Abstract
Test anxiety (TA) affects students in health professions education (HPE) academic performance and well-being, and has long-term consequences that last beyond graduation, jeopardizing patients' access to the best possible health care. This study aimed to investigate and categorize the factors that influence TA among HPE students and provide evidence-based foundation for future action. We conducted a scoping study using the following six electronic databases. Only 74 articles out of 995 were selected. Each study's identified factors were classified as increasing or decreasing TA. Seven themes emerged from the factors. Assessment system, study and learning skills, psychology/cognition, personal characteristics, and supporting and relationship were all found to be positively and negatively associated with TA. Curriculum overload increased TA, while interventional procedures decreased TA. This scoping review identified factors that contribute to test anxiety either by increasing or by decreasing it. The identified factors were further categorized into several themes. The themes that emerged could be used by different levels of curriculum management in HPE schools to minimize TA.
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Data Availability
Upon request.
Abbreviations
- TA:
-
Test anxiety
- HPE:
-
Health Professions Education
- PRISMA:
-
Preferred Reporting of Items for Systematic Reviews and Meta-Analyses
References
Akbari V, Asayesh H, Sharififard F, Qorbani M, Elahi A, Heidarpour A (2020) Breakfast consumption as a test anxiety predictor among paramedical students. J Nurs Midwif Sci 7(1):47 https://doi.org/10.4103/JNMS.JNMS_37_19
Alammari MR, Bukhary DM (2019) Factors contributing to prosthodontic exam anxiety in undergraduate dental students. Adv Med Educ Pract 10:31. https://doi.org/10.2147/AMEP.S187351
Ali M, Asim H, Edhi AI, Hashmi MD, Khan MS, Naz F, Jehan I (2015) Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan. Med Educ Online 20(1):27706. https://doi.org/10.3402/meo.v20.27706
Al-Sahman LA, Al-Sahman RA, Joseph B, Javali MA (2019) major factors causing examination anxiety in undergraduate dental students-a questionnaire based cross-sectional study. Ann Med Health Sci Res 9(6):2019
Arksey H, O’Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc Res Methodol 8(1):19–32. https://doi.org/10.1080/1364557032000119616
Aziz N, Serafi AH (2017) Increasing levels of test anxiety and psychological distress with advancing years of medical education. British J Med Health Res 4(3):40–42
Block, R. M. (2012) A Discussion of the Effect of Open-book and Closed-book Exams on Student Achievement in an Introductory Statistics Course. Primus : Problems, Resources, and Issues in Mathematics Undergraduate Studies, 22(3), 228–238. https://search.proquest.com/docview/1283741545?accountid=6724
Bloodgood RA, Short JG, Jackson JM, Martindale JR (2009) A change to Pass/Fail grading in the first two years at one medical school results in improved psychological well-being. Acad Med 84(5):655–662. https://doi.org/10.1097/ACM.0b013e31819f6d78
Boparai JK, Gupta AK, Singh A, Matreja PS, Khanna PML, Garg P (2013) Impact of test anxiety on psychomotor functions and satisfaction with life of medical undergraduates during second professional curriculum. Edu Med J. https://doi.org/10.5959/eimj.v5i4.172
Bovee B (2016) The impact of collaborative testing on test anxiety. Chiropractic J Australia 44(3):214–221
Brand HS, Schoonheim-Klein M (2009) Is the OSCE more stressful? Examination anxiety and its consequences in different assessment methods in dental education. Eur J Dent Educ 13(3):147–153. https://doi.org/10.1111/j.1600-0579.2008.00554.x
Brodersen LD (2017) Interventions for test anxiety in undergraduate nursing students: an integrative review. Nurs Educ Perspect 38(3):131–137. https://doi.org/10.1097/01.NEP.0000000000000142
Broyles IL, Cyr PR, Korsen N (2005) Open book tests: assessment of academic learning in clerkships. Med Teach 27(5):456–462. https://doi.org/10.1080/01421590500097075
Cai W, Pan Y, Chai H, Cui Y, Yan J, Dong W, Deng G (2018) Attentional bias modification in reducing test anxiety vulnerability: a randomized controlled trial. BMC Psychiatry 18(1):1–1. https://doi.org/10.1186/s12888-017-1517-6
Campbell, D. (2018). Testing faith: an investigation of the relationship between prayer and test anxiety. Social Work and Christianity, 45(1), 122–136. https://search.proquest.com/docview/2021963176?accountid=6724.
