Habitual rapid eye movement sleep predicts changes in test-anxiety levels weeks in advance.

Previous research has linked rapid eye movement sleep to emotional processing, particularly stress. Lab studies indicate that rapid eye movement sleep deprivation and fragmentation heighten emotional reactivity and stress response. This relationship extends to natural settings, where poor-quality sleep among college students correlates with increased academic stress and lower academic performance. However, there is a lack of research into how specific sleep stages, like rapid eye movement, affect real-life stress development. This study investigated whether habitual rapid eye movement sleep in college students can predict the future development of real-life stress symptoms associated with final exams. Fifty-two participants (mean age = 19 years, 62% females) monitored their sleep for a week during the academic semester using a mobile electroencephalogram device, and then completed self-evaluations measuring test anxiety and other relevant factors. They completed the same evaluations again just prior to final exams. We found that rapid eye movement sleep was the most dominant factor predicting changes in participants' test anxiety. However, contrasting with our predictions, habitual rapid eye movement sleep was associated with an increase rather than decrease in anxiety. We discuss these results in terms of the rapid eye movement recalibration hypothesis, which suggests rapid eye movement sleep modulates activity in stress-encoding areas in the brain, leading to both decreased sensitivity and increased selectivity of stress responses.

Association between malnutrition and anxiety in cancer patients-a retrospective study.

INTRODUCTION: The total number of cancer-related deaths and new cancer cases in 2020 was 19.3 billion and 10.8 billion, respectively. Therefore, prevention, diagnosis, and treatment of neoplastic disease, as well as management of comorbidities, are of paramount importance. In this regards, poor nutritional status and mental disorders are comorbidity conditions frequently observed in cancer patients. The aim of this study was to assess the association between malnutrition and anxiety in hospitalized adult cancer patients. METHODS: This is a retrospective study. Nutrition Risk Screening (NRS) 2002, body mass index (BMI), daily calorie intake, and weight difference between admission and discharge were used to evaluate nutritional status. Anxiety was assessed with the Hospital Anxiety and Depression Scale (HADS-A). Ordered logistic and linear logistic regressions adjusted for sex and age were used to estimate the association between malnutrition and anxiety in cancer patients. RESULTS: A total of 90 patients were included. Higher NRS risk [aß = 0.85; 95% CI (0.28-1.42); p = 0.004], disease stage [aß = 0.77; 95% CI (0.08-1.47); p = 0.029], and cachexia [aß = 2.20; 95% CI (0.75-3.65); p = 0.003] were significantly associated with anxiety symptoms. Moreover, cancer site different than gastrointestinal cancers was associated with a lower risk of anxiety symptoms [aß = - 2.11; 95% CI (- 3.55/ - 0.66); p = 0.005]. CONCLUSION: In the current study, we found a relatively high rate of malnourished patients, indicating the importance of routinely assessing nutritional status and screening cancer patients for mental health issues. This approach could help physicians to treat both in a timely manner, thereby significantly reducing the burden of the disease and improving the quality of life of patients.

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.

Academic Stress Interventions in High Schools: A Systematic Literature Review.

The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.

The impact of mentorship program on the level of anxiety and pre-internship exam scores among Iranian senior nursing students.

BACKGROUND: Mentorship involves a voluntary, collaborative, and non-hierarchical relationship where an experienced individual shares knowledge with a less-experienced individual. This study aimed to evaluate the effects of a mentorship program on anxiety levels and pre-internship exam scores among senior nursing students. METHODS: This quasi-experimental research was conducted on 37 nursing students in the sixth semester of the School of Medical Sciences in Saveh in the year 2023. Participants were selected based on initial criteria using a census method and were then randomly assigned to two groups: the control group (19 participants) and the intervention group (17 participants). The mentoring program for the intervention group was implemented one month before the pre-internship exam and consisted of six sessions, each lasting two hours, over two weeks (three sessions per week). Data collection tools included a demographic questionnaire, the Sarason Anxiety Questionnaire, and pre-internship exam scores. SPSS software version 23 was utilized for data analysis. RESULTS: The mean anxiety exam scores in the two control and intervention groups did not exhibit a statistically significant difference before the intervention (P = 0.34). However, the mean anxiety exam score of the intervention group students after the intervention (5.89 ± 15.11) was significantly lower than that of the control group students (7.04 ± 21.42) (P = 0.007). Additionally, the results showed that the mean anxiety exam scores of the intervention group students before (5.77 ± 17.53) and after the intervention (5.89 ± 15.11) had a statistically significant difference (P = 0.013). Furthermore, the mean pre-internship exam scores of the intervention group students (1.71 ± 17.72) were significantly higher than those of the control group students (1.15 ± 16.46) (P = 0.014). CONCLUSION: The mentorship program resulted in a reduction of exam anxiety in nursing students and improved their performance in the pre-internship exam to the extent that the exam scores of the participating students were higher than those of other students.

