Decreasing Test-Taking Anxiety in Nursing Students: Recommendations for Nursing Faculty

Saturday, 28 October 2017: 2:35 PM

Catherine C. Razzi, MSN
Frances M. Maguire School of Nursing and Health Professions, Gwynedd Mercy University, Chalfont, PA, USA
Rhonda S. Sullivan, PhD, MSN, MBA
Pressure Ulcer Prevention Team, Molnlycke Health Care, Norcross, GA, USA
Azita Amiri, PhD, MSN
Nursing, University of Alabama in Huntsville, Huntsville, AL, USA
Elizabeth Mackessy-Lloyd, MS, MA
Nursing, Prince George's Community College, Bowie, MD, USA
Tennille Curtis, MSN
Nursing, Jefferson College of Health Science, SW Roanoke, VA, USA


Test anxiety has been described as an individual’s body, mind, and behavior response that stimulates negative feelings about a test or exam. Schools of nursing use test and examination as the primary means of evaluating student learning. In this high stakes environment, students frequently report that test grades do not accurately reflect their preparation or content understanding. Fear and worry about testing also has adverse effects on students ability to concentrate and recall material. Johnson (2014) identified test anxiety as one of the major barriers to student success in nursing education programs.


To identify successful strategies which can be used by nursing faculty to reduce test-taking anxiety in nursing students.

Design and Review Methods

A systematic review in line with PRISMA guidelines.

Data Sources

A literature search was done to identify methods of reducing test anxiety. Databases used were CINAHL (Cumulative Index to Nursing & Allied Health Literature), Cochrane Database of Systematic Reviews, PubMed (Medline), and Ovid Nursing Journals. Key words used included “test anxiety and nursing students”, “test anxiety and students”, “decreasing test anxiety and nursing students”, and “reducing test anxiety and university students”. The applied limits were sources published between 2000 and 2016.


The literature review revealed a gap which highlights opportunities for future research. The body of evidence about general test taking anxiety is large. Conversely, the evidence surrounding test taking anxiety among nursing students is extremely limited. Many of the strategies to reduce test anxiety reviewed proved to be beneficial, while some showed no statistical significance. After reviewing physical, psychological, and sensory intervention strategies, we recommend that nursing faculty consider implementing muscle relaxation, deep breathing, psychological and educational counseling, co-meditation, emotional freedom technique, music intervention and the use aromatherapy. These methods showed the greatest statistical significance in reducing anxiety and were the most feasible for nursing faculty to easily utilize.


The sensory methods, aromatherapy and music therapy, were the most feasible for nursing faculty to implement. They do not require any special training nor additional time prior to the exam to implement. They also present little to no cost to the faculty. With the aromatherapy and the music therapy, the essentials oils and music were easily made available in the classrooms by the faculty.

By incorporating these techniques in faculty development curriculum, nursing faculty will be equipped with the necessary tools to better prepare students and enhance their academic experience. These techniques were efficacious in relieving stress, lowering blood pressures and pulses, and substantially increasing academic performance which all correlate with decreased test anxiety.