Chen Y, Henning M, Yielder J, Jones R, Wearn A, Weller J (2015) Progress testing in the medical curriculum: students’ approaches to learning and perceived stress. BMC Med Educ 15(1):147. https://doi.org/10.1186/s12909-015-0426-y
Cipra C, Müller-Hilke B (2019) Testing anxiety in undergraduate medical students and its correlation with different learning approaches. PLoS ONE 14(3):e0210130. https://doi.org/10.1371/journal.pone.0210130
Cobbett S, Snelgrove-Clarke E (2016) Virtual versus face-to-face clinical simulation in relation to student knowledge anxiety and self-confidence in maternal-newborn nursing: a randomized controlled trial. Nurse Educ Today 45:179–184. https://doi.org/10.1371/journal.pone.0210130
Crego A, Carrillo-Diaz M, Armfield JM, Romero M (2016) Stress and academic performance in dental students: the role of coping strategies and examination-related self-efficacy. J Dent Educ 80(2):165–172. https://doi.org/10.1002/j.0022-0337.2016.80.2.tb06072.x
Custer N (2018) Test anxiety and academic procrastination among prelicensure nursing students. Nurs Educ Perspect 39(3):162–163. https://doi.org/10.1097/01.NEP.0000000000000291
Duraku ZH (2017) Factors influencing test anxiety among university students. Eu J Social Behav Sci 18(1):2325–2334. https://doi.org/10.15405/eisbs.206
Durning SJ, Dong T, Ratcliffe T, Schuwirth L, Artino AR, Boulet JR, Eva K (2016) Comparing open-book and closed-book examinations: A systematic review. Acad Med 91(4):583–599. https://doi.org/10.1097/ACM.0000000000000977
Edelman M, Ficorelli C (2005) A measure of success: Nursing students and test anxiety. J Nurses Staff Dev 21(2):55–59. https://doi.org/10.1097/00124645-200503000-00004
Encandela J, Gibson C, Angoff N, Leydon G, Green M (2014) Characteristics of test anxiety among medical students and congruence of strategies to address it. Med Educ Online 19:25211. https://doi.org/10.3402/meo.v19.25211
Ergene T (2003) Effective interventions on test anxiety reduction: a meta-analysis. Sch Psychol Int 24(3):313–328. https://doi.org/10.1177/01430343030243004
Fernholz I, Mumm J, Plag J, Noeres K, Rotter G, Willich S, Schmidt A (2019) Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects. Psychol Med 49(14):2287–2306. https://doi.org/10.1017/S0033291719001910
Flaherty JA, Richman JA (1993) Substance use and addiction among medical students, residents, and physicians. Psychiatr Clin North Am. https://doi.org/10.1016/S0193-953X(18)30201-6
Fournier KA, Couret J, Ramsay JB, Caulkins JL (2017) Using collaborative two-stage examinations to address test anxiety in a large enrollment gateway course. Anat Sci Educ 10(5):409–422. https://doi.org/10.1002/ase.1677
Frajerman A, Morvan Y, Krebs M-O, Gorwood P, Chaumette B (2019) Burnout in medical students before residency: A systematic review and meta-analysis. Eur Psychiatry 55:36–42. https://doi.org/10.1016/j.eurpsy.2018.08.006
Furlong E, Fox P, Lavin M, Collins R (2005) Oncology nursing students’ views of a modified OSCE. Eur J Oncol Nurs 9(4):351–359. https://doi.org/10.1016/j.ejon.2005.03.001
Ganguly P, Yaqinuddin A, Al-Kattan W, Kemahli S, AlKattan K (2019) Medical education dilemma: How can we best accommodate basic sciences in a curriculum for 21st century medical students? (1). Can J Physiol Pharmacol 97(4):293–296. https://doi.org/10.1139/cjpp-2018-0428
Gerwing TG, Rash JA, Allen Gerwing AM, Bramble B, Landine J (2015) Perceptions and Incidence of Test Anxiety. Canadian J Scholarship Teaching and Learning 6(3):3. https://doi.org/10.5206/cjsotl-rcacea.2015.3.3
Ghiasi A, Keramat A (2018) The effect of listening to holy quran recitation on anxiety: a systematic review. Iran J Nurs Midwifery Res 23(6):411–420. https://doi.org/10.4103/ijnmr.IJNMR_173_17