Perceived Peer Integration, Parental Control, and Autonomy Support: Differential Effects on Test Anxiety during the Transition to Secondary School for Girls and Boys.

Although previous research has investigated the impact of parents and peers on test anxiety in secondary or tertiary education, little is known about younger students, especially during the transition to secondary school. Additionally, it is unclear whether these social factors affect girls' and boys' test anxiety differently. Therefore, the current study examined the role of perceived peer integration into the new class context, perceived parental control, and autonomy support on girls' and boys' test anxiety (worry and emotionality) during the transition to secondary school. Data from 1770 students (Mage = 10.47, SD = 0.56; 51% females) were analyzed before (4th grade) and after the transition (5th grade) using a multigroup (girls vs. boys) structural equation model. Both facets of test anxiety decreased from 4th to 5th grade. Perceived peer integration into the new class was only relevant for girls' test anxiety, while parental control predicted post-transition test anxiety for boys. The results suggest that the perceived social environment is an important factor in helping students cope with the demands of the transition to secondary school.

The effectiveness of badging systems in engaging, motivating, and incentivizing students in the mastery of nursing licensure materials.

INTRODUCTION: Integrating gamification methods into undergraduate nursing programs has prepared students to pass the nursing comprehensive predictor test and the licensure examination. LITERATURE REVIEW: Research demonstrates that the motivational factors of game elements like badging and leaderboards are of great value and utility to student engagement and motivation. The badges symbolize achievement, authority, and belonging, whereas leaderboards rank students based on different levels of course engagement. DISCUSSION: This paper explores the benefits, challenges, and strategies of incorporating digital badges and leaderboards in the undergraduate program. Immersion courses preparing students for professional practice are usually one of the last didactic courses offered in the undergraduate curriculum, designed to integrate all knowledge gained from the nursing program. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The digital badging system can encourage nurse educators globally to engage, motivate, and power students to achieve professional goals. Furthermore, nursing programs worldwide can benefit from adding digital badges and leaderboards to final semester preparatory courses or any nursing course with the same emphasis. CONCLUSIONS: Digital badges and leaderboards engage and motivate students to integrate knowledge and skills learned in the nursing program and successfully master nurse licensure materials.

An exploratory study of test anxiety management workshop based on the Unified Protocol / Estudio exploratorio de un taller basado en el Protocolo Unificado para el manejo de ansiedad ante exámenes.

Introduction: Test anxiety is a multidimensional construct, defined as a set of phenomenological, physiological and behavioral responses associated with cognitive processes linked to excessive concern about possible negative consequences in an evaluative situation. In university students, it presents occurrence rates between 10 % and 40 %. Therefore, the main objective of the present study is to evaluate the usefulness of a group and online workshop for managing this problem based on the Unified Protocol. Methods: A total of 31 Argentinian students aged 18 to 35 years (M=25; SD=5.24) participated in the study, from which 93.5 % were women. They were evaluated with pre, post and follow-up measures in symptomatology associated with test anxiety (GTAI-AR), emotional regulation strategies (ERQ) and mindfulness (MAAS). The Wilcoxon test corroborated intragroup differences, and Hedge's g was calculated to measure effect size (ES). Results: Regarding the primary variable, the differences were significant with moderate & large ES, which were maintained between the three measures applied. Respecting the secondary variables, in the pre-post measures, only cognitive reappraisal reflected significant ES (small).; in the post-follow-up, expressive suppression was the only dimension that showed meaningful ES (moderate), and in the pre-follow-up, it was found that only mindfulness showed considerable ES (small). Discussion: The results are consistent with the Unified Protocol framework and current research on its application. Conclusions: These results are expected to be helpful for the design of similar interventions. Although the results were encouraging, more rigorous research is needed to study their efficacy.

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 magnitude of neurocognitive impairment is overestimated in depression: the role of motivation, debilitating momentary influences, and the overreliance on mean differences.

