Self-efficacy, uncertainty and anxiety among nursing graduates in response to licensing test postponement due to the COVID-19 pandemic: A mixed-methods study

Aim: To examine the relationships between self-efficacy, uncertainty and anxiety among nursing graduates waiting for a mandatory nursing licensing test that was postponed due to the COVID-19 pandemic. Methods: A total of 352 graduates of nursing education programs participated in this mixed-methods study. The data were collected using an online questionnaire in June 2020. Results: The participants demonstrated high uncertainty and anxiety and low self-efficacy towards the ability to succeed in the licensing exam. Graduates, who started working, reported lower uncertainty. Self-efficacy, uncertainty, gender and family status contributed significantly to the explanation of 24% of the variance of the anxiety. The qualitative analysis revealed three themes: (a) emotional distress, cognitive challenge and social implications, (b) consequences for significant others and (c) strengthening of professional values and norms. Conclusions: A significant crisis like a pandemic is accompanied by acute cognitive burden and stressful emotional experiences and creates an unconventional situation that requires unusual solutions. Granting a temporary permit for employment as a nurse following the postponement of a licensing test contributed to the ability of nursing graduates to cope with the situation. Policies to deal with similar situations in the future emergencies should be developed and implemented.