Gilavand A, Moezzi M, Gilavand S (2019) Test anxiety in dental students: a study at the Ahvaz Jundishapur university of medical sciences. Iran J Res Med Dental Sci 7(1):108–113. https://doi.org/10.5812/erms.85884
Green M, Angoff N, Encandela J (2016) Test anxiety and United States medical licensing examination scores. Clin Teach 13(2):142–146. https://doi.org/10.1111/tct.12386
Guraya SY, Guraya SS, Habib F, AlQuiliti KW, Khoshhal KI (2018) Medical students’ perception of test anxiety triggered by different assessment modalities. Med Teach 40(sup1):S49-s55. https://doi.org/10.1080/0142159x.2018.1465178
Hashmat S, Hashmat M, Amanullah F, Aziz S (2008) Factors causing exam anxiety in medical students. J Pak Med Assoc 58(4):167–170
Hays LR, Cheever T, Patel P (1996) Medical student suicide, 1989–1994. Am J Psychiatry 153(4):553. https://doi.org/10.1176/ajp.153.4.553
Hjeltnes A, Binder P-E, Moltu C, Dundas I (2015) Facing the fear of failure: An explorative qualitative study of client experiences in a mindfulness-based stress reduction program for university students with academic evaluation anxiety. Int J Qual Stud Health Well Being. https://doi.org/10.3402/qhw.v10.27990
Huntley CD, Young B, Temple J, Longworth M, Smith CT, Jha V, Fisher PL (2019) The efficacy of interventions for test-anxious university students: a meta-analysis of randomized controlled trials. J Anxiety Disord 63:36–50. https://doi.org/10.1016/j.janxdis.2019.01.007
Hyseni Duraku Z, Hoxha L (2018) Self-esteem, study skills, self-concept, social support, psychological distress, and coping mechanism effects on test anxiety and academic performance. Health Psychology Open 5(2):2055102918799963. https://doi.org/10.1177/2055102918799963
Johnson CE (2014) Effect of aromatherapy on cognitive test anxiety among nursing students. Alternative and Complementary Therapies 20(2):84–87. https://doi.org/10.1089/act.2014.20207
Kalantari M, Zadeh N, Agahi R, Navabi N, Hashemipour M, Nassab A (2017) Measurement of the levels anxiety, self-perception of preparation and expectations for success using an objective structured clinical examination, a written examination, and a preclinical preparation test in Kerman dental students. J Educat Health Promotion. https://doi.org/10.4103/jehp.jehp_97_15
Khoshhal KI, Khairy GA, Guraya SY, Guraya SS (2017) Exam anxiety in the undergraduate medical students of Taibah University. Med Teach 39(sup1):S22-s26. https://doi.org/10.1080/0142159x.2016.1254749
Kim K-J (2016) Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study. Int J Med Educ 7:424–427. https://doi.org/10.5116/ijme.5845.caec
Klausenitz C, Hacker H, Hesse T, Kohlmann T, Endlich K, Hahnenkamp K, Usichenko T (2016) Auricular acupuncture for exam anxiety in medical students—a randomized crossover investigation. PLOS ONE 11(12):e0168338. https://doi.org/10.1371/journal.pone.0168338
Kolagari S, Modanloo M, Rahmati R, Sabzi Z, Ataee AJ (2018) The effect of computer-based tests on nursing students’ test anxiety: a quasi-experimental study. Acta Inform Medica 26(2):115–118. https://doi.org/10.5455/aim.2018.26.115-118
Kurt, A. S., Balci, S., and Kose, D. (2014). Test anxiety levels and related factors: Students preparing for university exams. J Pak Med Assoc, 64(11): 1235–1239. https://pubmed.ncbi.nlm.nih.gov/25831637/
Law, M., Stewart, D., Pollock, N., Letts, L., Bosch, J., and Westmorland, M. (1998a). Critical Review Form for Quantitative Studies. McMaster University Occupational Therapy Evidence-based Practice Research Group. Accessed June 18, 2019. https://srs-mcmaster.ca/wp-content/uploads/2015/04/Critical-Review-Form-Quantitative-Studies-English.pdf.