BACKGROUND: Meta-analyses agree that depression is characterized by neurocognitive dysfunctions relative to nonclinical controls. These deficits allegedly stem from impairments in functionally corresponding brain areas. Increasingly, studies suggest that some performance deficits are in part caused by negative task-taking attitudes such as poor motivation or the presence of distracting symptoms. A pilot study confirmed that these factors mediate neurocognitive deficits in depression. The validity of these results is however questionable given they were based solely on self-report measures. The present study addresses this caveat by having examiners assess influences during a neurocognitive examination, which were concurrently tested for their predictive value on performance. METHODS: Thirty-three patients with depression and 36 healthy controls were assessed on a battery of neurocognitive tests. The examiner completed the Impact on Performance Scale, a questionnaire evaluating mediating influences that may impact performance. RESULTS: On average, patients performed worse than controls at a large effect size. When the total score of the Impact on Performance Scale was accounted for by mediation analysis and analyses of covariance, group differences were reduced to a medium effect size. A total of 30% of patients showed impairments of at least one standard deviation below the mean. CONCLUSIONS: This study confirms that neurocognitive impairment in depression is likely overestimated; future studies should consider fair test-taking conditions. We advise researchers to report percentages of patients showing performance deficits rather than relying solely on overall group differences. This prevents fostering the impression that the majority of patients exert deficits, when in fact deficits are only true for a subgroup.

The effect of parietal glutamate/GABA balance on test anxiety levels in early childhood in a cross-sectional and longitudinal study.

The increased prevalence of test anxiety in our competitive society makes it a health issue of public concern. However, its neurobiological basis, especially during the years of formal education, is currently scant. Previous research has highlighted the association between neural excitation/inhibition balance and psychopathology and disease. We examined whether the glutamate/GABA profile tracks test anxiety levels in development, using a cross-sectional and longitudinal design in a cohort spanning from early childhood to early adulthood (N = 289), reassessed approximately 21 months later (N = 194). We used magnetic resonance spectroscopy to noninvasively quantify glutamate and gamma-Aminobutyric acid (GABA) levels in the intraparietal sulcus (IPS) and the middle frontal gyrus. We show that the glutamate/GABA balance within the IPS relates to current individual variation in test anxiety levels and predict future test anxiety approximately 21 months later. Critically, this relationship was observed during early childhood but not during the later developmental stages. Our results extend the use of the excitation/inhibition balance framework to characterize the psychopathology mechanisms of test anxiety, an underexplored yet widespread and debilitating condition that can impact early child development. Our findings provide a better understanding of the neurotransmitter basis underlying the emergence of anxiety disorders during development.

Self-perceived anxiety symptoms in school students with borderline intellectual functioning: A cross-sectional questionnaire-based study in Mumbai, Maharashtra, India.

Background and Objectives: Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the self-perceived anxiety symptoms of slow learners. Its secondary objective was to analyze impact of sociodemographic variables on their symptoms. Settings and Design: Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic of a public medical college in Mumbai. Subjects and Methods: One hundred slow learners aged ≥8 to <18 years were recruited by non-probability sampling. Their anxiety symptoms scores were measured using the Screen for Child Anxiety Related Disorders-Child version (SCARED-C) instrument. Statistical Analysis: Multivariate regression analysis was performed for determining the "independent" impact that variables had on the SCARED-C ("individual subscales" and "overall") scores. Results: Symptoms of "separation anxiety" were present in 40%, followed by "social anxiety" in 32%, "generalized anxiety" in 31%, "panic" in 26%, "significant school avoidance" in 24%; and "overall anxiety" in 38% of slow learners. Multivariate analysis revealed that: (i) co-occurring attention-deficit/hyperactivity disorder was significantly associated with having panic symptoms (P = 0.040), and, (ii) studying in a Secondary School Certificate or Higher Secondary Certificate educational board-affiliated school was significantly associated with having symptoms of "generalized anxiety," "social anxiety," and "overall anxiety" (P = 0.009, P = 0.026, and P = 0.046, respectively). Conclusions: Many slow learners in our city have symptoms of anxiety disorders and overall anxiety. There is an urgent need to screen them for anxiety disorders to facilitate their optimum rehabilitation.

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.

Effects of a blended design of closed-book and open-book examinations on dental students' anxiety and performance.

