The adverse effects of high test anxiety on academic performance of traditional undergraduate students is well documented in the literature. In nursing, research on test anxiety and related academic stressors has also focused on the traditional young, single student. The newest cohort of nursing students, called "non-traditional," are older, married, and have children (Rosenfeld, 1994). They make up a rapidly growing subgroup of nursing students, a trend reflected in recent nursing demographic studies. The average age of a new RN in 1992 was 33.7, a rise from 28.8 in 1988. This rise in age is accompanied by an increase in the number of married, divorced/separated students, many with dependent children. This trend toward older, more diverse non-traditional students is expected to continue into the next century as our society ages and schools of nursing target new groups of potential applicants. These changing demographics have significant implications for nursing education. There is a need to establish a knowledge base of similarities and differences between traditional and non-traditional students in areas like academic performance and stressors. This will help ensure that academic support services address the needs of all students. One concern is the limited research on test anxiety in non-traditional students (Mackenzie, 1994). It is suggested that diverse student groups may differ on levels of test anxiety and on the significance of factors which contribute to its occurrence (Meichenbaum & Butler, 1980). The identification of such differences is needed in order to design treatment interventions that best meet the needs of different student groups. Currently, there are no studies that empirically verify that differences exist and no reported test anxiety reduction interventions that are based upon assessment of specific individual or group characteristics. The purpose of this study was to determine differences between non-traditional and traditional baccalaureate student nurses on test anxiety and related factors.
Test Anxiety Research
Test anxiety has been conceptualized as a constellation of behaviors, including preoccupation with thoughts of worry over one's performance and poor study and testtaking skills which have a debilitating effect on performance (Arnkoff & Smith, 1988; Blankstein, Flett, & Watson, 1992; Everson, Millsap, & Brown, 1989; Kleijn, van der Ploeg, & Topman, 1994; Sarason, 1984). Test anxiety is linked to impaired recall and problems with reading speed and comprehension (Calvo & Carreiras, 1993; Mueller, Wiser, & Rollack, 1993). High test anxiety is a factor predisposing nursing students to cope poorly with strenuous academic demands, resulting in lower performance levels, high attrition rates and failures on the NCLEX-RN (Poorman & Martin, 1991).
Treatment approaches to test anxiety are varied and focus on three dominant areas: 1) behavioral interventions, i.e., progressive relaxation and systematic desensitization, 2) cognitive interventions such as attention control and cognitive restructuring, and 3) study/testtaking skill deficit interventions (Arnkoff & Smith, 1988; Bruch, Juster, & Kaflowitz, 1983; Bruch, Pearl, & Giordano, 1986; Condon & Drew, 1995; Covington & Omelich, 1987; Culler & Holahan, 1980; Deffenbacher & Hahnloser, 1981; Denny, 1980; Schwarzer & Jerusalem, 1992). Research data indicate that all three of these treatment approaches are effective in reducing selfreported test anxiety, but do not necessarily result in improved academic performance. Multi-designed intervention packages which combine several treatment approaches appear to be more effective in improving academic performance (Deffenbacher, 1988; Huebner, 1988; Meichenbaum, 1985; Meichenbaum & Deffenbacher, 1988).
Non-traditional Students, Test Anxiety and Related Factors
Non-traditional students come to universities with life experiences that are both quantitatively and qualitatively different from traditional students (Bean & Metzner, 1985). These students are reported to experience stress in making personal and academic adjustments to college life (Apps, 1981; Kasworm, 1990; Schlossberg, Lynch, & Checkering, 1989). Adult students must often exert maximum efforts to meet academic demands and personal responsibilities inherent in the roles of spouse, parent and breadwinner. A positive academic self-concept is important in the adult's adjustment and commitment to the student role (Chartrand; 1992). Adult learners, particularly females, tend to underestimate their potential and lack confidence in their ability to succeed in college (Brandenburg, 1974; Mackenzie, 1994; Miller, 1978). Testing is one of the greatest fears of adult students and may become a major obstacle to success, especially for adults with low selfesteem (Diaz, 1989; Mackenzie, 1994; Weare, 1984). The combination of these factors and others may result in high dropout rates for non-traditional students, especially females with children who work full-time (Astin, 1975; Bean & Metzner, 1985).