Law, M., Stewart, D., Pollock, N., Letts, L., Bosch, J., and Westmorland, M. (1998b). Guidelines for critical review form-Quantitative studies. McMaster University Occupational Therapy Evidence-based Practice Research Group. Accessed June 18, 2019. https://srs-mcmaster.ca/wp-content/uploads/2015/05/Guidelines-for-Critical-Review-Form-Quantitative-Studies.pdf.
Leal PC, Goes TC, da Silva LCF, Teixeira-Silva F (2017) Trait vs. State anxiety in different threatening situations. Trends Psychiatry Psychother 39(3):147–157. https://doi.org/10.1590/2237-6089-2016-0044
Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., and Westmorland, M. (2007a). Critical review form–qualitative studies (version 2.0). McMaster University Occupational Therapy Evidence-based Practice Research Group. Accessed June 18, 2019. https://srs-mcmaster.ca/wp-content/uploads/2015/04/Critical-Review-Form-Qualitative-Studies-Version-2-English.doc.
Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., and Westmorland, M. (2007b). Guidelines for Critical Review Form: Qualitative Studies (Version 2.0). McMaster University Occupational Therapy Evidence-based Practice Research Group. Accessed June 18, 2019. https://srs-mcmaster.ca/wp-content/uploads/2015/05/Guidelines-for-Critical-Review-Form-Qualitative-Studies.pdf
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100. https://doi.org/10.1016/j.jclinepi.2009.06.006
Liu D, Xu B (2017) Test anxiety: perceptions of American community college nursing students. Empirical Res Vocat Educat Training 9(1):1–15. https://doi.org/10.1186/s40461-017-0048-1
Long BC, Stavel R (1995) Effects of exercise training on anxiety: A meta-analysis. J Appl Sport Psychol 7(2):167–189. https://doi.org/10.1080/10413209508406963
Loya, N. S., and Jiwane, N. N. (2019) Exam Anxiety in Professional Medical Students. International Journal of Research and Review. https://mail.jpma.org.pk/PdfDownload/1364
Lyndon MP, Strom JM, Alyami HM, Yu T-C, Wilson NC, Singh PP, Hill AG (2014) The relationship between academic assessment and psychological distress among medical students: a systematic review. Perspect Med Educ 3(6):405–418. https://doi.org/10.1007/s40037-014-0148-6
Macauley K, Plummer L, Bemis C, Brock G, Larson C, Spangler J (2018) Prevalence and predictors of anxiety in healthcare professions students. Health Professions Educ 4(3):176–185. https://doi.org/10.1016/j.hpe.2018.01.001
Malathi A, Damodaran A (1999) Stress due to exams in medical students - Role of yoga. Indian J Physiol Pharmacol 43(2):218–224
Malik S (2015a) Assessing level and causes of exam stress among university students in Pakistan. Med J Social Sci 6(4S1):11–18. https://doi.org/10.5901/mjss.2015.v6n4s1p11
Malik S (2015b) Assessing level and causes of exam stress among university students in Pakistan. Mediterr J Soc Sci 6(4):11–18. https://doi.org/10.5901/mjss.2015.v6n4s1p11
Malik M, Fatima G, Abid HC (2016) Test anxiety and self-concept of university students enrolled in B Ed Honors degree program funded by USAID. Bull Educ Res 38(2):83–94
Manansingh S, Tatum SL, Elsa-Sofia M (2019) Effects of relaxation techniques on nursing students’ academic stress and test anxiety. J Nurs Educ 58(9):534–537. https://doi.org/10.3928/01484834-20190819-07
March AL, Robinson C (2015) Assessment of high-stakes testing, hopeful thinking, and goal orientation among baccalaureate nursing students. Int J Nurs Educ Scholarsh 12(1):1–7. https://doi.org/10.1515/ijnes-2014-0075
