Effect of a structured Maintenance of Certification-based training program on perceived stress among nursing students preparing for Egypt’s new pre-licensure examination: A quasi-experimental study

The introduction of Egypt’s national nursing pre-licensure examination has created new academic and psychological challenges for final-year nursing students, particularly because of limited familiarity with the examination format and insufficient structured preparation resources. Although combined examination-preparation and stress-management programs may improve students’ readiness, evidence regarding their effectiveness in reducing perceived stress among Egyptian nursing students remains limited. To evaluate the effect of a structured Maintenance of Certification-based training program on perceived stress among final-year nursing students preparing for the Egyptian national pre-licensure examination. A quasi-experimental comparative study was conducted among 1000 final-year nursing students recruited from 8 nursing faculties across Egypt. Participants were allocated to an intervention group that received a four-week structured training program comprising theoretical review, mock examinations, individualized feedback, and stress-management strategies, or a control group that continued with the standard curriculum. Perceived stress was assessed before and after the intervention using the 10-item Perceived Stress Scale. Data were analyzed using independent-samples and paired-samples t -tests, analysis of variance, and multiple linear regression. Baseline perceived stress scores were comparable between the intervention and control groups (28.8 ± 5.7 vs 29.2 ± 6.0, P  > .05). Following the intervention, the intervention group had a significantly lower mean stress score than the control group (12.1 ± 3.2 vs 31.1 ± 7.1, P  < .001). Perceived stress decreased significantly within the intervention group, whereas it increased significantly within the control group (both P  < .001). Higher academic GPA, good computer skills, and prior knowledge of the pre-licensure examination were significant predictors of lower post-intervention stress, while smoking was associated with higher stress. The regression model explained 54% of the variance in post-intervention perceived stress. The structured training program was associated with a substantial reduction in perceived stress among nursing students preparing for Egypt’s national pre-licensure examination. Integrating structured examination preparation and psychological support into final-year nursing curricula may improve students’ readiness for the transition from education to professional practice.