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Year : 2008  |  Volume : 17  |  Issue : 1  |  Page : 46-48 Table of Contents   

A study of exam related anxiety amongst medical students

1 Internee, Armed Forces Medical College, Pune, India
2 Assoc Professor, Department of Psychiatry, Armed Forces Medical College, Pune, India
3 Sc E, Armed Forces Medical College, Pune, India
4 Professor & HOD, Department of Psychiatry, Armed Forces Medical College, Pune, India
5 Assoc Prof, Department of Psychiatry, Armed Forces Medical College, Pune, India

Date of Web Publication13-May-2010

Correspondence Address:
B Pahwa
Internee, Armed Forces Medical College, Pune
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Source of Support: None, Conflict of Interest: None

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Background: The present study focuses on pre-examination anxiety amongst medical students & its personality co-relates. Material & Method : 91 medical students were administered Eysenck Personality Questionnaire to determine predominant personality trait if any and Beck's Anxiety Inventory. Results : There was an increase in anxiety levels prior to exam, more so in females and in students with neuroticism and extraversion temperaments. Conclusion: Anxiety levels increase in medical students prior to exams and are associated with certain personality traits, though the difference is not statistically significant.

How to cite this article:
Pahwa B, Goyal S, Srivastava K, Saldanha D, Bhattacharya D. A study of exam related anxiety amongst medical students. Ind Psychiatry J 2008;17:46-8

How to cite this URL:
Pahwa B, Goyal S, Srivastava K, Saldanha D, Bhattacharya D. A study of exam related anxiety amongst medical students. Ind Psychiatry J [serial online] 2008 [cited 2022 Jul 1];17:46-8. Available from: https://www.industrialpsychiatry.org/text.asp?2008/17/1/46/63064

Medical students are repeatedly subjected to rigorous examinations to check their potential to be a doctor as they have to deal with human life every single day. They have chosen a career which demands not only responsibilities but also ethical and legal liability for other's lives. The onus of this responsibility and sheer volume of syllabus places a medical student under tremendous stress prior to professional exams. This stress may manifest with varying magnitude of anxiety (Kidson and Hornblow, 1982) and decrease in psychological health (Aktekin et al, 2001). Further, test anxiety is associated with lower academic performance (Zeidner, 1990).

The criteria for selection into a medical college are purely academic and not individual personality. All students selected for medical education are exposed to a similar stressful environment in the college, yet all show varied degree of response from anxiety to depression, substance abuse to suicidal ideation. Each individual has his own personality traits based on his inherited genetic component and acquired behavioral trait. Temperament is that aspect of our personality that is genetically based, inborn, there from birth or even before and the other aspect of personality is learned behavior (Eysenck et al 1985). Each individual correspondingly behaves in his own way in a given situation. Studies have established that there is a modest but significant correlation between temperament and academic performance. Results of one such study indicated that conscientious, stable and introverted individual would be more likely to succeed in university-based academic settings and that these variables may account for around 15% of the variance in academic examination performance (Tomas and Furnham, 2003).

This study was planned to identify the personality traits and correlate pre exam anxiety with vulnerable personality traits in medical students.

   Material and Method Top

The study was carried out amongst 1st year MBBS students of a premier medical college of the country. The complete batch of 1st year medical students was informed about the purpose of interview and confidentiality assured. 91 students consented to participate in the study. Students with past history of medical illness were excluded. Socio-demographic data was collected in a specially designed performa. Eysenck Personality Questionnaire (EPQ), a standardized instrument was administered 02 months prior to the exam to categorize the students into 3 predominant personality traits - extraversion, psychoticism and neuroticism. Students not getting categorized with any of the traits as per standard norms served as an inbuilt control of the study group. Beck's Anxiety Inventory (BAI) was administered 02 months prior to the exam, to assess baseline anxiety levels and re-administered 02 weeks prior to the exam to evaluate pre-exam anxiety levels. The data collected was statistically analyzed to assess the co-relation of personality traits with exam related anxiety in medical students.

   Results and Discussion Top

91 medical students were assessed of which 69 were males and 22 females. Standardized norms with a cut off value were used to categorize the 3 predominant personality traits on EPQ. Different norms for males & females are available to remove gender bias. On administering EPQ only 28 students could be categorized in one of the 03 traits and remaining 63 students served as inbuilt control of the population since they did not score above the cut off value for any of the traits.

It was observed that none of the students had severe anxiety at baseline or just prior to exams. However, the number of individuals with moderate anxiety levels increased from 3 at baseline i.e. 2 months before exams to 6, two weeks before exam [Table 1].