Massey D, Byrne J, Higgins N, Weeks B, Shuker M-A, Coyne E, Mitchell M, Johnston ANB (2017) Enhancing OSCE preparedness with video exemplars in undergraduate nursing students. A mixed method study. Nurse Educ Today 54:56–61. https://doi.org/10.1016/j.nedt.2017.02.024
McDonald A (2010) OSCE: friend or foe? Student BMJ. https://doi.org/10.1136/sbmj.c5079
Messineo L, Gentile M, Allegra M (2015) Test-enhanced learning: analysis of an experience with undergraduate nursing students. BMC Med Educ 15(1):182. https://doi.org/10.1186/s12909-015-0464-5
Michael K, Lyden E, Custer T (2019) Open-Book Examinations (OBEs) in an ultrasound physics course: a good idea or a bad experiment? J Diagnostic Med Sonograp 35(3):174–180. https://doi.org/10.1177/8756479318821075
Montero-Marin J, Garcia-Campayo J, Pérez-Yus MC, Zabaleta-del-Olmo E, Cuijpers P (2019) Meditation techniques v. relaxation therapies when treating anxiety: a meta-analytic review. Psychol Med 49(13):2118–2133. https://doi.org/10.1017/S0033291719001600
Moran TP (2016) Anxiety and working memory capacity: A meta-analysis and narrative review. Psychol Bull 142(8):831. https://doi.org/10.1037/bul0000051
Motevalli S, Roslan SB, Sulaiman T, Hamzah SG, Hassan NC, Garmjani MG (2013) New study skills training intervention for students who suffer from test anxiety. Asian Soc Sci 9(7):85. https://doi.org/10.5539/ass.v9n7p85
Muldoon K, Biesty L, Smith V (2014) “I found the OSCE very stressful”: student midwives’ attitudes towards an objective structured clinical examination (OSCE). Nurse Educ Today 34(3):468–473. https://doi.org/10.1016/j.nedt.2013.04.022
Naeim M, Rezaeisharif A, Zandian H (2020) The relationship between internet addiction and social adjustment and test anxiety of the students of ardabil university of medical sciences. Shiraz E-Med J 21(11). https://doi.org/10.5812/semj.99209
Nemati A (2013) The effect of pranayama on test anxiety and test performance. Int J Yoga 6(1):55–60. https://doi.org/10.4103/0973-6131.105947
Newbury-Birch D, White M, Kamali F (2000) Factors influencing alcohol and illicit drug use amongst medical students. Drug Alcohol Depend 59(2):125–130. https://doi.org/10.1016/S0376-8716(99)00108-8
Numan, A., and Hasan, S. S. P. (2017). Test-Anxiety-Provoking Stimuli Among Undergraduate Students. Journal of Behavioural Sciences, 27(1), 1–20. https://search.proquest.com/docview/1928321082?accountid=30906
O’Carroll PJ, Fisher P (2013) Metacognitions, worry and attentional control in predicting OSCE performance test anxiety. Med Educ 47(6):562–568. https://doi.org/10.1111/medu.12125
Olopade FE, Adaramoye OA, Raji Y, Fasola AO, Olapade-Olaopa EO (2016) Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School. Adv Med Educ Pract 7:389–398. https://doi.org/10.2147/amep.s100660
Pahwa B, Goyal S, Srivastava K, Saldanha D, Bhattacharya D (2008) A study of exam related anxiety amongst medical students. Ind Psychiatry J 17(1):46–48
Parsons D (2008) Is there an alternative to exams? - Examination stress in engineering courses. Int J Eng Educ 24(6):1111–1118
Patil SG, Aithala MR (2017) Exam anxiety: Its prevalence and causative factors among Indian medical students. Nat J Physiol, Pharmacy and Pharmacol 7(12):1323–1328. https://doi.org/10.5455/njppp.2017.7.0516113072017
Pickard M, Bates L, Dorian M, Greig H, Saint D (2000) Alcohol and drug use in second-year medical students at the University of Leeds. Med Educ 34(2):148–150. https://doi.org/10.1046/j.1365-2923.2000.00491.x
