The Effect of Distance Reiki on State Test Anxiety and Test Performance: A Randomized Controlled Trial of Nursing Students.

BACKGROUND: This randomized controlled, pretest-post-test intervention study examined the effect of distance reiki on state test anxiety and test performance. METHOD: First-year nursing students (n = 71) were randomized into two groups. One week before the examination, intervention group participants performed reiki remotely for 20 minutes for 4 consecutive days, and control group participants received no intervention. RESULTS: The intervention group had lower posttest cognitive and psychosocial subscale scores than pretest scores (p > .05). The control group had a significantly higher mean posttest physiological subscale score than pretest score (p < .05). Final grade point averages were not significantly different between the intervention and control groups (p > .05). One quarter of the intervention group participants noted reiki reduced their stress and helped them perform better on the examination. CONCLUSION: Reiki is a safe and easy-to-practice method to help students cope with test anxiety. [J Nurs Educ. 2024;63(5):298-303.].

Coping with test anxiety using imagery rescripting: A two-session randomized controlled trial.

BACKGROUND: Up to 55 % of students experience test anxiety (TA), which is characterized by intense physiological and psychological symptoms before or during exams, such as anxiety, fear of failure, sweating, or increased heart rate. Furthermore, TA increases graduation times and can result in discontinuance of the graduate program all together. Previous research demonstrated the beneficial effects of combining cognitive behavioral therapy with imagery rescripting, however, treatment programs are comparably long. Hence, they do not account for the students´ time-sensitive schedules. Therefore, the present study investigates a two-session short-intervention using imagery rescripting to treat TA. METHODS: 44 students and pupils were randomly assigned to either the two-session imagery rescripting intervention (22 participants) or the waitlist-control condition (22 participants). One week before the intervention clinical interviews were conducted and self-report questionnaires on TA, self-efficacy, symptoms of depression, and intrusive prospective images were completed (T1). The same questionnaires were completed one week (T2) and six months after the intervention (T3). RESULTS: Test anxiety significantly decreased from T1 to T2, as well as from T1 to T3 within the intervention group. Furthermore, there were medium to large within and between group effects for situational test anxiety, self-efficacy, symptoms of depression, as well as prospective intrusive images, showing significant improvements for the intervention group at six months follow-up. LIMITATIONS: The study is limited to the comparably small sample size, as well as the sole usage of self-report measurements. CONCLUSIONS: The presented short-intervention provides a feasible treatment technique, which can be easily applied within school and university counseling centers.

Estudio exploratorio de un taller basado en el Protocolo Unificado para el manejo de ansiedad ante exámenes.

Introducción: La ansiedad ante exámenes es un constructo multidimensional, caracterizado por respuestas fenomenológicas, fisiológicas, conductuales y cognitivas asociadas a una preocupación excesiva sobre posibles consecuencias negativas ante una situación evaluativa. En estudiantes universitarios, presenta tasas de  ocurrencia entre 10 % y 40 %. El objetivo es evaluar la utilidad de un taller grupal y online para el manejo de esta problemática, basado en el Protocolo Unificado. Método: Participaron 31 estudiantes argentinos con edades de 18 a 35 años (M=25; DE= 5,24), siendo el 93.5 % mujeres. Se evaluó medidas pre, post y seguimiento en sintomatología asociada a la ansiedad ante exámenes (GTAI-AR) como variable primaria, y estrategias de regulación emocional (ERQ) y conciencia plena (MAAS) como variables secundarias. Para corroborar diferencias intra grupo se calculó la prueba de Wilcoxon, y como medida de tamaño del efecto (TE), la g de Hedges. Resultados: En cuanto a la variable primaria entre las tres medidas aplicadas, las diferencias fueron significativas con TE moderados y grandes. En las variables secundarias, solo la  reevaluación cognitiva reflejó TE considerables (pequeños) en el pre-post; en el post-seguimiento la supresión expresiva fue la única dimensión que reflejó TE significativos (moderados); y en el pre-seguimiento, únicamente la conciencia plena arrojó TE relevantes (pequeños). Discusión: Los resultados son coherentes con el marco del Protocolo Unificado y las investigaciones actuales sobre su aplicación. Conclusiones: Se espera que estos resultados sean útiles para el diseño de intervenciones similares. Si bien éstos fueron alentadores, se requieren investigaciones de mayor rigurosidad que permitan estudiar su eficacia.

