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Pre-Exam AnxietyEFTNCT07119138

Effect of Emotional Freedom Technique on Nursing Students Exam Anxiety

A study testing Emotional Freedom Technique in people with Pre-Exam Anxiety and Emotional Freedom Technique, run by Necmettin Erbakan University at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Aim: This study was conducted to evaluate the effect of Emotional Freedom Technique (EFT) on the state exam anxiety levels of nursing students. Background: Exam anxiety is a common problem among nursing students. EFT has emerged as a complementary method to reduce exam anxiety. Read more about this study

Who is it for?
Ages 18 to 35 yearsHealthy volunteers can take part
Conditions the study is for
Pre-Exam Anxiety, Emotional Freedom Technique
What is being tested?
Emotional Freedom Technique
Could I receive a placebo?
No, everyone receives an active treatment
How many people
82 participants
Where
1 siteTurkey (Türkiye)
Study dates
30 Jun 2025to 30 Aug 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Volunteers to participate in the study • Qualified to take the final exam of the Surgical Diseases Nursing course

Who cannot join

  • Refusing to participate in the study
  • Receiving psychiatric treatment/receiving psychological support
  • Failing the Surgical Diseases Nursing course application
  • Removal criteria
  • A student who did not take the course exam due to illness, delay, or similar reasons
  • Someone who wishes to withdraw from the study during the implementation phase after having agreed to participate.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mahsum Korkutan, Research Assistant contact

+905462023210

mahsum.korkutan@erbakan.edu.tr

Saide FAYDALI, Associate professor contact

+905056652357

sfaydali@erbakan.edu.tr

Turkey (Türkiye)1 site, 1 recruiting
  • Necmettin Erbakan University, Faculty of Theology, Laboratory

    Konya

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of Emotional Freedom Technique on State Exam Anxiety Levels of Nursing Students: A Randomized Controlled Trial

Aim: This study was conducted to evaluate the effect of Emotional Freedom Technique (EFT) on the state exam anxiety levels of nursing students.

Background: Exam anxiety is a common problem among nursing students. EFT has emerged as a complementary method to reduce exam anxiety. However, experimental studies on this subject are limited in the literature.

Read more

Design: Randomized controlled trial design.

Methods: This study was carried out with second-year students enrolled in the Surgical Nursing course at the Faculty of Nursing of a state university. Participants were assigned to intervention and control groups using simple random sampling. One hour before the exam, all students were present in the exam hall. While the intervention group received EFT, the control group was given free time. Data were collected using the State Test Anxiety Scale (STAS) and the Subjective Units of Distress Scale (SUD). Descriptive statistics, normality tests (Shapiro-Wilk/Kolmogorov-Smirnov), independent and paired samples t-test, Mann-Whitney U test, Wilcoxon test, and two-way mixed ANOVA were used for data analysis. The significance level was set at p<0.05.

Outcomes: There were no significant differences between the groups in the pre-test STAS total and subscale scores or SUD scores. However, post-test results revealed statistically significant differences between the intervention and control groups in all measurements (p<0.05), with effect sizes ranging from medium to large. The time and group-time interaction effects for STAS total and subscale scores and SUD scores were also significant (p<0.05), and the effect size of the change over time was determined to be large (η² > 0.14).

Conclusion: This study demonstrated that EFT is effective in reducing exam anxiety among nursing students. EFT should be considered a complementary intervention in managing exam anxiety. It is recommended that EFT be integrated into the support services provided to students prior to examinations.

Read the detailed description

Test anxiety is a set of phenomenological, physiological, and behavioral responses that accompany anxiety about possible negative outcomes or failure in an exam or assessment situation. Test anxiety is a form of situational anxiety and is an important factor affecting students' health and academic performance throughout their educational journey. It is stated in the literature that students' past experiences and beliefs, family attitudes, perceptions about course load, and time management skills can have an impact on test anxiety.

It is emphasized that low levels of anxiety support creativity and development in students, while high levels of anxiety can cause emotional and physiological arousal, leading to significant limiting behaviors such as excessive restlessness and anxiety.

It is stated that anxious students are easily distracted during exams and have difficulty understanding instructions. The severity of exam anxiety in students can reach clinical dimensions and negatively affect daily life, the educational process and career advancement . In the literature, it is stated that exam anxiety is associated with a number of negative variables such as increased risk of anxiety and depression in later life, difficulties in participating in teaching content, lack of attention, shorter concentration periods, decreased learning problems, low exam performance and decrease in academic achievement. Studies specifically link test anxiety to academic success and show that high test anxiety leads to a decrease in academic success. Nursing students also encounter various stressful situations throughout their academic journey.