Poorman SG, Mastorovich ML, Gerwick M (2019) Interventions for test anxiety: How faculty can help. Teaching and Learning in Nursing 14(3):186–191. https://doi.org/10.1016/j.teln.2019.02.007
Preoteasa, C. T., Imre, M., and Preoteasa, E. (2015) Dental students' psychological well-being during examination period and holiday. Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i, 119(2), 549–556
Quek TTC, Tam WWS, Tran BX, Zhang M, Zhang Z, Ho CSH, Ho RCM (2019) The global prevalence of anxiety among medical students: A meta-analysis. Int J Environ Res Public Health 16(15):2735. https://doi.org/10.3390/ijerph16152735
Quinn BL, Peters A (2017) Strategies to reduce nursing student test anxiety: a literature review. J Nurs Educ 56(3):145–151. https://doi.org/10.3928/01484834-20170222-05
Rajiah K, Saravanan C (2014) The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students. Am J Pharmaceutical Educ 78(9):163. https://doi.org/10.5688/ajpe789163
Rankin JA, Paisley CA, Mulla MM, Tomeny TS (2018) Unmet social support needs among college students: Relations between social support discrepancy and depressive and anxiety symptoms. J Couns Psychol 65(4):474. https://doi.org/10.1037/cou0000269
Rehman, F., Saeed, I., and Zubairi, M. U. (2020). Influencing Factors of Examination Anxiety among Medical Students in Lahore-Pakistan. Pakistan Journal of Medical Sciences
Ribeiro ÍJS, Pereira R, Freire IV, de Oliveira BG, Casotti CA, Boery EN (2018) Stress and quality of life among university students: a systematic literature review. Health Professions Educ 4(2):70–77. https://doi.org/10.1016/j.hpe.2017.03.002
Rice AH, Vogelweid CM, Kitchel T (2017) The influence of crib sheets on veterinary students exam performance, perceived stress, and retention of subject matter knowledge. NACTA J 61(1):66–72
Roberts RM, Dorstyn DS (2017) Does changing grade-based marking to pass-fail marking change student achievement in a postgraduate psychology course? Training Educ Professional Psychol 11(1):57–60. https://doi.org/10.1037/tep0000129
Rohe DE, Barrier PA, Clark MM, Cook DA et al (2006) The benefits of pass-fail grading on stress, mood, and group cohesion in medical students. Mayo Clin Proc 81(11):1443–1448. https://doi.org/10.4065/81.11.1443
Røykenes K, Smith K, Larsen TMB (2014) ‘It is the situation that makes it difficult’: experiences of nursing students faced with a high-stakes drug calculation test. Nurse Educ Pract 14(4):350–356. https://doi.org/10.1016/j.nepr.2014.01.004
Rukholm EE, Viverais GA (1993) A multifactorial study of test anxiety and coping responses during a challenge examination. Nurse Educ Today 13(2):91–99. https://doi.org/10.1016/0260-6917(93)90024-V
Sadker D, Zittleman K (2004) Test anxiety: are students failing tests—or are tests failing students? Phi Delta Kappan 85(10):740–751
Sansgiry SS, Sail K (2006) Effect of students’ perceptions of course load on test anxiety. Am J Pharm Educ 70(2):26. https://doi.org/10.5688/aj700226
Sansgiry SS, Bhosle M, Dutta AP (2005) Predictiors of test anxiety in doctor of pharmacy students: An empirical study. Pharm Educ 5(2):121–129. https://doi.org/10.1080/15602210500176941
Schwartz SM, Evans C, Agur AMR (2015) Comparison of physical therapy anatomy performance and anxiety scores in timed and untimed practical tests. Anat Sci Educ 8(6):518–524. https://doi.org/10.1002/ase.1508
