Journal of Nursing Education

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Test Anxiety in Master's Students: A Comparative Study

Ruby G Barnes, EdD, RN

Abstract

ABSTRACT

Evaluation events are major problems for graduate students in nursing. The purpose of this study was to determine the correlation of test anxiety before and cognitive interferences during a comprehensive examination. The sample (N=54) consisted of two groups of students (Group I, N=SO and Group II, N=24) in a master's program at a state university. Data were collected using three questionnaires: To measure general test anxiety, the Test Anxiety Questionnaire (TAQ) by Sarason was used; the Pre-Examination Questionnaire (PEQ) by Morris, Davis, and Hutchings (1981) was used to measure pretest anxiety; and to identify cognitive interferences during the examination, the Cognitive Interference Questionnaire (CIQ) by Sarason and Stoops (1976) was used. Findings revealed positive correlations between the two groups of students' general test anxiety and their cognitive interferences about evaluative outcome of the examination. Positive correlations were found also between the two groups' general test anxiety and their pretest anxiety immediately prior to writing the examination. No significant relationships were found between the students' performance rankings on the examination and their test anxiety.

Abstract

ABSTRACT

Evaluation events are major problems for graduate students in nursing. The purpose of this study was to determine the correlation of test anxiety before and cognitive interferences during a comprehensive examination. The sample (N=54) consisted of two groups of students (Group I, N=SO and Group II, N=24) in a master's program at a state university. Data were collected using three questionnaires: To measure general test anxiety, the Test Anxiety Questionnaire (TAQ) by Sarason was used; the Pre-Examination Questionnaire (PEQ) by Morris, Davis, and Hutchings (1981) was used to measure pretest anxiety; and to identify cognitive interferences during the examination, the Cognitive Interference Questionnaire (CIQ) by Sarason and Stoops (1976) was used. Findings revealed positive correlations between the two groups of students' general test anxiety and their cognitive interferences about evaluative outcome of the examination. Positive correlations were found also between the two groups' general test anxiety and their pretest anxiety immediately prior to writing the examination. No significant relationships were found between the students' performance rankings on the examination and their test anxiety.

Introduction

A major problem encountered by graduate students in nursing and their faculty is the students' reactions to evaluation events. The comprehensive examination is a particularly troublesome evaluative exercise for master's students. However, there are marked differences in students' reactions to this major examination. Some students become almost paralyzed and appear preoccupied by selfdoubt and fear of failure and its consequences. Other students react as accolade-seekers and approach this examination with confidence. Sarason (1978) notes that it is important to identify the cognitive events that influence these behaviors and the personal meaning an evaluative event has for a student. This study examined test anxiety before and cognitive interference during the comprehensive examination between two groups of students in a master's program in nursing.

Review of Theoretical and Empirical Literature

Recent theories of test anxiety support the notion that the major effect of anxiety in an evaluative event is as an interfering variable. Test anxiety is viewed as a proneness to emit self-centered interfering responses when confronted with evaluative situations. In evaluative situations high anxiety levels in students produce task-irrelevant responses that compete and interfere with task-relevant responses (Sarason, 1972; Speilberger, Anton, & Bedell, 1976; Wine, 1971). Wine (1971) contends that:

The highly test-anxious person divides his attention between self-relevant and test-relevant variables, in contrast to the low-test-anxious person who focuses his attention more fully on the task (p. 92).

Based on a factor-analytic investigation of the Test Anxiety Questionnaire by Sarason (1958), Liebert & Morris (1967) proposed two major components of test anxiety - worry (W) or cognitive concerns, and emotionality (E) or autonomie arousal, and devised an evaluative W and E scale. This distinction has stimulated many studies about test anxiety in undergraduate college students and in high school students. Findings reported by Doctor and AItman (1969), Morris and Liebert (1970), and Spiegler, Morris, and Liebert (1968) indicate that W scores are significantly and negatively correlated with students' ratings of pre-examination performance expectancies. E scores are not related to performance expectancy. Worry, then, requires more of the high-test-anxious students' attention and is more likely to cause a decrement in performance than is emotionality.