Nursing Students and Academic Performance Stressors
The acceleration of nursing knowledge and medical technology places greater stress on nursing students to learn the essentials for safe practice. Nursing students are reported to have high levels of anxiety (Williams, 1993). Specific sources of anxiety in nursing students are poor evaluations, fear of failure, lack of time, lack of selfconfidence and excessive academic load (Godbey & Courage, 1994; Grassi-Russo & Morris, 1981; Hilbert, 1987; Sherrod et al., 1992). Lengacher (1993) concludes that role conflict, role stress, and role strain resulting from increased expectations and academic pressures is a concern for female nursing students returning to school. Studies of test anxiety in nursing students document an inverse relationship between anxiety and performance (Beck & Srivastava, 1991; Carter & Mills, 1982; Hilbert & Allen, 1985) and an inverse relationship between test anxiety, grade point average, and success on NCLEX-RN (Hilbert & Allen, 1985; Howell & Swanson, 1989). Burns and Egan (1994) found that students experienced heightened anxiety (threat) in testing situations in which they perceived having little control. These general problems, when combined with the problems specific to the non-traditional student, present a serious concern.
The Meichenbaum and Butler Model of Test Anxiety
Meichenbaum and Butler (1980) proposed a comprehensive model of test anxiety and its treatment that includes both cognitive process and academic skills variables. The model consists of four interdependent components: 1) cognitive structures, 2) internal dialogue, behavioral acts, and 4) behavioral outcomes. This model which provides the framework for the present study was explored in two studies (Bagoon, 1988; Howell & Swanson, 1989). Both studies showed significant relationships between test anxiety and three of the model components: cognitive structures, internal dialogue and behavioral outcomes. Behavioral acts, as measured by study and testtaking skills, was not significant in either study. Neither study specifically addressed non-traditional students.
The sample for this descriptive study consisted of 110 undergraduate baccalaureate nursing students from two large state universities in the first semester of nursing studies. Table 1 presents descriptive data on the total sample in demographic categories of age, gender, race, marital status, child care responsibilities, employment, and financial support.
Historically, students have been classified according to age with traditional students being those less than 24 years of age and non-traditional students being 25 years or older. However, some adult educators are arguing that chronological age is not sufficient for defining who is an adult learner (Gordon & Merriam, 1982; Knowles, 1980). Most adult educators have adopted a functional definition which includes social and psychological maturity in regard to judgment, autonomy, responsibility, and the assumption of adult life roles such as worker, spouse and/or parent. This definition acknowledges that an adult is a person who performs socially productive roles and who has assumed primary responsibility for his or her own life. For this study, traditional students were defined as students between 18 and 24 years of age who had not assumed more than one of the social roles characteristic of adult status. Non-traditional students were defined as students 25 years or older or those students who had assumed at least two of the social roles characteristic of adult status such as marriage, parenthood, and financial independence. Based on analysis of biographical data, subjects were classified as either traditional or non-traditional students. Fifty-seven percent (n=63) of the sample were traditional students, while non-traditional students accounted for 43% (n=47) of the sample. Although one student in the traditional group reported having a child, there were no reported child care responsibilities or other adult social role responsibilities to classify the student as non-traditional. Institutional Review Board approval was obtained and participation was voluntary. Subjects completed four instruments and a biographical data questionnaire measuring the study variables.
Table 2 shows the variables selected to represent the model concepts and the instruments used for their measurements.
Test Anxiety-Test anxiety was measured using the Test Anxiety Inventory (TAI; Spielberger, 1980), a widely used 20-item self-report instrument with two subscales, worry and emotionality. Spielberger (1980) established test-retest reliability coefficients of .81 and .80 for high school and traditional college students. Validity is demonstrated by strong correlations between the TAI and other anxiety measures, including Sarason's (1980) Test Anxiety Scale (r=.82) and Liebert and Morris' (1967) Worry and Emotionality subscales (r=.69 to .85).