Shapiro AL (2014) Test anxiety among nursing students: A systematic review. Teaching and Learning in Nursing 9(4):193–202. https://doi.org/10.1016/j.teln.2014.06.001
Siddiqui IA, Abdulrahman KAB, Alsultan MA (2015) A learning skills course for the 1st year medical students: an experience at a saudi medical school. Adv Med Educ Pract 6:205–210. https://doi.org/10.2147/AMEP.S77717
Slavin SJ, Schindler DL, Chibnall JT (2014) Medical student mental health 3.0: improving student wellness through curricular changes. Acad Med 89(4):573. https://doi.org/10.1097/ACM.0000000000000166
Soares D, Woods K (2020) An international systematic literature review of test anxiety interventions 2011–2018. Pastoral Care Education. https://doi.org/10.1080/02643944.2020.1725909
Son HK, So W-Y, Kim M (2019) Effects of aromatherapy combined with music therapy on anxiety, stress, and fundamental nursing skills in nursing students: a randomized controlled trial. Int J Environ Res Public Health 16(21):4185. https://doi.org/10.3390/ijerph16214185
Spring L, Robillard D, Gehlbach L, Moore Simas TA (2011) Impact of pass/fail grading on medical students’ well-being and academic outcomes. Med Educ 45(9):867–877. https://doi.org/10.1111/j.1365-2923.2011.03989.x
Stewart RA, Hauge LS, Stewart RD, Rosen RL, Charnot-Katsikas A, Prinz RA (2007) A CRASH course in procedural skills improves medical students’ self-assessment of proficiency, confidence, and anxiety. Am J Surg 193(6):771–773. https://doi.org/10.1016/j.amjsurg.2007.01.019
Tagher CG, Robinson EM (2016) Critical aspects of stress in a high-stakes testing environment: a phenomenographical approach. J Nurs Educ 55(3):160–163. https://doi.org/10.3928/01484834-20160216-07
Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S (2013) Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms. Eur Rev Med Pharmacol Sci 17(1 Suppl):55–64
Trifoni A, Shahini M (2011) How does exam anxiety affect the performance of university students. Mediterr J Soc Sci 2(2):93–100
Tsegay L, Shumet S, Damene W, Gebreegziabhier G, Ayano G (2019) Prevalence and determinants of test anxiety among medical students in Addis Ababa Ethiopia. BMC Med Educ 19(1):423. https://doi.org/10.1186/s12909-019-1859-5
Turner J, Bartlett D, Andiappan M, Cabot L (2015) Students’ perceived stress and perception of barriers to effective study: impact on academic performance in examinations. Br Dent J 219(9):453–458. https://doi.org/10.1038/sj.bdj.2015.850
Uysal N, Yuksel O, Kizildag S, Yuce Z, Gumus H, Karakilic A, Ates M (2018) Regular aerobic exercise correlates with reduced anxiety and incresed levels of irisin in brain and white adipose tissue. Neurosci Lett 676:92–97. https://doi.org/10.1016/j.neulet.2018.04.023
Von der Embse N, Barterian J, Segool N (2013) Test Anxiety interventions for children and adolescents: a systematic review of treatment studies from 2000–2010. Psychol Sch 50(1):57–71. https://doi.org/10.1002/pits.21660
von der Embse N, Jester D, Roy D, Post J (2018) Test anxiety effects, predictors, and correlates: A 30-year meta-analytic review. J Affect Disord 227:483–493. https://doi.org/10.1016/j.jad.2017.11.048
Wadi M, Rahim AFA, Yusoff MSB, Baharuddin KA (2014) The effect of MCQ vetting on students’ examination performance. Educ Med J. https://doi.org/10.5959/eimj.v6i2.216
Warshawski S, Bar-Lev O, Barnoy S (2019) Role of academic self-efficacy and social support on nursing students’ test anxiety. Nurse Educ 44(1):E6–E10. https://doi.org/10.1097/NNE.0000000000000552
