Assessment Modalities That Provoke Test Anxiety Among Medical Students

Abstract

The prevalence of distress among medical students continues to rise. Studies have shown that stressrelated to examinations – test anxiety (TA) – is the most frequently reported source of distress. Research on the relationship between TA and assessment modalities is thus critical for determining the potential ramifications of this problem. This study aimed to explore assessment modalities that aggravate TA among medical students in a Malaysian medical school. A cross-sectional study was conducted among medical students at the School of Medical Sciences (SMS) of Universiti Sains Malaysia (USM). Students rated TA for each assessment modality used in the school. Each modality was scored from 1 to 10, with 1 indicating no TA and 10 representing extreme TA. Forty-five students participated in the study. The group was divided almost equally in terms of sex. The assessment modalities that provoked the most TA were the objective structured clinical examination (OSCE), the short case, the short essay question (SEQ) and the long case, with mean scores of 7.9, 7.8, 7.7 and 7.7, respectively. The case write-up, the problem-based learning (PBL) assessment, the multiple true-false (MTF) questions and the Simplified Thematic Engagement of Professionalism Scale (STEPS) were the assessment methods that induced the least TA, with mean scores of 5.1, 5.0, 4.4 and 4.0, respectively. This study found that the worst assessment modalities in terms of TA were the OSCE, the short and long cases, and the short essay question, while the case write-up, the PBL assessment, the MTF questions, and the STEPS induced the least TA. Most students reported that memorisation difficulties and facing examiners were the most common causes of TA. Remedial measures include examiner training on how to deal with examinees during assessments, evaluating the distribution of marks according to assessment modality and student training focused on study skills and exam preparation.