactive faculty involvement in identifying at-risk students and guiding them toward academic and psychological resources.

The literature consistently highlights that no single intervention fully eliminates stress or guarantees academic success. Instead, a multidimensional approach is required—one that addresses emotional health, builds adaptive coping mechanisms, and fosters resilience while simultaneously supporting academic skill development. Faculty play a critical role in reframing anxiety as a normal part of professional growth rather than a weakness, which can empower students to persist in the face of challenges and reduce attrition.

In conclusion, stress and anxiety remain pervasive barriers in undergraduate nursing education, yet numerous evidence-based strategies offer promise in supporting student success. Nursing programs are encouraged to integrate mindfulness, music, relaxation techniques, and resilience training into curricula, alongside structural supports such as counseling, tutoring, and skill-building workshops. By adopting a holistic, proactive approach, educators can strengthen both academic outcomes and student well-being, ultimately preparing resilient, competent nurses for the workforce. Continued research is needed to evaluate the long-term impact of these interventions on student retention, NCLEX success, and professional readiness.