From a review of the literature on Liebert and Morris' two-component distinction, Morris, Davis and Hutchings (1981) concluded that the inverse relationship between anxiety and various performance variables under appropriate conditions is attributable primarily to the worryperformance relationship. Studies by Culler and Holahan (1980), Kirkland and Hollandsworth (1979), Lin and McKeachie (1970), and Whittmaier (1972) documented that high-test-anxious students have lower academic ability and poorer study habits than low-test-anxious students. The high-test-anxious student then may experience a double bind, if anxiety produces poor performance and poor ability produces anxiety. Using the information process model, Benjamin, McKeachie, Lin and Holinger (1981) compared high-, medium-, and low-test-anxious students and found that high-test-anxious students had problems in encoding and organizing information and in retrieving that information. Thus, worry reported by test-anxious students may be due to the lack of knowledge of content rather than to personality characteristics.

Treatment procedures for test-anxious students have been more effective in alleviating worry than in reducing emotionality. The performance measure, however, is the crucial variable accounting for either positive or negative results. Positive results were found more often when course grades and grade point averages were used than when anagrams and digit symbols were the measures (Colley & Spiegier, 1980; Deffenbacher & Dietz, 1978; Deffenbacher, Mathis, & Michaels, 1979; Goldfried, Linehan, & Smith, 1978; Kaplan, McCordi, & Twitchell, 1979; Kirkland & Hollandsworth, 1980; Thompson, Griebstein, & Kuhlenschmidt, 1980).

The few reported studies on test-anxiety in nursing students document inverse relationships between the interfering effect of anxiety and cognitive outcomes. In exploring the cognitive learning and anxiety that occurred in registered nurses in Continuing Education Unit Courses that were both CEU-contingent and CEU-noncontingent, Carter and Mills (1982) found that test anxiety adversely affected post test scores in two groups of registered nurses, but it improved the post test performance in one of two control groups. In a convenience sample of nursing students, Hubert and Alien (1985) investigated the relationship of social support to educational outcomes and found a significant inverse correlation with test anxiety, grade point average, and National Council Licensure Examination (NCLEX-RN) results. Sobol's findings (1978) supported the prediction that level of self-actualization is a factor in the differential perception of evaluative events.

Based upon the theoretical evidence, two assumptions undergirded this study: a) test anxiety is comprised of two conceptually distinct components, worry and emotionality; and b) worry associated with test anxiety will impair the quality of performance- Thus, it is expected that the comprehensive examination will place the master's students in a divided-attention situation and have a deleterious effect on their performance.

Hypotheses

The following hypotheses were tested:

1. There is a positive correlation between graduate students' general test anxiety and their test anxiety immediately prior to writing a comprehensive examination.

2. There is a positive correlation between graduate students general test anxiety and their cognitive interference during the completion of a comprehensive examination.

3. There is a positive correlation between graduate students' pre-test anxiety and their cognitive interference during the completion of a comprehensive examination.

4. Graduate students' general test anxiety will be related significantly to their performance rankings on the comprehensive examination.

5. Graduate students' cognitive interference during the comprehensive examination will be related significantly to their performance rankings on the examination.

Method

Sample: The population of this two-group comparative study consisted of 54 graduate students in a master's program in nursing at a state university. The two groups consisted of students who completed the comprehensive examination as a requirement for the master's degree in the spring of 1984 (Group I, N=30) and in the spring of 1985 (Group II, N=24). All students taking the examination had completed more than two thirds of the required course work in a program of studies related to either nursing administration or nursing education. Before being asked to participate in the study students were informed of the study purposes and assured anonymity. There were four black students in each of the two groups and one male student in Group I. The mean age was 34.12 years in Group I and 38.17 years in Group H. The mean grade point average was 3.7 for Group I and 3.8 for Group II.