BACKGROUND: While closed-book examinations (CBEs) have traditionally been implemented in dental education, open-book examinations (OBEs) are being introduced for the purpose of acquiring higher levels of knowledge and promoting long-term memory. This study examines whether it is effective to use a blended assessment of CBEs and OBEs for dental students to reduce test anxiety and enhance academic performance. METHODS: Using a quasi-experimental research method, a blended assessment that combined CBEs in class and OBEs online was designed for a dental course. In 2020, when the pandemic was at its peak, student assessment was ineffective, and the 2020 cohort was omitted for our study; instead, two cohorts of predoctoral dental students (N = 178) enrolled in Restorative Dentistry in the spring semesters of 2019 and 2021 were included in the study. These students were informed about the experimental design, and they provided written consent for data collection, thereby voluntarily participating in the survey. Their self-perceived responses to open-ended survey questions on assessment methods were qualitatively analyzed. RESULTS: There was no significant difference in test anxiety between the CBEs and OBEs at the p-values of 0.001 in all items. Traditional and blended assessment showed a similar trend of lower scores in midterm exams compared to higher scores in final exams, thus discriminating against students' performances. In particular, a low-achieving group was better predicted by a blended assessment. An analysis of the students' self-perceived responses produced highly topical themes, including exam burden, learning effects, and fairness issues. CONCLUSIONS: This study confirmed the feasibility of blended assessment that can be implemented in online and in-person educational environments. Moreover, it can be used as the groundwork to develop new models of assessment in dental education.

The framework of Systematic Assessment for Resilience (SAR): development and validation.

BACKGROUND: Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. METHODS: We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. RESULTS: The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. CONCLUSIONS: The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).

Effects of greenness in university campuses on test anxiety among Chinese university students during COVID-19 lockdowns: a correlational and mediation analysis.

The purpose of this study is to investigate the correlations of greenness exposure with test anxiety among university students during COVID-19 lockdowns and to explore their mechanisms. We conducted a cross-sectional study with 2609 university students in Anhui and Shandong provinces, China. We assessed perceived campus greenness using a five-point Likert scale for quality, visibility, abundance, usage, and accessibility. Objective greenness was estimated via average normalised difference vegetation index (NDVI) in 1,000-, 1,500-, and 2,000-m radius zones around each of the campuses. A generalised linear mixed model examined the associations between greenness and test anxiety and to evaluate the mediation effects of physical activity, body mass index (BMI), and air pollution. Results showed that higher NDVI1500-m correlated with lower test anxiety (OR = 0.871; 95% CI: 0.851, 0.891), physical activity may partially mediate this association. Increased campus greenness may alleviate test anxiety among Chinese university students.

Perceived Nexus Between Non-Invigilated Summative Assessment and Mental Health Difficulties: A Cross Sectional Studies.

The COVID-19 pandemic rapidly led to changes in the mode of teaching, learning and assessments in most tertiary institutions worldwide. Notably, non-invigilated summative assessments became predominant. These changes heightened anxiety and depression, especially among individuals with less resilient coping mechanism. We explored the perceptions and experiences of mental health difficulties of students in tertiary education regarding non-invigilated alternative assessments in comparison to invigilated assessments. A pragmatic, mixed method cross sectional design was conducted online via Qualtrics. Thematic analysis of text was carried out using NVivo 12. In the quantitative analysis, univariable and multivariable ordinal logistic models were used to examine the potential factors for preference among students in higher education. A total of 380 Nursing and Social Science students responded to the survey. Approximately 77% of students perceived non-invigilated assessments to be less stressful compared to invigilated exams. Age, course of study, stage of studies, and number of units enrolled per semester were identified as significant drivers for students' perceived preference for non-invigilated assessments. There was an inverse relationship between the perception of stress associated with invigilated exams and the age of students. For instance, students aged between 18-24 were 5 times more likely to prefer non-invigilated exams compared to those aged 55 or more. Comparatively, students in early stages of studies had higher preference for non-invigilated assessments. However, there was a preference reversal for students enrolled in 2 or less units per semester. Social sciences students were two times more likely to prefer non-invigilated examinations to invigilated examinations compared to nursing students. The findings reinforce the use of alternative assessments in higher education as a mitigating agency to lessen the mental health burden of tertiary students in post COVID-19 era. Supplementary Information: The online version contains supplementary material available at 10.1007/s10805-023-09472-w.

Test Anxiety Does Not Predict Exam Performance When Knowledge Is Controlled For: Strong Evidence Against the Interference Hypothesis of Test Anxiety.