Nursing education includes both theoretical and practical teaching processes, and this curriculum includes intense course loads, rigorous exams, and pressure to achieve a high GPA in a competitive environment. Clinical education, in which skill development is especially assessed, stands out as one of the first steps in acquiring professional skills and creates a significant source of stress and anxiety in nursing students, becoming a situation that needs to be managed. In the literature, it is stated that the test anxiety experienced by nursing students worldwide is one of the most important problems that prevent the acquisition of professional skills, and it is reported that 50% to 100% of nursing students experience test anxiety at least once during their undergraduate education. Therefore, there is a need for effective therapeutic interventions using complementary methods to reduce the negative effects of exam anxiety among nursing students. When the studies are examined, it is seen that many methods such as hand massage, music therapy, aromatherapy, auriculotherapy, gum chewing, trust training, coping program, animal-assisted intervention, guided imagery, expressive writing, mindfulness exercises, relaxation with cognitive behavioral methods are used to reduce exam anxietyç. It is known that another method used in the management of exam anxiety is the Emotional Freedom Technique (EFT).

EFT is an evidence-based therapeutic method that combines cognitive reframing and exposure therapies with light tapping on acupuncture points (acupressure) to induce relaxation. This method, which involves touching specific acupressure points while focusing on emotional concerns, stimulates the body's energy meridians to promote relaxation. EFT, which has a mechanism of action that alters emotional responses through limbic pathways by reactivating disturbing memories or triggers and allows the release of intense emotional experiences, is used to improve an individual's negative emotions and manage associated emotional and physical disorders. In the literature, EFT has been shown to be effective on depression, phobias, post-traumatic stress disorder, pain, insomnia, autoimmune diseases, professional performance, sports performance, anxiety, and exam anxiety. EFT studies on students show that this technique has a very therapeutic effect in overcoming anxiety and student motivation problems. Many other studies have also found that EFT significantly reduces exam anxiety in nursing students who receive clinical and theoretical training with an intensive curriculum.

As a self-help tool, EFT is easy to learn and apply, provides effective results in a short time and has been proven to reduce exam anxiety. EFT and exam anxiety have been studied limitedly internationally and two studies on this subject have been found at the national level. In this direction, this study aims to contribute to the literature by evaluating the effect of EFT on exam anxiety in nursing students. Surgical Diseases Nursing course is one of the basic courses given in the second year of nursing education, including theoretical and clinical components. The academic success of students in this course is decisive in terms of the quality of nursing education. Therefore, as a surgical nursing instructor, it is thought that reducing exam anxiety will positively affect student success. This study also aims to increase student success through anxiety management.

Being tested
Emotional Freedom Technique
Keywords
Pre-Exam Anxiety, Nursing student, Mind-Body Therapies, Surgical nursing, Randomised controlled trial

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Emotional Freedom TechniqueBehavioural

    Emotional Freedom Technique (EFT) is used as an effective method for managing various adverse conditions, including the reduction of exam anxiety. Although there are several studies in the literature on this topic, research conducted specifically with nursing students remains limited. In particular, the Surgical Nursing course is a fundamental subject offered in the second year of nursing education, encompassing both theoretical and clinical components. Academic success in this course is an important indicator of the quality of nursing education. Therefore, as a surgical nursing instructor, it is believed that reducing exam anxiety can positively influence student performance.

    This study also aims to improve student success through anxiety management. To date, no studies addressing this issue with nursing students have been found in the literature.

Study groups in NCT07119138
Study groupRoleWhat they receive
ExperimentalExperimentalEFT arm
Receives: Behavioral: Emotional Freedom Technique
ControlNo interventionControl arm

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Exam Anxiety Scale scores

    Change in Exam Anxiety Scale (STAS) scores before and after the intervention

    Measured: The intervention started one hour before the surgical nursing final exam. The STAS pre-test was administered one hour before the exam, followed by the intervention (EFT). After the intervention, the STAS post-test was conducted.

Secondary outcomes (1)
  1. Change in Subjective Units of Distress (SUD) scores

    Change in Subjective Units of Distress (SUD) scores before and after the intervention

    Measured: The intervention started one hour before the surgical nursing final exam. The SUD pre-test was administered one hour before the exam, followed by the intervention (EFT). After the intervention, the SUD post-test was conducted

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Aug 2025
  2. Study start30 Jun 2025
  3. Primary completion30 Jul 2025
  4. Study completion30 Aug 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
It was planned to assign students who meet the selection criteria for the study and volunteer to participate in the study to the EFT group and the control group using the block randomization method. Blocks of 8 will be created according to the number of volunteer participants.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
82 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07119138
Sponsor's protocol ID
25000
Acronym
EFT
Status last verified
Aug 2025
First submitted
11 Jul 2025
Last updated
12 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Participants' personal information will not be shared. Demographic data and scale scores included in the statistical analysis are being considered for sharing.

