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Exam anxiety for medical students: A literature Review



Exam anxiety for medical students: A literature Review


It is well known that medical education is more stressful than other professional courses. A high proportion of medical students experience and suffer from exam-related anxiety. Although it is normal for a student to experience a certain degree of anxiety during or prior to the exam, high levels of anxiety can negatively impact his or her performance. In such cases, anxiety is a sign that the student has a problem. Klausenitz, Hacker, Hesse, Kohlmann, Endlich, Hahnenkamp, and Usichenko (2016) describe exam anxiety as a type of situational anxiety that is especially common among university students. According to these researchers, it produces undesirable mental and physiological symptoms and can negatively influence a student’s academic performance.

High levels of exam anxiety have been found to interfere with the ability of a student to prepare for the examination. Researchers have also found that there are several factors that influence the level of anxiety that students develop. They include their examination strategy (Browne & Cantelo, 2017), effort and reward imbalance (Hahn, Kropp, Kirschstein, Rücker, & Müller-Hilke, 2017), and an individual’s level of emotional intelligence (Ahmadpanah, Keshavarz, Haghighi, Jahangard, Bajoghli, and Sadeghi (2016). The information presented by these researchers indicates that difficulties in recalling information or remembering key points coupled with lack of confidence, poor time management, and ineffective study techniques heighten the level of anxiety among students. There are also a number of demographic variables that may influence the level of exam anxiety among students. They include their gender, age, marital status, ethnicity, and economic status. Among medical students, extensive curricular, the frequency of evaluation, enormous contents, voluminous textbooks, and pressure to score good marks have been identified as the main factors that contribute to exam anxiety. Since exam anxiety negatively impacts academic performance of medical students, there is a need to identify issues related to it in order to develop a plan that will help these learners to overcome this phenomenon.

Trend-exam anxiety for medical students: A literature Review

Although it is normal for a student to experience exam anxiety, numerous studies focusing on medical students’ exam anxiety have been conducted in recent years. Given the extensive curriculum, enormous content, and rigorous examinations that these students are subjected to, the motive of these studies is to determine the impact of this type of anxiety on students and identify possible ways through which the affected individuals may be helped. The findings obtained indicate that medical students experience exam-related anxiety throughout their study period. According to some of the latest studies, 60% of medical students are affected by this type of anxiety. While most researchers have focused on presenting facts about exam anxiety, others have conducted studies that seek to evaluate differences in exam anxiety levels between the genders.

Hypothesis-exam anxiety for medical students: A literature Review

Higher emotional intelligence, effort/reward balance, effective examination strategy, and lower exam anxiety are related. Female medical students exhibit more intense symptoms of exam anxiety than their male counterparts.

Criteria-exam anxiety for medical students: A literature Review

Ten different articles relating to exam anxiety among students were studied to gain a better understanding of the issue at hand. All these articles were published between 2016 and 2018. In eight out of the ten studies discussed in the articles, the researchers examined medical students. The two remaining sources were not specific to medical students but studied exam anxiety among students in general. One of them examined the relationship between the level of exam anxiety and emotional intelligence among learners while the remaining source explored different emotion regulation strategies used by learners in two different settings: exam-related context and non-exam related. The studies examined participants from different countries that included France and the US. The number of participants was not constant across the studies. However, one study had the lowest number of participants at ten. On the other hand, the study with the most participants surveyed 10,985 medical students.

Literature Reviewed

First Group of Studies

Second Group of Studies

Third Group of Studies


First Similarity

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First Difference

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Further Research and Studies




Ahmadpanah M, Keshavarz M, Haghighi M, Jahangard L, Bajoghli H, Sadeghi Bahmani D, . . .   S. (2016). Higher emotional intelligence is related to lower test anxiety among

students. Neuropsychiatric Disease and Treatment,2016(Issue 1), 133-136.

Bäumler, Klausenitz, Hesse, Hacker, Hahnekamp, & Usichenko. (2016). Auricular acupuncture

for pre-exam anxiety in medical students: A prospective observational pilot

investigation. Deutsche Zeitschrift Fuer Akupunktur,59(3), 30-31.

Browne, C., & Cantelo, J. (2017). Exam anxiety: Does examination strategy play a role? Medical

 Teacher, 39(6), 668.

Fond, Bourbon, Auquier, Micoulaud-Franchi, Lançon, & Boyer. (2018). Venus and Mars on the

benches of the faculty: Influence of gender on mental health and behavior of medical        students. Results from the BOURBON national study. Journal of Affective

            Disorders, 239, 146-151.

Guraya, Salman Y., Guraya, Shaista S., Habib, Fawzia, Alquiliti, Khalid W., & Khoshhal,

Khalid I. (2018). Medical students’ perception of test anxiety triggered by different

assessment modalities. Medical Teacher, 40(Sup1), 49-55.

Hahn, H., Kropp, P., Kirschstein, T., Rücker, G., & Müller-Hilke, B. (2017). Test anxiety in

medical school is unrelated to academic performance but correlates with an effort/reward

imbalance. PloS One, 12(2), E0171220.

Klausenitz, Hacker, Hesse, Kohlmann, Endlich, Hahnenkamp, & Usichenko. (2016). Auricular

Acupuncture for Exam Anxiety in Medical Students-A Randomized Crossover

Investigation. PloS One, 11(12), E0168338.

Rottweiler, A., Taxer, J., & Nett, U. (2018). Context Matters in the Effectiveness of Emotion

Regulation Strategies. AERA Open, 4(2), 13.

Schultz, Altenstein, Klausenitz, Hesse, Hacker, Petersmann, . . . Usichenko. (2017). Auricular

acupuncture vs. progressive muscle relaxation and no intervention for exam anxiety in

medical students – A randomized controlled trial with non-randomized condition. Brain

            Stimulation, 10(2), 431.

Stojanovic Goran, Vasiljevic-Blagojevic Milica, Stankovic Bratislav, Terzic Negra, Terzic-

Markovic Dragana, & Stojanovic Dusan. (2018). Test Anxiety in Pre-Exam Period and

Success of Nursing Students. Serbian Journal of Experimental and Clinical Research, 19(2), 167-174.