Instruments: After consent was obtained from the School of Nursing Human Subjects Review Committee, three instruments were administered to the two-group study sample: The Test Anxiety Questionnaire (TAQ), the PreExamination Questionnaire (PEQ), and the Cognitive Interference Questionnaire (CIQ). The students' completion of the questionnaires was considered informed consent. Their permission was obtained also to collect demographic data from the school's academic records.

The Test Anxiety Questionnaire (TAQ) developed by Sarason (1958, 1978) consists of 37 true-false items designed to measure the worry (W) and emotionality (E) components of anxiety. Sarason established a test-retest reliability coefficient of .87 for intervals of several weeks. In 1975 Wagaman, Cormier, and Cormier used the TAQ and reported a test-retest reliability of .87 for 283 male and 237 female undergraduate students.

The Pre -Examination Questionnaire (PEQ) was developed by Morris, Davis and Hutchings in 1981 and consists of 10 statements: Five statements relate to worry (W) and five are about emotionality (E). Subjects rate their present thoughts on a 5-point scale from 1 (The statement does not describe my present condition.) to 5 (The statement describes my condition very well.).

In selecting the five worry items and the five emotionality items, the authors used the factor-analytic statistic and found correlations (following oblique rotations) of .23, .24 and .37 in three samples of students. In the third sample, the internal consistencies of worry and emotionality scales were .81 and .86, respectively. The sum of the five worry items correlated .48 (df = 221) with the sum of the five emotionality items. Garden (1979) and Parks (1980) administered the worry-emotionality subscales to two groups of college students in course examination settings, and for the subscales reported r(57) = .43, and r(36) = .41, respectively. In both studies, W and E were unrelated to test performance.

The Cognitive Interference Questionnaire (CIQ) developed by Sarason and Stoops (1976) consists of 11 items which give a measure of cognitive interference on a 5- point scale from 1 (never occurred) to 5 (occurred very often). An example is, "I thought about my level of ability." One single item is included also and requests the student to circle the number on a 7-point scale from 1 (not at all) to 7 (very much) which best represents the degree the mind wandered during the examination. Sarason and Stoops, in testing hypotheses about performance and cognitive process, illustrated two significant factors in analysis of cognitive interference scores - test anxiety (p < .001) and test anxiety times conditions (p < .05). The two significant factors were reported also for the single item, mind wandered.

For the present study, one untested item was appended to the CIQ. The students were asked to indicate on a 7-point scale from 1 (not at all) to 7 (very much) the degree evaluative outcome of the comprehensive examination increased their thought interference during the examination.

Procedure: Data were collected for Group I (N= 30) in Spring 1984 and for Group II (N=24) in Spring 1985. The three questionnaires used in data collection were each administered at one of three time periods.

In January 1984, 46 students completed the TAQ, which gave a measure of those students' general test anxiety (GTA). Ofthat number, 30 students (Group I) met the study criteria in April 1985, and they completed the scheduled comprehensive examination. Prior to writing the examination, these students completed the PEQ, giving a measure of their pretest anxiety. To identify cognitive interferences (CI) during the examination, the students completed the CIQ immediately after the examination.

Students in Group II (N=24) completed the TAQ in January 1985. Three months later, in April 1985, these students completed the PEQ prior to their writing the comprehensive examination. The CIQ was administered immediately following their writing the examination.

Data Analysis: To test the correlation between the two groups' test anxiety and their cognitive interference, the Kendall Taub Correlation Coefficient was selected in analysis of data related to hypotheses 1, 2, and 3. This statistic is most conservative in testing the significance of ordinal data and in considering all tied ranks as error (Shelley, 1984, pp. 197 & 199). To increase the statistical power of Kendall's Taub, combined group data were tested, also.

In testing hypotheses 4 and 5, the one-way analysis of variance (ANOVA) was used to determine whether there were significant relationships between the two groups' GTA scores and their performance rankings on the examination and between their CI scores and performance rankings. The .05 confidence level was established.