The relationship between COVID-19 stress and test anxiety in art students: the chain mediating roles of intolerance of uncertainty and sleep quality.

BACKGROUND: The global spread of COVID-19 has brought immense physiological and psychological distress to students, such as test anxiety and poor sleep quality. This study aims to explore the relationship between COVID-19 stress and test anxiety and the mediating roles of intolerance of uncertainty and sleep quality between them. METHODS: A study was conducted in China during the late stage of the pandemic. A total of 936 Chinese art students (age M = 18.51, SD = 2.11, 46.6% female) completed the Coronavirus Stress Measure (CSM), the 12-item Intolerance of Uncertainty (IUS-12), the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI), and the Test Anxiety Inventory (TAI). A chain mediation model analysis was conducted to examine the mediating effects of intolerance of uncertainty and sleep quality on the association with COVID-19 stress and test anxiety. RESULTS: COVID-19 stress was positively associated with test anxiety (ß = 0.50, p < 0.001). The intolerance of uncertainty and sleep quality partially and serially mediated the relationship between COVID-19 stress and test anxiety (ß = 0.01, 95% CI = 0.01 to 0.02). CONCLUSION: These findings suggest that art students' intolerance of uncertainty and sleep quality partially and serially mediate the relation between COVID-19 stress and test anxiety. The results have significant implications for the intervention and prevention of test anxiety, providing additional evidence for the relationship between COVID-19 stress and test anxiety.

EEG correlates of trait test anxiety in the flanker task for adolescents.

Adolescents face constant exams and often experience severe test anxiety. Previous studies suggested that test anxiety impairs individuals' inhibitory control. Neurophysiological evidence suggests that anxiety interferes with the recruitment of the prefrontal region of the brain, which modulates top-down attentional control during the completion of inhibitory control tasks. However, there is little neurophysiological evidence regarding how test anxiety impairs inhibitory control in adolescents. This study used the flanker task to measure individuals' inhibitory control ability, and both event-related potential and electroencephalography indicators were used to measure neurophysiological processes. The results showed that increased trait test anxiety was significantly negatively correlated with theta power oscillation, while adolescents performed both incongruent and congruent trials. This finding suggests that trait test anxiety adolescents are less able to exert greater effort to complete the inhibitory control task and show impoverished top-down attentional control resources.

Test anxiety: Perceptions of Omani nursing students - A descriptive qualitative study.

BACKGROUND: Excessive anxiety may have a detrimental effect on nursing students' performance. Understanding students' experiences of test anxiety (TA) is crucial to improve their academic performance and help them lead a successful professional life. OBJECTIVES: To explore TA from the perspective of nursing students, identify the factors that affect TA and possible interventions to reduce it. METHOD: the setting is a nursing college from Oman. All regular undergraduate nursing students from years 2, 3, 4 and 5 and bridging students (those doing BSc nursing after a diploma in nursing) were invited through their cohort leaders. The interested participants from each cohort signed the consent to participate in the focus group. RESULTS: Thirty students from different academic years participated in five focus groups, each comprising 5-8 undergraduate students and lasted from 45 to 60 minutes. Approximately 80% of the students experienced moderate to severe TA. The causes were divided into students, courses and examiner-related factors. Other themes were signs and symptoms of TA, the impact of TA on different aspects of life, effective management techniques and suggestions for improvement. The findings indicate that TA improves with experience as students advance academically. Furthermore, bridging students face less TA in their clinical practice than regular students and TA impacts more aspects of their lives. CONCLUSION: This study highlights the TA experiences of nursing students at different levels and in different programs. the findings showed that most students experienced test anxiety, but the perception of TA improved when students advanced their academic lives. the distinct experiences of Omani nursing students highlight the importance of tailored interventions to mitigate its impact on academic performance and overall well-being.

The effect of working memory training on test anxiety symptoms and attentional control in adolescents.

