Background: The landscape of global health professional certification is increasingly dominated by computer-based testing (CBT), such as the Prometric exams, which assess the competencies of nursing candidates for international practice. These exams are pivotal for nurses in Pakistan aiming for employment abroad, presenting unique challenges and opportunities that reflect both the individual and systemic dimensions of professional certification. Objective: This study aimed to explore the experiences of nurses in Pakistan who have undertaken Prometric exams, focusing on the challenges faced, strategies employed for preparation, and the motivational factors influencing their journey. It sought to provide insights into the complexities of navigating international nursing certification processes. Methods: A qualitative descriptive study design was implemented from May to October 2023, involving semi-structured interviews with 13 nursing graduates in Peshawar, Pakistan, who had participated in Prometric exams. Participants were selected using non-probability purposive sampling. Data analysis was conducted using a modified thematic analysis of Braun and Clarke’s framework, allowing for the identification of themes, sub-themes, and codes related to exam experiences. Results: The study's demographic analysis revealed a predominance of male participants (76.92%) with the majority holding a Bachelor of Science in Nursing (84.61%). Five main themes were identified: Challenges Faced, Strategies Followed, Insight into Prometric Exams, Suggestions for Future Nurses, and Inspiration Figure. These themes encompassed a range of sub-themes including test center allocation limitations, effective preparation methods, understanding exam patterns, and the crucial role of personal and professional support networks. Notably, challenges such as content preparation, language barriers, and socioeconomic factors were highlighted, alongside strategies for overcoming these hurdles. Conclusion: Nurses in Pakistan facing Prometric exams encounter a spectrum of challenges that require multifaceted strategies and support systems for successful navigation. The study underscores the importance of comprehensive preparation, informed decision-making regarding exam and country selection, and the cultivation of resilience and motivation. Future research should expand to include a broader range of health professionals and adopt mixed-methods approaches to deepen the understanding of international certification processes.
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