Results

Equivalence of Groups: Ties or similar means, variances, and ranges are shown for three score distributions for the two groups of students - general test anxiety (GTA), pretest anxiety (PTA), and cognitive interference (CI) (Table 1). General test anxiety distributions of Group I, x = 16.52, SD = 5.33, and Range 7-27, and Group II, ? = 16.52, SD - 5.06, Range 6-25, were tied or equivalent. Similarly, the two groups did not differ in total score distributions with respect to pretest anxiety, and to cognitive interference. For the purposes of this study, the two groups of students were considered equal in score distribution characteristics.

Jesting the Hypotheses: fendali Tau correlation Coefficient: Hypothesis 1, there is a positive correlation between graduate students' general test anxiety and their test anxiety immediately prior to writing the comprehensive examination, was supported. Table 2 depicts Kendall Taub correlations between general test anxiety and pretest anxiety for the two groups of graduate students as measured by the TAQ and PEQ. When Group I and Group II scores were analyzed separately, there were no significant correlations between students' general test anxiety and their pretest anxiety immediately prior to writing the comprehensive examination. Thus, the PTA two-component distinction, worry and emotionality, did not correlate significantly, either positively or negatively, with GTA (Table 2). When the two groups were analyzed together, however, the GTA and the PTA cognitive (worry) components were correlated significantly. Students with higher scores on general test anxiety tended to show higher pretest worry scores.

In Hypothesis 2, to test the correlations between the students' general test anxiety and their cognitive interferences during the completion of the comprehensive examination, Groups I and II were first studied separately. In contrast to Group II, GTA in Group I was significantly correlated (Tau .4602) with the degree to which students perceived that the evaluative outcome of the examination increased their interfering thoughts while writing the examination. Significant correlations were not found between GTA and CI thought (Th) scores or between GTA and mind wandering (MW) scores in either of the two groups.

Combined group scores were used to explore the sensitivity between all students' general test anxiety and their cognitive interference while writing the examination. Students' perceptions of the degree to which evaluative outcome (EO) of the examination increased their cognitive interferences during the examination again correlated significantly in a positive direction (Tau .3990). Table 3 presents these data. Hypothesis 2 was thus supported, based upon the significant positive group and combined correlations.

Table

TABLE 1MEANS, STANDARD DEVIATIONS AND RANGES FOR GROUPS I AND Il ON GENERAL TEST ANXIETY, PRETEST ANXIETY, AND COGNITIVE INTERFERENCES

TABLE 1

MEANS, STANDARD DEVIATIONS AND RANGES FOR GROUPS I AND Il ON GENERAL TEST ANXIETY, PRETEST ANXIETY, AND COGNITIVE INTERFERENCES

Table

TABLE 2KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND PRETEST ANXIETY FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

TABLE 2

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND PRETEST ANXIETY FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

Individual and combined group significant correlations supported Hypothesis 3. Significant correlations between the students' pretest anxiety responses and their cognitive interference responses while writing the comprehensive examination were found for each group and for the combined groups (Table 4). In both Group I and Group II, positive significant correiations were observed between PTA emotionality and interfering thoughts, though the correlation for Group I (Tau .4086} was stronger than for Group II (Tau .3484). In contrast to Group I, student CI caused by concern about evaluative outcome of the examination correlated significantly with PTA worry in Group II (Tau .4536).

Four significant correlations in the combined groups are of special interest. The PTA emotionality responses before the examination correlated significantly with those of interfering thoughts during the examination. The extent to which concern about EO increased cognitive interference during the examination correlated significantly with PTA worry and emotionality. Worry before the comprehensive examination also correlated with cognitive interference during the examination. It is important however, that no significant correlations were found between PTA (worry or emotionality) and mind wandering (MW) during the examination in either group or in the combined groups.