OBJECTIVE: The percentage of adolescents with test anxiety is increasing rapidly. Working memory (WM) training has been demonstrated to reduce anxiety levels and enhance attentional control in individuals. Therefore, we investigated whether adaptive dual n-back WM training could lower test anxiety level and improve attentional control in adolescents. METHODS: Forty adolescents were allocated to either adaptive dual n-back WM training (n = 21) or non-adaptive dual 1-back WM training (n = 19) for 10 days. The Test Anxiety Scale was applied to measure individuals' test anxiety symptoms. The Attentional Control Scale (ACS), the flanker task, and the Go/Nogo task were used to measure attentional control. RESULTS: Compared with the control group, the training group reported significantly relief of test anxiety symptoms; however, there were no significant differences between the two groups in pre-to-post changes in ACS scores or performance on the flanker task and Go/Nogo task. CONCLUSION: In sum, adaptive dual n-back WM training effectively reduced adolescents' level of test anxiety but did not improve their attentional control.

Integrative neuro-cardiovascular dynamics in response to test anxiety: A brain-heart axis study.

Test anxiety (TA), a recognized form of social anxiety, is the most prominent cause of anxiety among students and, if left unmanaged, can escalate to psychiatric disorders. TA profoundly impacts both central and autonomic nervous systems, presenting as a dual manifestation of cognitive and autonomic components. While limited studies have explored the physiological underpinnings of TA, none have directly investigated the intricate interplay between the CNS and ANS in this context. In this study, we introduce a non-invasive, integrated neuro-cardiovascular approach to comprehensively characterize the physiological responses of 27 healthy subjects subjected to test anxiety induced via a simulated exam scenario. Our experimental findings highlight that an isolated analysis of electroencephalographic and heart rate variability data fails to capture the intricate information provided by a brain-heart axis assessment, which incorporates an analysis of the dynamic interaction between the brain and heart. With respect to resting state, the simulated examination induced a decrease in the neural control onto heartbeat dynamics at all frequencies, while the studying condition induced a decrease in the ascending heart-to-brain interplay at EEG oscillations up to 12Hz. This underscores the significance of adopting a multisystem perspective in understanding the complex and especially functional directional mechanisms underlying test anxiety.

[A Cognitive Behavioural-Based Intervention in Reducing Test Anxiety in High School Students: A Pilot Cluster Randomized Controlled Trial]. / Intervenção de Base Cognitivo-Comportamental na Redução da Ansiedade Perante os Testes em Alunos do Ensino Secundário: Estudo Piloto Aleatorizado e Controlado Por Clusters.

INTRODUCTION: School-age test anxiety is an important risk factor for school performance. Notwithstanding, few studies seek to identify which strategies are effective in improving test anxiety. The aim of this study was to assess whether a cognitive-behavioural intervention for high school students could significantly reduce test anxiety. MATERIAL AND METHODS: Two-arm, cluster-randomized controlled, unblinded, parallel, trial. Participants were 10th grade students from Alves Martins High School in Viseu, Portugal. Students were randomized at class level to receive a cognitive-behavioural-based intervention combined with mindfulness, psychoeducation, and relaxation techniques, or to a control group with no intervention. Participants' anxiety levels were measured using the Test Anxiety Questionnaire. The analysis of the effect of the intervention was carried out on an intention-to-treat basis at the class level, using multilevel mixed effects models and Bayesian modelling. RESULTS: The intervention had a significant effect in reducing test anxiety (d = 0.81, 95% CI 0.45;1.17, Bayes factor = 31.3). Male gender was an independent risk factor for smaller reductions in anxiety levels. The intervention was more effective in reducing the worry component of test anxiety (d = 0.76, 95% CI 0.41;1.11, Bayes factor = 19.9) than the emotionality component (d = 0.63, 95% CI 0.31;0.95, Bayes factor = 6.6). CONCLUSION: A cognitive-behavioural intervention specifically designed to reduce test anxiety, using a combination of mindfulness, psychoeducation and relaxation techniques, was effective in reducing test anxiety levels. TRIAL REGISTRATION: Retrospectively registered on clinicaltrials.gov (NCT05481099) in 08/01/2022.