Weeks BK, Horan WSA (2013) A video-based learning activity is effective for preparing physiotherapy students for practical examinations. Physiotherapy 99(4):292–297. https://doi.org/10.1016/j.physio.2013.02.002
Wong SS (2008) The relations of cognitive triad, dysfunctional attitudes, automatic thoughts, and irrational beliefs with test anxiety. Curr Psychol 27(3):177–191. https://doi.org/10.1007/s12144-008-9033-y
Yildirim İ (2007) Depression, test anxiety and social support among Turkish students preparing for the university entrance examination. Üniversite Seçme Sınavına Hazırlanan Türk Öğrencilerde Depresyon, Sınav Kaygısı Ve Sosyal Destek 29:171–184
Yildirim I (2008) Family variables influencing test anxiety of students preparing for the university entrance examination. Egitim Arastirmalari - Eurasian Journal of Educational Research 31:171–186
Young I, Montgomery K, Kearns P, Hayward S, Mellanby E (2014) The benefits of a peer-assisted mock OSCE. Clin Teach 11(3):214–218. https://doi.org/10.1111/tct.12112
Yusefzadeh H, Iranagh JA, Nabilou B (2019) The effect of study preparation on test anxiety and performance: a quasi-experimental study. Adv Med Educ Pract 10:245. https://doi.org/10.2147/AMEP.S192053
Yusoff MSB (2011) Impact of summative assessment on first year medical students’ mental health. International Medical Journal 18(3):172–175
Yusoff MSB, Rahim AFA, Yaacob MJ (2010) Prevalence and sources of stress among Universiti Sains Malaysia medical students. The Malaysian Journal of Medical Sciences: MJMS 17(1):30
Yusoff MSB, Yee LY, Wei LH, Siong TC, Meng LH, Bin LX, Rahim AFA (2011) A study on stress, stressors and coping strategies among Malaysian medical students. Int J Students’ Res 1(2):45–50
Zeidner M (1998) Test anxiety: The state of the art. Kluwer Academic Publishers, New York
Zeidner M (2007) Test Anxiety in Educational Contexts: Concepts, Findings, and Future Directions. In: Schutz PA, Pekrun R (eds) Emotion in Education. Academic Press, Burlington, pp 165–184
Zhang N, Henderson CN (2019) Predicting stress and test anxiety among 1st-year chiropractic students. J Chiropr Educ 33(2):133–139. https://doi.org/10.7899/JCE-18-11
Zhang N, Walton DM (2018) Why so stressed? A descriptive thematic analysis of physical therapy students’ descriptions of causes of anxiety during objective structured clinical exams. Physiother Can 70(4):356–362. https://doi.org/10.3138/ptc.2016-102.e
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This research is part of a larger project supported by Fundamental Research Grant Scheme (FRGS: 203.PPSP.6171219), Ministry of Education, Malaysia.
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MW and MSBY were involved in the conception, design, review, and analysis of the data, as well as writing the initial draft manuscript and incorporating all co-authors' revisions. AFAR was involved in the conception and design of the manuscript, as well as in its revision. By reviewing, analyzing, and revising the protocol, NAZNL contributed to its improvement. All authors read and approved the final version of the manuscript.
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Wadi, M.M., Yusoff, M.S.B., Rahim, A.F.A. et al. Factors influencing test anxiety in health professions education students: a scoping review. SN Soc Sci 2, 174 (2022). https://doi.org/10.1007/s43545-022-00459-9
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DOI: https://doi.org/10.1007/s43545-022-00459-9