Cognitive Structures- The model concept, cognitive structures, is defined as academic self-concept and was measured by the Post High School Self-Concept of Ability Scale (Brookover, personal communication, December 1990). This is a 12-item scale designed to measure the individual's assessment of his ability to learn in the school environment in comparison to peers. It is a revised version of the original form developed for use with high school students. The original version has established internal reliability coefficients ranging from .77 to .82 (Brookover, Erickson, & Joiner, 1967; Paterson, 1967). Face validity of the post-high school version was established by a panel of experts (director of research, psychologist, nurse educator). Results of test-retest assessments established internal reliability coefficients of .92 and .95. Negative correlations have been reported between academic self-concept and test anxiety, (-.68), and between academic self-concept and GPA (-.49) (Howell & Swanson, 1989).
Model Concepts, Study Variables and Instruments
Internal Dialogue- Internal dialogue was measured by Sarason's (1976) Cognitive Interference Questionnaire (CIQ). The CIQ is an 11-item scale measuring the frequency of task-irrelevant, interfering thoughts during test-taking situations. Alphas of .69 and .71 were reported for CIQ internal consistency (Hunsley, 1987; Zatz & Chassin, 1983). Hunsley (1987) reported positive correlations between test anxiety measurements and CIQ scores (.47 and .44), indicating that high test anxiety is associated with more frequent negative cognitions during examinations.
Behavioral Acts- Study and test-taking skills were measured by the Effective Study Test (EST) (Brown, 1975). The 125-item true/false instrument, designed to measure knowledge of effective study methods and factors influencing their development, includes four 25-item subscales measuring study skills and a subscale measuring test-taking behaviors. A test-retest reliability coefficient of .80 and correlation coefficients of .54 and .57 between EST total and undergraduate GPA were reported (Brown, 1975).
Behavioral Outcomes- Each student's cumulative grade point average (GPA) on admission to the nursing major, obtained from the school records offices, was used to measure behavioral outcomes.
Data were collected on two different occasions at 2 to 4 week interval periods. During the first session, students completed the biographical data questionnaire, the TAI, EST and the Post-High School Self-Concept of Ability Scale. In order to identify the frequency of negative internal thoughts, students completed the CIQ at the conclusion of a regularly scheduled examination.
Means and standard deviations for each of the selected variables were calculated for each student group. A correlated T-test for mean differences was used to determine if any of the variable means differed significantly between the traditional and non-traditional student groups. Fisher's Z-transformation of r was used to determine if there were any significant differences in the relationships between test anxiety and model variables for the two student groups. Table 3 presents means, variances of the model variables and analysis of T-test findings for the two student groups, Traditional (Group O) and Non-traditional (Group 1). TAI scores for both groups fell within the moderate range (40 to 60) for overall test anxiety. Mean scores for the traditional student group were slightly higher on all three measurements of test anxiety (TAITOT, mean=45.2; Worry, mean=16.3; Emotionality, mean= 19.4) as compared to the non-traditional student group (TAITOT, mean=43.7; Worry, mean=14.8; Emotionality, mean=19.1). These mean scores are slightly higher than those reported by Spielberger (1980) for undergraduate college students. Higher means may be explained by the high percentage of female participants (89%) who are reported to consistently score 3 to 5 points higher than males (Spielberger, 1980). Means for academic self-concept indicate that both groups viewed their academic abilities positively in relation to their peers. Results of the EST total scores for both groups (Traditional, mean=102.6; Non-traditional, mean= 104.3) were in the average category for national norms for college freshmen (Brown, 1975). Mean scores for three of the four subscales were in the average to above-average categories for both student groups. The mean score of 31.1 on the CIQ for the traditional student group indicates high cognitive interference (29 and above) as compared to the non-traditional student group (mean=27.1). There was no appreciable difference on GPAs for the two groups.
