Background: Modern technology increases nowadays in the academic institutions as a result of
digital transformation. Electronic exam is a new system that becomes a necessary assessment
tool in the online learning process due to its efficacy and effectiveness. Aim: The current study
aimed to assess maternity students' perception, anxiety and satisfaction regarding electronic
exam. Subjects and method: A descriptive cross- sectional study design was followed. The
study was conducted in the Maternity Nursing Laboratory at the Faculty of Nursing, Mansoura
University, Egypt. A convenience sample was applied included One hundred and fifty eight
undergraduate students who were in active enrollment of Maternity &Gynecology Course. Data
collected through an online electronic survey on Google platform to assess students' personal
characteristics, levels of perception, anxiety and satisfaction regarding Electronic exam. Results:
More than fifty percent of the students agreed that electronic exam is a better assessment method
than the paper-based exam, it provides them with an opportunity to obtain good results, results
can be obtained faster than the paper-based exam, and e-exam improves student technical and
computing skills. Despite nearly two-thirds of studied students were highly satisfied about
electronic exam, but, more than two-thirds of them had a moderate anxiety level. Conclusion: E-
exam is an effective assessment tool than paper-based exam, but it is not suitable for clinical
courses, doesn't reflect students' full performance, and there are some technical and practical
issues that increase student's anxiety during the E-exam. Therefore, conducting a regular
meeting with the students to provide a clear explanation about the nature of electronic exam and
maintaining psychological and technical support during E-exam is recommended to alleviate
student's anxiety.