Interventional Strategies to Reduce Test Anxiety among Nursing Students: A Systematic Review

Anxiety in Nursing Students during the COVID-19 Pandemic: Systematic Review and Meta-Analysis

OBJECTIVES

To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved.

DESIGN

A systematic review and meta-analysis.

DATA SOURCE

PubMed, CINAHL, Scopus and Web of Science.

BACKGROUND

Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings.

METHODS

A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis.

RESULTS

We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety.

CONCLUSIONS

The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety.

Nurse Certification and Test Anxiety

OBJECTIVE

To determine the relationship between scores on the Westside Test Anxiety Scale (WTAS) and nurse certification rates.

BACKGROUND

Nurse certification is associated with improved outcomes. Understanding intrinsic factors associated with low certification rates including test anxiety could help nurse leaders improve certification rates.

METHODS

This descriptive, correlational study used a convenience sample of 577 RNs with at least 2 years of nursing experience. Participants completed a survey of their demographics and the 10-question WTAS.

RESULTS

Certified nurses were significantly older and had more years of experience. Noncertified nurses had significantly higher scores on the WTAS.

CONCLUSIONS

Facilities working to increase their nurse certification rates may consider adding test anxiety reduction interventions to other levels of support.

What are the thoughts of postgraduate nursing students regarding the 'Applied Scientific Research' course? A qualitative study on achievements, benefits, challenges, and suggested solutions

OBJECTIVE

This research aimed to examine students' emotions, opinions, and suggestions regarding the "Applied Scientific Research" course.

METHOD

The study was conducted in a province in eastern Turkey between June and July 2023. Data were collected from 9 postgraduate students attending the "Scientific Research" course at a university's Institute of Health Sciences using a 'Descriptive Information Form' and a 'Semi-Structured Questionnaire'. Content analysis was employed for the qualitative data evaluation.

RESULTS

The participants' ages ranged from 25 to 32. Six participants were female, five were academicians, and five were doctoral students. Six participants had taken a statistics or research course before the scientific research course. Additionally, seven had attended scientific conferences, five followed a scientific publication regularly, five had conducted scientific research before, and five had not published scientific research before taking the course. Through the analysis of data obtained from participant interviews, three themes, namely "Effects of Activities in the Course," "Reasons for Recommendations and Preferences," and "Outcomes of the Course," were identified. Six sub-themes and 18 codes were generated, including "Most Challenging Activity," "Least Challenging Activity," "Recommendations for the Course," "Reasons for Choosing the Course," "Contributions of the Course," and "Feelings Towards the Course."

CONCLUSION

The research results indicate that students improved their skills in conducting scientific research, writing articles, and getting published after taking the course. Furthermore, the course evoked positive feelings in students and increased their perceived competence.

Prevalence of test anxiety and its determinants among nursing students in Selangor, Malaysia

The current education system significantly emphasizes tests and evaluations as crucial factors in determining a student's future career path. It has been shown that nursing students have moderate to high levels of Test Anxiety (TA), which results in decreased academic performance, low self-esteem, and an inability to complete the program and pursue a career in nursing successfully. This study aimed to determine nursing students' level of TA and its relationship with demographic characteristics. Four hundred twenty-one nursing students at seven private universities and colleges in Selangor participated in this cross-sectional study. The level of TA was measured using the TA Inventory (TAI). A total of 62.5% of the respondents had mild TA, 25.4% had moderate TA and 2.1% had severe TA. There were significant relationships between TA level and household income (χ2 = 6.70, p = 0.035) and ethnic groups (F (3,417) = 5.20, p = 0.002) where Chinese and Indians are protective from TA compared to the Malays and other ethnic groups and high anxiety was significant in the Ringgit Malaysia (RM 3000) and below group. The study's findings indicate that a significant percentage of nursing students involved in the research had mild to moderate levels of test anxiety (TA) and there is a significant association between TA and demographic characteristics. The results indicate the importance of early identification of TA and the need for interventions to overcome TA to ensure they are emotionally, physically, and academically successful.

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.