Traditional student group data (Table 4) showed significant correlations between academic self-concept and test anxiety, cognitive interferences and GPA. Academic selfconcept showed an inverse relationship with TAITOT, Worry, and Emotionality (r=-.42, r=-.43, r=-.35, respectively) as well as CIQ (r=.27). Academic self-concept correlated positively with GPA (r=.25). These findings support Meichenbaum and Butler's perception of the mediating role of influence cognitive structures has on the other model components and are consistent with previous studies (Bagoon, 1988; Bruch, Juster, & Kaflowitz, 1983; Galassi, Frierson, & Sharer, 1981; Howell & Swanson, 1989). The strongest correlation was between CIQ and scores on test anxiety (TAITOT, r=.42; Worry, r=.44; Emotionality, r=.34). As the frequency of negative thoughts increases, scores on test anxiety also increased. These findings are consistent with studies by Bagoon (1988), Galassi and colleagues (1981), and Howell and Swanson (1989). There were no significant correlations between study and test-taking skills in the traditional student group.
T-Tests on Variable Means for Traditional (n=63) and Non-traditional Student Groups (n=47)
Intercorrelations Among Variables in Traditional Student Group
Non-traditional student group data (Table 5) showed the strongest correlation between test anxiety and CIQ (TAITOT, r=.61; Worry r=.55; Emotionality, r=.58). The only other significant correlations noted were between SRO and TAITOT (r=-.33) and SRO and Emotionality (r=-.33). This suggests that students with higher test anxiety, especially related to physiological/affective responses, demonstrated less knowledge of problems related to effective study habits.
Intercorrelations Among Variables in Non-traditional Student Group
Testing of Hypotheses
H1: There is a significant difference between traditional and non-traditional student nurses on the criterion variable of teat anxiety. Data analysis (Table 3) failed to show a significant difference in the two groups on test anxiety or its main components, worry and emotionality. Thus, Hl was rejected, indicating that, for this sample, traditional and non-traditional students did not differ on test anxiety.
H2: There is a significant difference between traditional and non-traditional student nurses in the variables: academic self-concept, cognitive interferences, study and test-taking skills, and grade point average (GPA). Table 3 presents results of the T-tests comparing means of the model variables for both student groups. Only knowledge of effective test-taking skills was significantly different for the two groups. One other variable, CIQ, approached significance with traditional students demonstrating more frequent negative interfering thoughts while taking the mid-term exam.
H3: The relationship between test anxiety and each of the model variables will differ significantly between traditional and non-traditional student nurses. The correlations of all variables for each student group were used to obtain the z-scores (refer to Tables 3 and 4). Examination of the z-scores, shown in Table 6, reveal that two correlations were significantly different for the two groups: 1) academic self-concept and knowledge of methods for effective time management and study organization (SSO) and 2) academic self-concept and worry. The correlation matrices showed a near zero correlation between academic self-concept and SSO for the traditional group (r=- .023) but a stronger positive correlation for the non-traditional group (r=.26). The traditional group showed a strong negative correlation between academic self-concept and worry (r=-.43), as compared to almost no correlation at all for the non-traditional group (r=-.04).
The lack of difference between the two groups in overall test anxiety is an interesting finding when compared with past assumptions about adult learner capabilities. These assumptions, have suggested that the academic performance of adult undergraduates is inferior to that of young, traditional students, that adults have less self-confidence in their ability to succeed, and demonstrate higher anxiety in testing situations (Kasworm, 1990). This study did not support these assumptions, but found that non-traditional and traditional students are more similar than different in the area of test anxiety and its related components.
The results of this study indicate that differences in test anxiety and its major components can be determined for various student populations. The findings that nontraditional students score significantly higher on knowledge of test-taking skills may be explained by the fact that most non-traditional students are older and have, perhaps, been exposed to more testing situations in which to develop their skills. Life experiences that move an individual into adulthood require development of problemsolving, decision-making, and critical thinking skills. These skills are essential elements of effective test-taking behaviors and are likely to be more highly developed in adult learners.
