Exam Anxiety and Factors Influencing Exam Preparation: A Mixed Method Study

Abstract

Background: The time of examination is a stressful period for students. However, an optimum level of stress can help in motivating the students, this stress can be from test anxiety which arises from stimuli of being tested or judged academically. Nursing students experience a higher level of exam anxiety comparing to students from other disciplines. Aims and objectives: This study aimed to assess the level of exam anxiety perceived by nursing students in selected setting. Along with exam anxiety; this research explored factors influencing exam preparation among nursing students. Material and methods: A mixed-method research study was conducted to assess test anxiety and to explore factors influencing their exam preparations. Total enumeration sampling technique was used to recruit 272 BSc nursing students from a nursing college attached to a tertiary care hospital in South India. Data were collected using a sociodemographic pro forma, a test anxiety scale to assess test anxiety, and a focus group discussion (FGD) was conducted using an FGD guide to explore factors influencing exam preparations of nursing students. Demographic data and test anxiety scores were analyzed using frequency and percentage. Qualitative data recorded were transcribed and identified repeated concepts, then coding was done to develop themes. Results: The study revealed that more than half of subjects 53.3% (145) having high exam anxiety, followed by 39.7% (108) subjects who had medium exam anxiety and 7.0% (19) had low exam anxiety. On comparison of mean test anxiety scores, the mean test anxiety score of first-year BSc nursing students (21.88 ± 5.384) remained higher than the second year (20.06 ± 4.403), third-year (19.17 ± 4.529), and fourth-year (20.84 ± 4.857) nursing. From FGD, three themes emerged as nursing students described their experiences and feelings toward factors influencing exam preparation. (1) Materialistic and environmental factors for exam preparation. (2) Motivational determinants that promote exam preparation. (3) Perceived barriers or distractions in preparing for an exam. Conclusion: This study concludes that faculty who are in close association with students can improve student outcomes by early identification of test anxiety, intervening if necessary, and sometimes by referring to a psychiatrist for ruling out further mental health issues that may arise from exam anxiety.