Journal of Nursing Research and Practice

Sign up for email alert when new content gets added: Sign up

Reezena Malaska*
Trauma Critical Care RN, USA
*Correspondence: Reezena Malaska, Manager, Trauma Critical Care RN, USA, Tel: 757-416-2416, Email: [email protected]

Received Date: May 05, 2018 / Accepted Date: May 14, 2018 / Published Date: May 28, 2018

Citation: Malaska RH. Instructor: Nursing student, how to create a culture conducive to a positive testing environment for students with test anxiety. J Nurs Res Pract. 2018;2(2):30-31.

This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact [email protected]

Test anxiety is a common condition suffered by many nursing students especially those faced with the everyday challenges of juggling a job, studies, and raising a family, in some situations single parent family. What is test anxiety and why is it important for nursing instructors to be self-aware of their own behaviors and actions and the impact on nursing students? What are the environmental factors that affect test anxiety? What is the most effective way to create a culture conducive to a positive testing environment? As a nursing instructor for the past seven years, the experience, have been taught to many students in the Bachelor of Sciences in Nursing (BSN), Associate Degree in Nursing (ADN) and more recently the Licensed Practical Nursing (LPN) programs and the issues are all similar. It gave an opportunity to study the problem closely because of the suffering with test anxiety throughout the formative schooling and in nursing school. In the duration many articles were read and a self-help behavioral approach to curb the anxiety was used and luckily external help was not needed. This editorial will explore strategies that can be utilized to help the individual student with test anxiety to be successful in tests and exams [1].

Experts define test anxiety as the level of anxiety that prevents a student from performing well on exams. This does not necessarily mean the student is not prepared, it means the student because of their anxiety level are unable to perform at their optimum. Simply put, test anxiety is a form of mental paralysis that manifests in acute loss of memory thus inhibiting the student from completing exams successfully. This is a common way of measuring students’ knowledge that demonstrates to instructors what they have learned. According to experts, a certain degree of anxiety is necessary for best performance. However, test anxiety is a higher degree of anxiety that carries an emotional component including fear which overcomes the individual thereby affecting their behavior and subsequent performance. This emotional state carries with it physical symptoms including headache, gastrointestinal upset (nausea, diarrhea), shortness of breath, rapid heart rate, and can lead to panic attacks, all of which can be related to. The physical and emotional symptoms make it difficult for the individual to concentrate adding fuel to an already difficult emotional situation. Managing the complexities of test anxiety requires a multi-faceted approach [2,3].

The steps associated with the nursing process were used as a guide to help the students, similar to the nursing process that was used in caring for patients. To recap, this includes assessment, planning, implementation, evaluation, and re-evaluation. Identifying test anxiety and assessment of the individual is the first step in the process similar to completing an admission assessment when a patient is admitted. Ask the questions about study habits, study skills, the environment, priorities, distractions such as cell phones, taking calls while studying, stresses in their home and personal life, health, and time management. These are only some of the questions one can ask. Listening to the student is the single most important aspect of the process before developing an action plan. Active listening is the most important part of effective communication and involving the student in the decision making is the second most important. Essentially, we should examine the structures, process, and outcomes [4].

Action plans must be behavior based, realistic, measurable, and individualized to the student’s needs. The focus should be on changing the behaviors for better outcomes. This includes incorporating in the plan, relaxation techniques, study skills, reading for short periods and when one is saturated and has lost focus, to walk away and concentrate on doing an unrelated task in order to rest the brain. The student’s buy-in is essential for the plan to work. Now that the action plan is in place, we must take this a step further. The testing environment must be positive which means the person proctoring the exam must present a positive attitude, encouraging behavior. Utilize relaxation techniques to coach the student with test anxiety (takes only a few minutes) just prior to the exam is highly recommended and beneficial in relaxing the student. When our minds are calm and clear we are able to perform at our optimum. When we think negatively we tend to act negatively and unknowingly it reflects in our non-verbal behavior observed by the student whom is already highly anxious (anecdotal accounts). The exam proctor’s actions and non-verbal behaviors must match the spoken words. Employ humor, some fun enjoyable discourse or human caring activities for ten to fifteen minutes with students to relieve their stress prior to the exam. Get them to laugh or share a funny personal story or reflection from my nursing school days of three decades ago so they can laugh, relieve the anxieties, rewire their thinking to refocus on the task at hand. Reflective practice is a great strategy in supporting student learning [5,6].

Therapeutic communication is essential to promote a positive energy in the testing environment. Synergy is essential in creating a culture conducive to a positive testing environment. These strategies were implemented (tested) three times in two and a half weeks on one student and each time based on personal interview, feedback from the student, it worked. Caring practice and mindfulness must be employed when teaching, coaching and helping students to reach academic success. It was believed that the teaching with a heart by role modeling, using Watson’s Human Caring Science practices to inspire and encourage the future generation of nurses, teaching in a caring therapeutic positive environment. Give students the tools to empower and strengthen their internal resolve to overcome test anxiety and whatever else they may be struggling with. Take that bit of extra time, some patience, and authentic effort to make a difference one person at a time, one day at a time. There is an art and science to teaching.