Background: Self-efficacy is crucial for student success. Studies have demonstrated a positive relationship between flipped learning approach and self-efficacy. Anxiety, however, can reduce self-efficacy. Objective: Testing the relationship between the flipped approach and self-efficacy by flipping a nursing module within an externally-imposed and once-off anxiety-inducing context. Method: Students completed a self-efficacy survey before (n = 71) and after (n = 91) a compressed semester, which provided the anxiety-inducing context. Results: Pre-semester self-efficacy was 2.93/4, and post-semester was 2.98/4. The results demonstrated no significant change in students' self-efficacy. Conclusion: We argue the flipped approach counters anxiety-inducing effects to maintain self-efficacy. In less anxiety-inducing contexts, we argue the flipped approach would develop students' confidence, capability, persistence and strength beliefs, collectively enhancing self-efficacy perceptions.