The goal of this clinical trial is to assess if a resilience enhancement training program can help nursing students manage stress more effectively. The main question it aims to answer is:

Does the program improve nursing students' resilience levels?

Does the program lower nursing students' perceived stress levels?

Researchers will compare students who receive the training during the semester with students who do not receive it until after the study is completed to see if the training has an effect.

Participants will:

1. Complete questionnaires on resilience and stress before and after the training.
2. Attend a structured resilience enhancement training program for 10 weeks alongside their usual studies.
3. Be part of either the study group (receiving the training first) or the comparison group (receiving the training after study completion).

This quasi-experimental study is designed to evaluate the effect of a resilience enhancement training program on perceived stress among nursing students. Nursing students commonly face high academic and clinical demands, long working hours, and frequent exposure to emotionally challenging situations. Such pressures often lead to elevated stress levels, anxiety, and potential burnout, which can impair learning, professional growth, and the quality of patient care. Evidence from prior studies (e.g., meta-analyses of stress-management interventions in healthcare students) indicates that programs focused on resilience building-such as cognitive restructuring, mindfulness, and self-compassion practices-can strengthen coping skills, reduce perceived stress, and enhance well-being.

Low resilience has been associated with higher susceptibility to stress and psychological distress. Interventions that explicitly teach resilience skills may empower students to adapt more effectively and sustain academic performance. Building on this evidence, the present study aims to:

1. Assess baseline resilience and perceived stress levels among nursing students.
2. Develop and implement a 10-week structured resilience enhancement training program tailored to the needs of nursing students.
3. Evaluate the impact of the program on resilience and perceived stress by comparing outcomes between a study group and a control group.

Hypothesis:

The resilience enhancement training program will significantly increase resilience levels and reduce perceived stress levels among nursing students.

Design and Methods:

A quasi-experimental research design with study and control groups will be used. Participants will be undergraduate nursing students enrolled in the Psychiatric and Mental Health Nursing (PMHN) course at the Faculty of Nursing, Ain Shams University, during the first semester of the academic year 2025-2026. Students will be randomly allocated into two groups:

Study group: Receives the resilience enhancement training program in addition to their standard curriculum.

Control group: Follows the standard curriculum during the study period and will receive the program after the study ends to ensure fairness.

Sample size: all nursing students who enrolled in the psychiatric and mental health nursing course will be included in this study. Participation will be voluntary, and written informed consent will be obtained.

Intervention Structure: The 10-week resilience enhancement training program includes structured sessions (approximately 90 minutes each) that cover key skills such as self-awareness, self-regulation, stress management, cognitive restructuring, self-compassion, gratitude practices, optimism training, and self-evaluation. Each session has a specific objective to build coping skills and strengthen resilience. The program concludes with a wrap-up and evaluation session.

Data Collection and Evaluation

Data will be collected at two time points:

• Pre-intervention: October 2025
• Post-intervention: immediately after program completion in December 2025

Outcomes:

• Primary outcome: change in perceived stress levels measured by validated stress-scale instruments.
• Secondary outcome: change in resilience scores assessed with a standardized resilience scale. Fidelity of program delivery will be monitored through attendance records and facilitator checklists.

Ethical Considerations and Significance Ethical approval was obtained from the Scientific Research Ethics Committee, Faculty of Nursing, Ain Shams University (Study Number: 25.04.662; Approval Date: March 17, 2025). Participation is voluntary, and confidentiality will be maintained.

Findings are expected to demonstrate the effectiveness of a structured resilience-enhancement training program in strengthening students' coping skills and reducing perceived stress.

The results will guide future training programs designed to help undergraduate nursing students manage stress more effectively.

Inclusion Criteria:

• Nursing students enrolled in the Psychiatric and Mental Health Nursing (PMHN) course at the Faculty of Nursing, Ain Shams University during the first semester of the academic year 2025-2026.
• Willing to participate and able to provide informed consent

Exclusion Criteria:

• Students who decline participation or withdraw consent at any time.
• Students absent for the majority of the program sessions.