Introdução: A ansiedade face aos testes é um importante fator condicionante da performance escolar. Contudo, são escassos os estudos que procuram identificar quais as estratégias eficazes na sua melhoria. Este estudo teve como objetivo testar a eficácia de uma intervenção cognitivo-comportamental na redução da ansiedade face aos testes em alunos do ensino secundário. Material e Métodos: Estudo experimental, aleatorizado por clusters (turmas), controlado, sem ocultação, com dois grupos paralelos, com alunos do 10.º ano da Escola Secundária Alves Martins em Viseu, Portugal. Os alunos foram aleatorizados ao nível da turma para receber uma combinação de técnicas cognitivas e comportamentais, de mindfulness, psicoeducação e técnicas de relaxamento, ou para um grupo controlo sem intervenção. Os níveis de ansiedade dos participantes foram medidos através do Questionário de Ansiedade face aos Testes. A análise do efeito da intervenção foi realizada na base de intenção de tratar ao nível da turma recorrendo a modelos de efeitos mistos multinível e modelação bayesiana. Resultados: A intervenção teve um efeito significativo na redução da ansiedade face aos testes (d = 0,81, IC 95% 0,45;1,17, fator de Bayes = 31,3). Pertencer ao sexo masculino revelou-se um fator de risco independente para uma menor redução nos níveis de ansiedade. O efeito da intervenção foi mais pronunciado na redução da preocupação face aos testes (d = 0,76, IC 95% 0,41;1,11, fator de Bayes = 19,9) quando comparado com a emocionalidade (d = 0,63, IC 95% 0,31;0,95, fator de Bayes = 6,6). Conclusão: Uma intervenção especificamente desenhada para reduzir a ansiedade face aos testes, usando uma combinação de técnicas cognitivas e comportamentais de mindfulness, psicoeducação e técnicas de relaxamento, foi eficaz na redução dos níveis de ansiedade. Registo do Estudo: Estudo registado a posteriori (registo retrospetivo) em ClinicalTrials.gov com o número NCT05481099 em 01/08/2022.

Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.

Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.

Self-regulated learning profiles including test anxiety linked to stress and performance: A latent profile analysis based across multiple cohorts.

INTRODUCTION: Medical educators aim to understand why students differ in performance and stress. While performance and stress are associated with student demographics, school factors and aspects of self-regulated learning (SRL), it remains unclear how these elements interact within individuals. This multi-cohort study identified SRL profiles among medical students and explored their associations with performance and stress. Additionally, we examined the identified profiles' associations with gender, migration status and assessment policy. METHODS: We used latent profile analysis (LPA) to identify profiles on Motivated Strategies for Learning Questionnaire (MSLQ) scores of six cohorts (2014-2019) of Year 1, first semester medical students (n = 1894) in a Dutch medical school. We used nine MSLQ subscales that measure test anxiety (TA), self-efficacy, deep learning, resource management and value. The university's assessment policy varied, demanding students to obtain 100% or 75% of Year 1 credits to remain enrolled. We defined optimal performance as obtaining all credits at the end of Year 1. Two cohorts completed the Perceived Stress Scale (PSS-14, n = 409) in the 2nd semester. RESULTS: We identified three distinct student profiles: 693/1894(36.6%) were classified as TAhighSRLhigh, 661/1894(34.9%) as TAlowSRLhigh and 540/1894(28.5%) as TAmoderateSRLlow. Females were more likely to belong to TAhighSRLhigh profiles compared to males (effect size [ES] Cramer's V = .13, small). Migration background was not associated with these profiles. The TAhighSRLhigh profile was more prevalent under the 100% assessment policy (ES Cramer's V = .10, negligible). TAlowSRLhigh students demonstrated lower stress levels (PSS = 23.9 out of 56) compared to TAhighSRLhigh students (PSS = 28.7, ES Cohen's d = .62, medium) and TAmoderateSRLlow students (PSS = 28.2, ES Cohen's d = .51, medium). Performance differed among the three profiles (ES Cramer's V = .16, small): 82.5% optimal performance in the TAlowSRLhigh, 71.9% in the TAhighSRLhigh and 65.2% in the TAmoderateSRLlow profile. DISCUSSION: Three distinct SRL student profiles associated with gender, academic performance and perceived stress were identified. Test anxiety had additional value in distinguishing subgroups with differential academic performance and stress. These profiles may aid educators to inform personalised support strategies for novice learners.

