Page 1 of 11
Journal for Studies in Management and Planning
Available at http://internationaljournalofresearch.org/index.php/JSMaP
e-ISSN: 2395-0463
Volume 01 Issue 08
September 2015
Available online: http://internationaljournalofresearch.org/ P a g e | 104
Examination Related Anxiety and its Management
amongst Medical Students.
Huda Naim1, Wajeeha Ali Khan 2, Muhammad Hasham Naim 3, Dr. Masood Jawaid4
1-2 Final Year MBBS, Dow Medical College, Dow University of Health Sciences Karachi.
3 Third year, Dow Medical College, Dow University of Health Sciences Karachi
4 Consultant General Surgeon, Darul Sehat Hospital, Karachi
Email ID: huda_naim@live.com; Email ID: jiakhan2005@hotmail.com;
Email ID: hasham_naim@live.com ; Email ID: masood@masoodjawaid.com
ABSTRACT:
Objective:
To assess examination related anxiety
amongst medical students by test anxiety
inventory and to determine the factors
contributing and management of exam
anxiety by medical students.
Methods:
A cross sectional study using structured self- administered questionnaire and an online
questionnaire was carried out over four
weeks in May 2013 at Dow Medical College
students of the different years of study.
Survey questionnaire consisted of Standard
Test Inventory to measure intensity of exam
anxiety, questions regarding Factors
Causing Exam Anxiety and Management
techniques to overcome Exam anxiety. The
data was analyzed using SPSS 16.0.
Result:
A total of 300 filled in the questionnaire.
There were 262 (87.3%) female and
38(12.7%) male students. The analysis
revealed that the major factors contributing
to exam anxiety was extensive course load
177 (59%) whereas 98 (32%) students
thought that inadequate rest during exams
contributed to exam anxiety. 128 students
(42.7%) reported sleep disturbances before
the exam, 96 (32%) said that they could not
relax physically.172 (57.3 %) students felt
that praying was the best way to combat exam
anxiety, 119 (39.7%) maintained a positive
attitude.
Conclusion:
This study indicates moderate prevalence of
exam anxiety amongst students of Dow
Medical College (DMC) and also highlights
Page 2 of 11
Journal for Studies in Management and Planning
Available at http://internationaljournalofresearch.org/index.php/JSMaP
e-ISSN: 2395-0463
Volume 01 Issue 08
September 2015
Available online: http://internationaljournalofresearch.org/ P a g e | 105
factors such as extensive course load, lack of
exercise and long duration of exams which
contribute to Exam Anxiety and techniques
such as praying and maintaining a positive
attitude to reduce anxiety.
Keywords: medicalstudents; anxiety;prayer;
relaxationtherapy; examination.
INTRODUCTION:
According to the American Psychiatric
Association anxiety disorders are the most
common of emotional disorders manifesting
as overwhelming panic and fear,
uncontrollable obsessive thoughts, painful,
intrusive memories and recurring nightmares.
Untreated anxiety disorders can push people
into avoiding situations that trigger or worsen
their symptoms. People with anxiety
disorders are likely to suffer from depression,
and they also may abuse alcohol and other
drugs in an effort to gain relief from their
symptoms, job performance, school work,
and personal relationships can also suffer1
.
Examinations provoke anxiety for some
students. They may worry about an exam for
days before it is to take place or during exam,
they may experience negative thoughts and
unpleasant physical symptoms which prevent
them from performing to the best of their
ability2
. Inadequate rest, insufficient physical
activity, poor nutrition and lack of time
management are found to be the contributing
factors leading to exam anxiety as reported
by many authors3
. Some students panic
excessively that they are unable to prepare for
the exam, cannot perform well in the
examination, and are unable to answer the
questions asked in the exam despite knowing
the answers. Anxiety disorders are prevalent
in the students and can have a destructive
influence on students’ personality.
Medical education is generally regarded as
stressful and demanding, subjecting students
to enduring distress and depression. There are
four main areas of reported stresses which
can contribute to exam anxiety including life
style issues, lack of required information,
studying style and psychological factors.
The current teaching system implemented at
Dow Medical College (DMC) affiliated with
Dow University of Health Sciences is a new
system of integrated teaching comprises of
applied knowledge in which the students are
taught basic subjects in the usual manner
which is later on followed by clinically
oriented teaching sessions so as to explain the
clinical application of the basic knowledge. 4
Each module ranges for 4-8 weeks which is
Page 3 of 11
Journal for Studies in Management and Planning
Available at http://internationaljournalofresearch.org/index.php/JSMaP
e-ISSN: 2395-0463
Volume 01 Issue 08
September 2015
Available online: http://internationaljournalofresearch.org/ P a g e | 106
immediately followed by a module
examination. Upon completion of all the
modules for a particular semester, the
semester examination is held which includes
theory papers comprising of theory question,
Objective Structured Practical Examination
(OSPE) diagrams and Case Based Scenarios.
The last exam is an unobserved OSPE as
known as the viva examination.
The aim of this study was to determine the
factors causing examination anxiety amongst
medical students, the behavior of students
before an examination. We aimed to
investigate students’ opinion regarding the
purpose of examination and whether it served
as a means of academic excellence. We also
tried to determine the relaxation techniques
practiced by students that helped them
control their anxiety and focus on their
examination.
Methods:
A cross sectional study using structured self- administered questionnaire and an online
questionnaire was carried out over four
weeks in Dow Medical College using sample
size of 300 students of the different years of
study, 60 each from first year to final year.
Students were recruited on a voluntary basis
after informed consent Duration of study was
four weeks in May 2013. Students were
excluded from the study if they declined
participation, or if the student was in the first
year of MBBS with no prior medical exam
experience, or if the questionnaire was
returned incomplete.
The exam anxiety was analyzed using
Standard Test Inventory. The questionnaire
was divided in to five parts. The first part of
the questionnaire explained the purpose of
the study and the need for conduction of the
study. The first part all questioned the
responders their name (if they wished to
answer), their gender, age and year of study.
The second part of the questionnaire
questioned their mental state and physical
expression of exam anxiety before and during
an exam. The third part of the questionnaire
assessed the students’ approach and opinion
regarding the importance of examination
results in the development of their self-image
and how their family and peers viewed them.
It was also asked if students thought that their
university exams could help them achieve
their goals and the results predicted their
future success and security. The fourth part of
the questionnaire assesses students’ views
regarding their preparation, the factors
causing exam anxiety and their performance