Table

TABLE 3KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

TABLE 3

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

Table

TABLE 4KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF PRETEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

TABLE 4

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF PRETEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

A one-way ANOVA was used to analyze the data for Hypotheses 4 and 5. The mean differences between the students' level of GTA and their performance rankings (high, medium, and low) on the examination were not significant, in either group or in the combined groups. Likewise, no significant relationship was found between the students' cognitive interferences during the examination and their performance rankings (high, medium, and low) on the examination. Thus, neither Hypothesis 4 nor Hypothesis 5 was supported.

Summary of Findings

Findings that supported the predictions of this study were as follows: (!) There was a significant positive correlation between graduate students' general test anxiety and their pretest anxiety worry immediately prior to writing the comprehensive examination; (2) there was a significant positive correlation between graduate students' general test anxiety and their cognitive interference (evaluative outcome) during the completion of the comprehensive examination; and (3) there was a significant positive correlation between graduate students' pretest anxiety (worry and emotionality) and their cognitive interference (thoughts and evaluative outcome) during the completion of the examination.

Findings that did not support the predictions were as follows: (1) There was no significant correlation between graduate students' pretest anxiety and their cognitive interference caused by mind wandering (MW) during the completion of the examination; (2) no significant relationship was found between the graduate students' general test anxiety and their performance rankings (high, medium, and low) on the comprehensive examination; and (3) no significant relationship was found between graduate students' cognitive interference during the comprehensive examination and their performance rankings (high, medium, and low) on the comprehensive examination.

Limitations and Discussion

Several limitations of the study are acknowledged. The sample groups were small and represented one school. Part-time student enrollment increased student writer attrition. The single appended item to the Cognitive Interference Questionnaire (CIQ) was not pretested for validity and reliability.

In this study, students with higher scores on general test anxiety tended toward higher pretest anxiety (worry) scores and to experience cognitive interference during the comprehensive examination. In contrast, students' pretest anxiety (emotionality) scores correlated significantly with cognitive interference (thoughts and evaluative outcome) during the examination. Thus, graduate students' interfering thoughts and worry about evaluative outcome of the examination persisted throughout the study, whereas their arousal of emotionality peaked significantly during the examination. In the sense of time differential on arousal and maintenance, these findings are congruent with the assumption that test anxiety consists of two conceptual components, worry and emotionality. Possible explanations of these findings were situational factors influencing the students' worry and emotional reactions. Satisfactory completion of the comprehensive examination was a school requirement for the degree. Thus, students placed great importance on the EO of the examination and a sense of failure could have been a threat. This is consistent with Morris and Liebert (1970) who used the failure threat among undergraduate students and aroused worry, but it had no effect on emotionality. The students' performance expectations as they entered the examination could have been a situational factor (Morris & Liebert, 1970).

Another situational factor, nonevaluative cues, could have aroused the students' emotionality experience during the examination. The stimulus of setting of the physical environment, the professor's passing out the examination, and students' talking about the examination were probably salient to the arousal of autonomie reactions. Morris et al. (1981) concur with this idea.

The significant correlations of the students' pretest anxiety (E and W) scores with interfering thoughts during the examination indicate divided attention to the intellectual task of writing the comprehensive examination. What the students were thinking about during the examination is significant: How poorly were they performing? What would the faculty think about their performance? What would be the consequences of the evaluative results? It is difficult not to interpret the students' worry about performance evaluation as a complicating factor. However, students could have used their interfering thoughts in a positive manner in preparation for and in coping with the stress of writing the examination. Worry is supportive in a threatening situation (Janis, 1958; Wine, 1971).

In this study, mind wandering during the examination did not seem to be a significant factor in the students' test anxiety. Neither W nor E correlated significantly with MW. This finding, however, is not congruent with Sarason and Stoops (1976) who reported mind wanderingas a significant factor in test anxiety and in test anxiety times conditions. Thus students' worry could have been used advantageously rather than destructively in processing information relevant to the examination.