Do test-anxious students perform worse in exam situations than their knowledge would otherwise allow? We analyzed data from 309 medical students who prepared for a high-stakes exam using a digital learning platform. Using log files from the learning platform, we assessed students' level of knowledge throughout the exam-preparation phase and their average performance in mock exams that were completed shortly before the final exam. The results showed that test anxiety did not predict exam performance over and above students' knowledge level as assessed in the mock exams or during the exam-preparation phase. Leveraging additional ambulatory assessment data from the exam-preparation phase, we found that high trait test anxiety predicted smaller gains in knowledge over the exam-preparation phase. Taken together, these findings are incompatible with the hypothesis that test anxiety interferes with the retrieval of previously learned knowledge during the exam.

Reducing socioeconomic disparities in the STEM pipeline through student emotion regulation.

Educational attainment is one lever that can increase opportunity for economically disadvantaged families-especially in Science, Technology, Engineering, and Math (STEM). Unfortunately, students from lower-income backgrounds often perform poorly and fail high school STEM courses, which are a necessary step in pursuing fast-growing and lucrative STEM careers, graduating high school, and matriculating to college. We reasoned that, because high school STEM courses often use high-stakes tests to gauge performance, and such tests can be especially stressful for lower-income students, interventions that help students regulate their negative emotions during tests should reduce the achievement gap between higher- and lower-income students. In a large-scale (n = 1,175) field experiment conducted in ninth grade science classrooms, students were asked to complete a control exercise, or they were given the opportunity to complete an exercise to help them regulate their worries and reinterpret their anxious arousal before their tests. We found significant benefits of emotion regulation activities for lower-income students in terms of their science examination scores, science course passing rate, and students' attitudes toward examination stress, suggesting that students' emotions are one factor that impacts performance. For example, 39% of lower-income students failed the course in the control group compared with only 18% of students failing the course if they participated in the emotion regulation interventions-a reduction in course failure rate by half. Our work underscores the crucial importance of targeting students' emotions during impactful points in their academic trajectories for improving STEM preparedness and enhancing overall academic success.

Test anxiety in online exams: scale development and validity.

Considering the increasing use of online tests, this study aims to develop an up-to-date and reliable scale to measure university students' online test anxiety. This study was designed by using mixed research model by combining qualitative and quantitative research methods together. The study consisted of four stages: planning, structuring, quantitative evaluation, reliability and validation. While in the first phase an extensive literature review was conducted, students' opinions were obtained to create an item pool in the second phase. In the third phase, the 29-item scale was administered to 442 university students for factor and reliability analysis. A total of nine items were dropped out from the pool. The Cronbach's alpha value was .98. Exploratory factor analysis revealed that the items loaded on two factors: the psychological and physiological anxiety factor (α = .95), the technical anxiety factor (α = .89). The two-factor solution accounted for more than 63% of the total variance. The final version of the scale was administered to 387 university students for confirmatory factor analysis in the fourth stage. The results proved that the scale had two factors and the fit indices were at an acceptable level. The reliability analysis was run and Cronbach's alpha values were .94 the whole scale, .93 for the psychological and physiological anxiety factor, and .90 for the technical anxiety factor. According to the result, it was concluded that the Test Anxiety Scale for Online Exams is a reliable and valid measurement tool in determining university students' online test anxiety. Finally, recommendations for future research are provided.

The relationship between test anxiety and emotion regulation: the mediating effect of psychological resilience.

BACKGROUND: Test anxiety has been widely found in medical students. Emotion regulation and psychological resilience have been identified as key factors contributing to anxiety. However, studies on relationships were limited. This study investigated the links between psychological resilience, emotion regulation, and test anxiety in addition to exploring the differences about socio-demographic factors. METHODS: A sample of 1266 medical students was selected through cross-sectional survey from a medical university in China during 2019. Data were obtained by network technique using designed questionnaire, which assesses the level of test anxiety, emotion regulation and psychological resilience, respectively. RESULTS: Medical students experienced test anxiety at different levels, 33.7% of these were seriously. It revealed significant effects of the gender and academic performance on test anxiety. Results of logistic regression indicated that test anxiety was significantly associated with emotion regulation and psychological resilience (p < 0.01). Psychological resilience played a mediating role on the relationship between emotion regulation and test anxiety. CONCLUSIONS: These findings highlight the importance of psychological resilience and emotion regulation in understanding how psychological resilience relates to test anxiety in medical students. Resilience-training intervention may be developed to support students encountering anxiety during the exam.