The Effect of Guided Reflection on Test Anxiety in Nursing Students

BACKGROUND: Anxiety disorders are common and test stress affects many students. Guided reflection is a new and effective method for reducing stress. OBJECTIVES: To assess the effect of guided reflection on test anxiety in second and third-year nursing students of Fatima Nursing and Midwifery College, Shiraz University of Medical Sciences, Shiraz, Iran. MATERIALS AND METHOD: This study was designed to assess the effect of guided reflection on test anxiety among nursing students of second and third year of education in Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Data was collected using demographic data questionnaires and the Sarason and Abolghasemi test anxiety scale. Based on the latter questionnaire, of the 147 participants, 100 had test anxiety with scores ranging from 13-63 (mild-severe anxiety), of which 80 students were randomly selected and divided into case and control groups. We used Johns’s 9-stage guided reflection model through Q and A, lecture, and discussion. The case group participated in a 2-day guided reflection workshop for six hours each day. The control group received no intervention. Sarason and Abolghasemi’s test anxiety questionnaire was completed by the students at the beginning of the first session, immediately after and three months after intervention. RESULTS: The test anxiety mean scores were 35.34 ± 9.50 and 35.47 ± 10.66 before the intervention in the control and intervention groups respectively. No significant difference was found between the two groups with respect to socio-demographic characteristics. The Mean ± SD of test anxiety scores increased to 36.48 ± 9.34 three months after the intervention in the control group (P = 0.1). However, in the intervention group, the Mean ± SD test anxiety scores reduced immediately after (16.31 ± 8.61) and three months after (27.72 ± 10.09) the intervention, compared to before the intervention (35.47 ± 10.66) (P < 0.001, paired T-test). CONCLUSIONS: Guided reflection is effective in reducing test anxiety in nursing students. This method can be used for reducing test anxiety and increasing learning and academic progress among students.