Validity and reliability of the short Test Anxiety Inventory (TAI-5) in Dutch adolescents.

The present study examined the psychometric properties of the short Test Anxiety Inventory (TAI-5) in a Dutch adolescent sample. The sample consisted of 2063 secondary school students (mean age 13.6 years, 48% girls) who filled out a battery of screening questionnaires for a routine health check. We investigated structural validity with a confirmatory factor analysis, scale reliability with internal consistency coefficients, and construct validity with hypotheses testing and convergent validity. The proposed one-factor structure fitted well in the present sample. However, there was an indication of measurement variance for gender. Scale reliability was high (ω = 0.88), and sufficient positive correlations were found between TAI-5 scores and anxiety, depression, worry, executive functioning, and sleep problems (r ranging from 0.36 to 0.56). Girls had significantly higher test anxiety scores than boys (d = 0.47). The present study provided evidence for the validity and reliability of TAI-5 scores in a general population of Dutch adolescents.

Exam stress and the metacognitive strategies of reading in students with dyslexia: The role of motivational mechanisms and educational support.

Despite numerous studies on dyslexia, there is still a lack of empirical data on the factors determining the functioning of students with dyslexia in the context of written exams. Therefore, the aim of the study is to identify the relationship between sources of stress in an exam situation and the reported use of reading strategies by dyslexic students in terms of motivation and therapeutic interventions in the educational environment. This descriptive-analytical study used data from a larger project focused on children with and without dyslexia. The research sample (n = 640) included girls (n = 280) and boys (n = 360) aged between 14 and 15 years (M = 14.40, SD = 0.55), attending the 7th or 8th grade in Polish mainstream primary schools. Random and intentional sampling was used. All students completed four questionnaires. The results were analyzed using regression analysis in Model templates for PROCESS v4 for SPSS by Hayes. The study showed significant weak and moderate positive correlations between the sources of exam stress and the reading strategies reported by students, ranging from 0.186 to 0.570, as well as significant moderate and strong correlations between reading strategies and experienced educational support, ranging from 0.229 to 0.505, and between reading strategies and motivation to read, ranging from 0.582 to 0.701. The type of stress source significantly influenced the selection of specific reading strategies. Motivation acted as a mediator, while educational support was a moderator in the relationship between exam stress and the reported use of reading strategies. Based on our results, the source of stress may be perceived as factors activating metacognitive mechanisms aimed at selecting appropriate strategies for working with texts. Researchers and teachers should be aware of the need to undertake activities to support students with dyslexia focused on developing the ability to recognize the sources of exam stress and select effective coping strategies.

Prediction of exam scores using a multi-sensor approach for wearable exam stress dataset with uniform preprocessing.

BACKGROUND: Physiological signals, such as skin conductance, heart rate, and temperature, provide valuable insight into the physiological responses of students to stress during examination sessions. OBJECTIVE: The primary objective of this research is to explore the effectiveness of physiological signals in predicting grades and to assess the impact of different models and feature selection techniques on predictive performance. METHODS: We extracted a comprehensive feature vector comprising 301 distinct features from seven signals and implemented a uniform preprocessing technique for all signals. In addition, we analyzed different algorithmic selection features to design relevant features for robust and accurate predictions. RESULTS: The study reveals promising results, with the highest scores achieved using 100 and 150 features. The corresponding values for accuracy, AUROC, and F1-Score are 0.9, 0.89, and 0.87, respectively, indicating the potential of physiological signals for accurate grade prediction. CONCLUSION: The findings of this study suggest practical applications in the field of education, where the use of physiological signals can help students cope with exam stress and improve their academic performance. The importance of feature selection and the use of appropriate models highlight the importance of engineering relevant features for precise and reliable predictions.

Perfectionism, test anxiety, and neuroticism determines high academic performance: a cross-sectional study.