The mean of BAI scores at baseline was compared with that prior to exams [Table 2].

Pair t test was applied and the difference was statistically significant (p< 0.05) in that the mean baseline anxiety levels were significantly lower than the mean pre exam anxiety level. Therefore, though the individual didn't shift from mild to moderate levels of anxiety, within the group with mild anxiety there was increase in anxiety levels. Professional examinations are considered to be difficult and more important consequences are attached to successful performance, thus these exams are more likely to be perceived as threatening by the students and greater effect of situation specific anxiety is present (Pablo J et al, 1990). The increase in anxiety didn't reach psycho-pathological proportions warranting specialized intervention & majority of students coped by falling back on their preferred method of relaxation.

The difference in mean baseline and pre-exam anxiety levels is seen more in female than male population, indicating greater increase in anxiety levels amongst females. [Table 3].

This is in agreement with other studies that substantiate presence of sex differences in exam related anxiety, with female students having higher test anxiety than male students (Chapell et al 2005, Eller et al 2006).

The relationship between mean anxiety levels with personality traits was studied [Table 4].

Increase in anxiety levels before exams is observed maximum in those with neuroticism traits, followed by extraversion. Individuals with psychoticism trait have increase in anxiety levels but less than in control population. Sample size of students with a predominant personality trait being small, non-parametric Kruskal Wallis Test was used to determine whether there is significant difference between the three personality traits and also the control in relation to increase in pre-exam anxiety levels. The differences was not significant (p>0.05). It appears that the moody, irritable and excitable nature of a neurotic individual is counter productive for a student's study habit. In the case of extraversion, primary traits namely activity, gregariousness, warmth and excitement are associated with poorer study habits, hence inadequate preparation for exams resulting in increased pre-exam anxiety.

Anxiety manifests with varying symptoms in different individuals [Table 5]. In this study group, most frequently present symptom was 'nervous' (38%), followed by 'fear of worst happening' and 'heart pounding' (55%). Also, frequently present were 'feeling hot', 'unable to relax', 'terrified' or 'scared'. Least common were 'difficulty in breathing' and 'feeling of choking' (13%). None of the students had 'fear of dying'.

   Conclusion and Recommendations Top

There is significant increase in anxiety levels before exams in medical students, especially females. Though there is a trend towards association with neuroticism, there is no statistically significant correlation of increase in mean anxiety levels before exams with the three personality traits evaluated.

It is recommended that susceptible students should be screened with BAI and specialized intervention be offered to those with high anxiety levels. A student counselor would help in guiding students in dealing with pre-anxiety level. Further all students should be encouraged to adopt healthy & effective means of relaxation like yoga, breathing exercises and non-formal counseling.

The students followed various methods of relaxation [Table 6], of which confiding in parents and friends was most common (32%), followed by exploring options and self assessment. Least preferred modes were listening to music (4%) and eating high calorie food (2%). The purpose of asking this open ended question was to ascertain preferred method of relaxation in the current generation of students.[8]

   References Top

1.Chapell MS, Blanding B, Silverstein ME et al (2005). Test anxiety and academic performance in undergraduate and graduate students. J Educ Psychol; 97:268-74.  Back to cited text no. 1      
2. Eller T, Aluoja A, Vasar V, Veldi M (2006). Symptoms of anxiety and depression in Estonian medical students with sleep problems, 23(4): 250-61  Back to cited text no. 2      
3. Eysenck HJ, Eysenck SBG, Barrett P (1985). A revised version of the psychoticism scale. Personality and Individual Differences, 6, 21-29.  Back to cited text no. 3      
4. Kidson M, Hornblow A. (1982) Examination anxiety among medical students: experiences with the visual analogue scale for anxiety. Medical education: 16(5) : 247-50.  Back to cited text no. 4      
5. Mehmet Aktekin, Tata Karaman, Yesin Yigiter Senol, Sukru Erdem, Hakan Erengin, Mustafa Akaydin (2001). Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey. Medical education 35(1): 12-17.  Back to cited text no. 5      
6. Pablo de J, Subira S, Martin MJ, de Flores J, Valdes M (1990). Examination associated anxiety in students of medicine. Acad Med: 65: 706-7  Back to cited text no. 6      
7. Tomas Chamorro - Premuzic, Addrian Furnham, Personality Traits and Academic Examination Performance. Eur J Pers, 17: 237-250.  Back to cited text no. 7      
8. Zeidner M (1990). Does test anxiety bias scholastic aptitude performance by gender and sociocultural group? J Person Assess, 55, 145-60.  Back to cited text no. 8      


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]


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