Digital Literacy Moderates the Relationship Between Technology Access and Examination Anxiety in Pioneer Nursing Students
Abstract
The integration of digital technologies into nursing education has exposed and amplified existing inequalities, particularly in resource-constrained settings. Test anxiety is a significant barrier in nursing education. However, the role of digital literacy in moderating the relationship between technology access and examination anxiety remains poorly understood. This study examined whether digital literacy moderates the relationship between technology access and test anxiety among first-cohort ("pioneer") nursing students in Nigeria. Data were collected between May and June 2026. A cross-sectional correlational design was employed with 49 pioneer National Diploma I nursing students (98% response rate) at a newly established college of nursing sciences in Kaduna, Nigeria. Data were collected using the Digital Literacy Scale, Westside Test Anxiety Scale, technology access measures, and objective grade point average (GPA) from college records. Moderation and moderated mediation analyses were conducted using PROCESS macro with bootstrap confidence intervals (5000 resamples). Technology access demonstrated a moderate, statistically significant negative correlation with test anxiety (r = -0.31, p < 0.05). Digital literacy was significantly negatively correlated with test anxiety (r = -0.38, p < 0.01) and positively correlated with GPA (r = 0.35, p < 0.01). Digital literacy significantly moderated the technology access-test anxiety relationship (interaction β = -0.28, p = 0.022). The indirect effect of technology access on GPA through test anxiety was significant only for students with low digital literacy (indirect effect = -0.16, 95% CI: -0.32 to -0.05). Rural students scored 36% lower on digital literacy than urban students. These findings indicate that digital literacy buffers the negative associations of limited technology access with test anxiety. Students with low digital literacy and limited access are at greatest risk of a cascade of negative outcomes: limited access was associated with higher anxiety, which in turn was associated with lower GPA. Institutions should implement a dual approach: improving technology access while simultaneously providing foundational digital skills training, with targeted support for rural students.