BACKGROUND: Academic performance is an important issue for Korean students. Various psychological factors contribute to academic performance. We aimed to evaluate the psychological factors that affect academic performance integratively. METHODS: A total of 102 academic high achievers and 120 comparison participants were recruited. We evaluated psychological factors (test anxiety, perfectionism, personality traits, resilience, and self-efficacy) and measured academic performance using the College Scholastic Ability Test and the current college grade. We compared psychological factors and academic performance between the academic high achiever and comparison groups. Multiple linear regression was then conducted to identify the significant psychological factors for high academic performance. Further, we used cluster analysis to classify the comparison group by the significant psychological factors and compared them among clusters and academic high achievers to determine the psychological characteristics of academic high achievers. RESULTS: The academic high achiever group showed lower test anxiety (p = .002), less neuroticism (p = .001), higher self-efficacy (p = .028), and less socially prescribed perfectionism (p < .001) than the comparison group. Multiple linear regression results (p = .020) clarified that neuroticism (p = .020), test anxiety level (p = .047), and perfectionism (p = .035) were important factors predicting better academic performance. Academic high achievers had moderate test anxiety and perfectionism levels, with the best performance on the College Scholastic Ability Test. CONCLUSIONS: Neuroticism, test anxiety levels, and perfectionism are important psychological factors for high academic performance. Interventions targeting these factors may help to improve academic accomplishments.

Effects of auricular acupressure on test anxiety in medical students: a randomized parallel-group trial.

BACKGROUND: Test anxiety is a prevalent issue among students, including those in the medical field. The present study aims to examine the impact of auricular acupressure on reducing test anxiety specifically among medical students. METHODS: In this single-blind randomized parallel-group trial, a total of 114 medical students from Kermanshah, Iran, were allocated into two groups: intervention and control. Each group consisted of 57 students. The data collection instruments included a demographic information form and the Sarason Anxiety Inventory. In the intervention group, bilateral auricular acupressure was administered on the Shen Men point for a duration of 10 min. On the other hand, the control group received bilateral auricular acupressure on the Sham point, located in the earlobe, as a placebo, also for 10 min. RESULTS: The mean test anxiety scores in the Shen Men acupressure group exhibited a significant reduction from 18.4 ± 5.3 before the intervention to 13.3 ± 4.8 after the intervention (P = 0.001). Conversely, in the Sham acupressure group, the mean test anxiety scores showed no significant change, with values of 16.36 ± 6.4 before the intervention and 16.4 ± 6.1 after the intervention (P = 0.963). Prior to the intervention, the majority of participants in both the intervention group (87.7%) and control group (86.0%) exhibited moderate to severe levels of test anxiety. Following acupressure, a significant improvement was observed in the intervention group, with 52.6% of participants experiencing a reduction to mild anxiety levels (P = 0.001); however, no notable change in anxiety levels was observed in the control group. Furthermore, a statistically significant difference in anxiety intensity after the intervention was found between the two groups (P = 0.001). CONCLUSION: Shen Men auricular acupressure demonstrates efficacy in reducing test anxiety among medical students. However, to validate its effectiveness, further research using objective measures is warranted.

Efficacy of Hypnosis Interventions: Fibromyalgia, Sleep, Oncology, Test Anxiety, and Beliefs.

This issue of the International Journal of Clinical and Experimental Hypnosis addresses the efficacy and feasibility of hypnosis interventions for several medical problems and issues. The lead article provides a narrative review of the efficacy of hypnosis interventions for Fibromyalgia. This is followed by a feasibility study of self-administered hypnosis for sleep disturbances in college students and an article on self-hypnosis for self-care in oncology patients. The effect of self-hypnosis on test anxiety is added in a study of secondary school students in Malaysia. These articles are complemented by a survey about hypnosis among students, therapists, and the general public in Poland. These are impactful topics that are addressed from an international perspective. The feasibility and potential efficacy of hypnosis interventions for a range of medical concerns are addressed as well as the impact of beliefs and attitudes about clinical hypnosis.

Medication administration competency for clinical preparedness: Comparing testing modalities and test anxiety in undergraduate nursing students.