The lack of a relationship found between the students' performance rankings (high, medium, and low) on the examination and their test anxiety indicates an inconsistency with the second basic assumption underlying the study. Worry associated with test anxiety did not appear to impair the quality of the students' performance. This finding is consistent with Mandler and Sarason 's (1952) original view of test anxiety which indicated that "for students without a habitual class of interfering responses, anxiety may facilitate task-relevancy" (p. 173).

Implications and Recommendations

In summary, study findings show that students' general test anxiety and their pretest anxiety correlated positively with cognitive interference, but neither GTA nor CI was correlation between graduate students' pre-test anxiety examination. These findings have direct implications for nursing education and research. The first implication concerns the need for further research related to test anxiety. By exploring possibilities of cognitive events that influence graduate students' test anxiety and the personal meaning the comprehensive evaluative events have for students, the nursing faculty may assist students in understanding why test anxiety develops and in using appropriate coping strategies. This will facilitate the development of curricular strategies for preventing - or at least reducing - such anxiety, rather than instituting treatment modalities for students who subsequently appear unable to cope.

One can raise the question whether anxiety interferes with effective test-taking skills or whether poor test-taking skills result in test anxiety. Although the former explanation is usually supported, anxiety reduction techniques without appropriate test-taking skills may be insufficient in treatment of test anxiety (Mitchell & Ng, 1972). Wine (1971) supports the notion that attention - self-focusing tendency - is closely related to existing theories of test anxiety. This implies that test-anxious students may improve their performance by directing their attention to relevant test variables and away from self-evaluative worry. Important then are investigations of situations designed to alter interfering responses caused by test anxiety during comprehensive evaluative events.

The second implication is directed toward instructional strategies. Thaching strategies, for reducing test anxiety in master's students, both didactic and clinical, may be approached from several directions. Together, master's students and faculty should establish broad, integrative learning objectives that are relevant to the mission and goals of the nursing program and to those of the students. Planned learning opportunities in attainment of these objectives should emphasize clinical application of knowledge and theoretical constructs to numerous, broad problems in nursing rather than to the mere integration of nursing objectives specific to each problem. Imperative then are such teaching strategies as independent learning projects, the use of faculty role models, selected preceptorships, and mentors. Better integration of broad clinical problems increases opportunities for students' organization and integration of learning outcomes, and in turn, increases the possibilities for their success in comprehensive evaluative performances.

Another teaching strategy concerns timing for evaluating student progress. Feletti and Neame (1981) argue that formative assessments, if constructed in parallel with summative assessments, would be similar to summative evaluations in format and level of difficulty. Students would feel more adequately prepared for responding to the type of questions included on the end-of-program comprehensive examination, thus reducing the students' fear of failure and test anxiety but raising their sense of control and confidence.

The third implication concerns students' test= anxiety reduction through intervention techniques. Physical and mental relaxation techniques, biofeedback, and therapeutic touch are examples of appropriate humanistic approaches to test=anxiety reduction. By using these techniques in seminar, professionally prepared faculty can help students interrupt nonproductive anxiety=coping patterns and discover more productive ones (Gordy, 1984).

The results of this research indicate that further study of test anxiety among other graduate students in nursing is warranted. Results of studies in evaluative situations that evoke test anxiety and in treatment techniques would be helpful for graduate students and faculty. The ability to generalize findings and to increase the validity and reliability of instruments could be realized.

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TABLE 1

MEANS, STANDARD DEVIATIONS AND RANGES FOR GROUPS I AND Il ON GENERAL TEST ANXIETY, PRETEST ANXIETY, AND COGNITIVE INTERFERENCES

TABLE 2

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND PRETEST ANXIETY FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

TABLE 3

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF GENERAL TEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

TABLE 4

KENDALL TAU CORRELATION COEFFICIENTS: MEASURES OF PRETEST ANXIETY AND COGNITIVE INTERFERENCES FOR TWO GROUPS OF GRADUATE NURSING STUDENTS

10.3928/0148-4834-19870101-05

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