Publications

  • Bach D, Groesbeck G, Stapleton P, Sims R, Blickheuser K, Church D. Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health. J Evid Based Integr Med. 2019 Jan-Dec;24:2515690X18823691. doi: 10.1177/2515690X18823691.

    PubMed 30777453
  • Boath, E., Stewart, A., & Carryer, A. (2013). Tapping for success: A pilot study to explore if emotional freedom techniques (EFT) can reduce anxiety and enhance academic performance in university students. Innovative Practice in Higher Education, 1(3).

  • Church, D. (2013). The EFT manual. Hay House, Inc.

  • Church D, Stapleton P, Vasudevan A, O'Keefe T. Clinical EFT as an evidence-based practice for the treatment of psychological and physiological conditions: A systematic review. Front Psychol. 2022 Nov 10;13:951451. doi: 10.3389/fpsyg.2022.951451. eCollection 2022.

    PubMed 36438382
  • Cici R, Ozkan M. Effects on Anxiety and Vital Signs of the Emotional Freedom Technique and Music Before Surgery for Lumbar Disc Hernia. Altern Ther Health Med. 2022 Jul;28(5):20-27.

    PubMed 34097649
  • Clond M. Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. J Nerv Ment Dis. 2016 May;204(5):388-95. doi: 10.1097/NMD.0000000000000483.

    PubMed 26894319
  • Craig G. (2011). The EFT manual (2nd ed.). Fulton, CA: Energy Psychology Press.

  • Craig, G., & Fowlie, A. (1995). Emotional freedom techniques. Self-published manual. The Sea Ranch.

  • Dincer B, Inangil D. The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial. Explore (NY). 2021 Mar-Apr;17(2):109-114. doi: 10.1016/j.explore.2020.11.012. Epub 2020 Dec 3.

    PubMed 33293201
  • Dincer B, Ozcelik SK, Ozer Z, Bahcecik N. Breathing therapy and emotional freedom techniques on public speaking anxiety in Turkish nursing students: A randomized controlled study. Explore (NY). 2022 Mar-Apr;18(2):226-233. doi: 10.1016/j.explore.2020.11.006. Epub 2020 Dec 2.

    PubMed 33309466
  • Efroliza, E. (2023). The Effect of Mentoring and Emotional Freedom Technique (M-EFT) on Nurses Students' Readiness and Anxiety Facing Competency Tests. Indonesıan Nursıng Journal of Educatıon And Clınıc (Injec), 8(1), 22-30

  • Azzizadeh Forouzi M, Taebi M, Samarehfekri A, Rashidipour N. The effect of emotional freedom techniques on test anxiety in Iranian Paramedical students: a randomized controlled trial study. Ann Med Surg (Lond). 2024 Apr 3;86(5):2745-2751. doi: 10.1097/MS9.0000000000002023. eCollection 2024 May.

    PubMed 38694321
  • Guler, S., Demir, G., & Sahan, S. (2023). The effect of aromatherapy performed to nursing students on the level of test-taking anxiety and academic achievement. International Journal of Caring Sciences, 16(3), 1728.

  • Hendricks-Patel S, Harvey K. Emotional Freedom Technique for Stress Reduction in Nursing Students: A Pilot Project. J Nurs Educ. 2025 Jul;64(7):436-439. doi: 10.3928/01484834-20250108-03. Epub 2025 Mar 13.

    PubMed 40071786
  • Huntley CD, Young B, Temple J, Longworth M, Smith CT, Jha V, Fisher PL. The efficacy of interventions for test-anxious university students: A meta-analysis of randomized controlled trials. J Anxiety Disord. 2019 Apr;63:36-50. doi: 10.1016/j.janxdis.2019.01.007. Epub 2019 Feb 6.

    PubMed 30826687

Questions about this trial

What is this clinical trial studying?

A study testing Emotional Freedom Technique in people with Pre-Exam Anxiety and Emotional Freedom Technique, run by Necmettin Erbakan University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 12 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mahsum Korkutan, Research Assistant (+905462023210, mahsum.korkutan@erbakan.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Exam Anxiety Scale scores (time frame: The intervention started one hour before the surgical nursing final exam. The STAS pre-test was administered one hour before the exam, followed by the intervention (EFT). After the intervention, the STAS post-test was conducted.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07119138, which also lists 37 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2025.

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