BACKGROUND: Adverse drug events, which occur at various stages of the medication preparation and administration process, cause over half a million injuries or deaths yearly. Upon graduation, prelicensure nursing students lack the skill and competency required for safe medication administration. Therefore, it is essential to ascertain their medication administration proficiency throughout their curriculum prior to participation in clinical experiences. Historically, this has been a deeply embedded process of high-stakes testing. Aligned is cognitive test anxiety which can severely limit a student's performance. Thus, nursing student competency and control appraisal in medication administration can be linked to the Control Value Theory framework. OBJECTIVES: The purpose of the research was to determine whether an e-simulated high-stakes medication administration test was associated with less anxiety than a standard high-stakes medication math assessment within and between two nursing tracks over three semesters to capture sequencing of medical-surgical clinical courses. DESIGN: The prospective, quantitative, longitudinal study received Institutional Review Board approval. PARTICIPANTS/SETTING: Students were recruited from a traditional BSN track and an online LPN-to-BSN track per course level over three semesters. METHODS: Participants completed the State-Trait Anxiety Inventory prior to their course level high-stakes assessment modality. RESULTS: For both tracks, testing anxiety remained a factor with no significant difference in the anxiety level between assessment modalities. There was a trend for anxiety scores to slightly decrease over time with each testing modality, but results were non-significant. There was a trend for traditional BSN students (n = 435) to have slightly lower anxiety scores than the LPN-to-BSN (n = 246) students. CONCLUSIONS: Researchers must continue investigating teaching, learning, and testing modalities in medication calculation/administration that maintain rigor, enhance student self-efficacy, and provide accurate assessment. These can be aligned with research regarding study skills training and cognitive-behavioral interventions to help mitigate the challenge of cognitive test anxiety.

A qualitative study of imaginary pills and open-label placebos in test anxiety.

BACKGROUND: The efficacy of open-label placebos (OLPs) has been increasingly demonstrated and their use holds promise for applications compatible with basic ethical principles. Taking this concept one step further an imaginary pill (IP) intervention without the use of a physical pill was developed and tested in a randomized controlled trial (RCT). To explore participants' experiences and views, we conducted the first qualitative study in the field of IPs. METHODS: A reflexive thematic analysis (RTA) of semi-structured interviews with test anxious students (N = 20) was nested in an RCT investigating an IP and OLP intervention. In addition, open-ended questions from the RCT were evaluated (N = 114) to corroborate the RTA and pill characteristics were included to more accurately capture the IP experience. RESULTS: Four key themes were identified: (1) attitude towards the intervention, (2) applicability of the intervention, (3) experience of effects, and (4) characteristics of the imagination. The IP intervention was well-accepted, easily applicable, and various effects, pill characteristics and appearances were described. While many participants did not desire a physical pill, either due to the absence of the imagination component or aversion to pills, the approach was considered to be cognitively and time demanding, which in turn, however, encouraged the establishment of a therapeutic ritual that protected against the increase in test anxiety during the preparation phase. OLP findings were comparable, and especially the importance of a treatment rationale was stressed in both groups, counteracting an initial ambivalent attitude. The RTA findings were supported by the open-ended questions of the RCT. CONCLUSION: IPs appear to be a well-accepted and easily applicable intervention producing a variety of beneficial effects. Thus, the IP approach might serve as an imaginary based alternative to OLPs warranting further investigations on its application to harness placebo effects without a physical pill.

Effect of Self-Hypnosis on Test Anxiety among Secondary School Students in Malaysia.

Test anxiety comprises cognitive, physiological, and behavioral reactions due to anxiety about failure or a lower academic performance score on an exam or evaluation. This study examined the effect of self-hypnosis on reducing test anxiety among upper secondary school students using a quantitative methodology with a pre-experimental design. The prevalence of test anxiety was measured using the Friedben Test Anxiety Scale (FTAS) and students' demographic data were collected. Twenty-two 16-year-old students with moderate to high test anxiety were selected for a self-hypnosis intervention over a period of 5 weeks. The FTAS questionnaire was administered 4 times: at baseline, 3rd week, 5th week, and at follow-up (3 weeks after the intervention). Students' test anxiety differences were statistically significant across 4 time points. Self-hypnosis intervention decreased students' overall test anxiety scores and in the 3 constructs: social, cognitive, and tenseness. The outcomes indicate that self-hypnosis training can help students cope with test anxiety and should be further explored for managing test anxiety in school settings.