Nursing Students Perception on the Effects of Relaxation Methods to Decrease Test Anxiety

Monday, 18 November 2019: 9:00 AM

Laraine Amoia-Watters, EdD
Catherine C. Razzi, MSN
Frances M. Maguire School of Nursing and Health Professions, Gwynedd Mercy University, Gwynedd Valley, PA, USA

Test anxiety has been defined as the response of an individual’s body, mind, and behavior that stimulates negative feelings about a test or exam (Chaniotis, 20013). Many nursing faculty can attest to the numerous accounts of test anxiety seen in their classrooms across the country. Not only is nursing faculty concerned about its vast prevalence but also how it can affect the nursing students’ performance. Many students report that test grades to not adequately reflect their preparation for testing (Duty, 2016). Students also report that fear and worry about testing had adverse effects on their ability to concentrate and recall material (Duty, 2016). Johnson (2014) identified test anxiety as one of the major barriers to student success in nursing education programs. This barrier serves to reduce graduation rates and can prevent students from entering the workforce (Johnson, 2014).Test anxiety among nursing students has been well documented (Timmins, Corroon, Byrne, Mooney, 2011). Cognitive function as well as somatic complaints due to anxiety can lead to poor test scores (Lilly, 2014). Research has shown a direct correlation between test anxiety and academic performance in nursing students.

Methods to alleviate anxiety among these students must be studied in order to increase test performance and student success. As nursing faculty, we know that our students have many stressors, test taking being one of them. While some stress may actually be beneficial in motivating students to prepare for tests, high levels of anxiety can impede their performance. If anxiety prevents students from performing at their optimal potential, then as faculty, one of our goals should be to help students decrease their stress level. Preparing nursing students to be successful test takers is important throughout their academic career. And essentially, the end goal is not only to prepare these students to be successful on the NCLEX but to also become prudent, competent nurses that provide safe, quality care to our communities.

Evidence has demonstrated that several methods are successful in reducing test anxiety in nursing students. Physiological methods, including deep breathing meditation has been shown to reduce test anxiety. 7 Aroma therapy has been studied and found to be an effective method for reducing test anxiety (Johnson, 2014). Oils can not only have a positive influence on decreasing anxiety prior to nursing examinations, but can improve the student’s well-being (America Nurse Today, 2018). Music as an auditory intervention has been studied and found to have positive effects on anxiety as well as on vital signs. One study assessed blood pressure and heart rate before, during, and after the music intervention, as the physiologic measure of anxiety (Lilley, 2014).

The above methodologies of deep breathing, aromatherapy, and music therapy were chosen as interventions because they were based on existing evidence and were the most feasible for faculty to implement. No special training or time allotment is required, and cost is minimal.

The purpose of this evidence based intervention was to determine student’s perception on various relaxation methods used to decrease their test anxiety. First semester sophomore students enrolled in a baccalaureate nursing program were used to evaluate the methods. There were 212 students enrolled in the class and the same intervention was used for all students prior to examinations. Utilized relaxation methods included: Test 1- a two minute meditation video, Test 2-aromatherapy using pure essential lavender oil and relaxation music and video Test 3-aromatherapy using pure essential lavender oil, relaxation music and video, darkened room, and two deep breaths.

A questionnaire inviting students to share their feedback on their perception of the implemented relaxation methods was sent to the students. Responses were gathered to establish if students felt that the relaxation methods helped, hindered, or had no effect on their test anxiety. Questions were specific to each attempted method to ascertain if one method was felt to have more of an influence on decreasing pre-test anxiety than another. Finally, a question was included to elicit student opinions regarding their thoughts on including relaxation interventions prior to nursing examinations.

Although responses varied in terms of specific relaxation methods, most responses evenly indicated that students either felt the methods helped or had no effect on their anxiety prior to the test. However, the majority of students felt that relaxation methods should be utilized prior to testing in the nursing program. The results to our perception survey were contradictory. If majority of students felt that relaxation methods should be utilized, results on the other questions would support the use of specific methods more fully. Our perception survey results indicate the need for further study. Perhaps using a mixed method and large sample size would produce more conclusive results. Additionally, the option for open ended response should be included to provide the researcher with a better understanding to the rationale behind specific responses.

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