Although academic self-concept evidenced significant correlations with most model variables in the traditional student group, no such pattern of strong correlation was present in the non-traditional student group. In fact, the two groups differed significantly in two of these correlations. The correlation of academic self-concept and SSO was moderately positive for the non-traditional group (r=.26), yet near zero for the traditional group (r=-.023). This may suggest that perception of academic ability is more closely associated with effective time management and study organization skills for non-traditional adult students. Academic self-concept showed a significant negative correlation with worry in the traditional study group (r=-.43) as compared with almost no correlation for the non-traditional group (r=-.04). The scale used in this study was designed to measure the student's assessment of ability to learn in comparison to peers in school. These perceptions of academic ability are based on evaluations of the student's ability by his peers, educators, and relevant others may operate more strongly on traditional students, influencing thoughts, feelings and behaviors. Findings from this study may suggest that the worry component of test anxiety (concerns about grades, consequences of failure, unfavorable comparison with peers) operates more strongly in the traditional student, resulting in more negative perceptions of ability to succeed in relation to peers. Jarvis (1983) states that adults may see little meaning or value in meeting standards set for them by others and are more concerned with whether they are changing in directions they have set for themselves. Therefore, perceptions of how they compare to their peers in school may exert less influence on the behaviors of nontraditional adult students than on traditional students. It is also possible that other cognitive processes such as motivation and self-efficacy operate more strongly in adults and should be included in future studies.
Z-Scores for Traditional and Non-traditional Groups
In both groups cognitive interference showed the strongest correlation of all variables with test anxiety. This lends support to cognitive theorists who place considerable emphasis on the thought processes of test-anxious students (Deffenbacher, 1988; Wine, 1971), and indicate that cognitive interferences may be more closely associated with test anxiety than ineffective study and test-taking skills or past experiences.
LIMITATIONS AND RECOMMENDATIONS
This study is limited by the relatively small (N=110), primarily female convenience sample. The restricted range of GPA scores, a common problem in studies of nursing students, may have reduced the magnitude of correlations between variables, possibly distorting the true relationship between GPA and other study variables. Instruments used in this study were developed for use with traditional students; perhaps findings would differ with instruments designed to specifically measure the model concepts in adult learners.
Recommendations based on the results of this study are:
1. Further research to identify factors which contribute to success of non-traditional students in nursing programs.
2. Further research comparing learner characteristics of non-traditional and traditional students which contribute to success or lack of success in nursing programs.
3. Further investigation of the variables that may influence test anxiety and academic achievement with nursing students as well as students in other professional programs such as engineering and law.
4. Studies leading to the development of treatment programs which address specific needs of important subgroups of nursing students.
Successful recruitment of "non-traditional" students has bolstered nursing school enrollments in recent years. The size of this subgroup is predicted to rise as older adults enter nursing programs and enrollment of traditional students decline. The educational process for nursing students is highly stressful. Students in nursing must take standardized test for licensure and certification, a situation which generates high test anxiety for many. Support services should be available to ensure that all students receive assistance in developing effective testtaking strategies. Non-traditional adult students, particularly females, experience increased stress from the demands of many roles that compete for their time and energies which can contribute to academic problems. At the same time, adults possess certain strengths acquired from life experiences that aid them in their academic goals. By nature of their age and stage of development young, traditional students are not likely to have encountered these same conflicts or life experiences. Greater attention is needed to identify how non-traditional students are alike and different from traditional students. This is important for the development of effective strategies to reduce academic stress and facilitate the success of all students in our nursing programs.
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Model Concepts, Study Variables and Instruments
T-Tests on Variable Means for Traditional (n=63) and Non-traditional Student Groups (n=47)
Intercorrelations Among Variables in Traditional Student Group
Intercorrelations Among Variables in Non-traditional Student Group
Z-Scores for Traditional and Non-traditional Groups