Test anxiety in objective structured clinical examinations (OSCEs) compared with traditional assessment methods in undergraduate midwifery students


BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women; the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method; therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.

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Faramarzi, M. , Pasha, H. , Bakhtiari, A. , Salmalian, H. , Delavar, M. , Amiri, F. and Nikpour, M. (2013) Test anxiety in objective structured clinical examinations (OSCEs) compared with traditional assessment methods in undergraduate midwifery students. Health, 5, 2204-2209. doi: 10.4236/health.2013.512299.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Wachelka, D. and Katz, R.C. (1999) Reducing test anxiety and improving academic self-esteem in high school and college students with learning disabilities. Journal of Behavior Therapy and Experimental Psychiatry, 30, 191-198. http://dx.doi.org/10.1016/S0005-7916(99)00024-5
[2] Khosravi, M. and Bigdely, I. (2008) The relationship between personality factors and test anxiety among university students. Journal of Behavioral Sciences, 2, 13-24.
[3] Harden, et al. (1975) Assessment of clinical competence using objective structured examination. British Medical Journal, 22, 447-451.
[4] Ross, M., Carroll, G., Knight, J., Chamberlain, M., Fothergill-Bourbonnais, F. and Linton, J. (1988) Using the OSCE to measure clinical skills performance in nursing. Journal of Advanced Nursing, 13, 45-56.
[5] Rushforth, H.E. (2007) Objective structured clinical examination (OSCE): Review of the literature and implications for nursing education. Nurse Education Today, 27, 481-490
[6] Barry, M., Noonan, M., Bradshaw, C. and Murphy, S.T. (2011) An exploration of student midwives’ experiences of the objective structured clinical examination assessment process. Nurse Education Today, 32, 690-694
[7] Forward, J. and Hayward, M. (2005) Classroom versus practice-based OSCEs: A comparative evaluation. Nurse Prescribing, 3, 204-209.
[8] Sloan, D., Donnelley, M.B., Stewards, R.W. and Stolid, W. (1995) The objective structured clinical examination. The new gold standard for evaluating post graduate clinical performance. Annals of Surgery, 6, 735-742.
[9] Zarghami, M., Sheykh Mounesi, F., Taghva, A. and Khalilian, A. (2007) Attitude of Iranian psychiatry residents toward psychiatric objective structured clinical examination. Iranian Journal of Psychiatry and Clinical Psychology, 13, 34-40.
[10] Tabatabai, K., Yazdi, M., Ebrahimzadeh, S., Bahreini Toosi, V. and Bahreini Toosi, K. (2002) Medical students viewpoints about the evaluation methods at internship stage (Mashad University). MUMS, 45, 97-103.
[11] Biabangard, A. (1996) Test anxiety. 2nd Edition, Farhang Eslamic, Tehran.
[12] Mousavi, M., Haghshenas, H., Alishahi, M. and Najmi, B. (2008) Anxiety test and some correlated socio-demographic factors in high school students. Shiraz Journal of Research in Behavioural Sciences, 6, 17-25.
[13] Cheraghian, B., Fereidooni-Moghadam, M., Baraz-Pardejani, S. and Bavarsad, N. (2008) Test anxiety and its relationship with academic performance among nursing students. Knowledge & Health, 3, 25-29.
[14] Neuderth, S., Jabs, B. and Schmidtke, A. (2009) Strategies for reducing test anxiety and optimizing exam preparation in German university students: A preventionoriented pilot project of the University of Würzburg. Journal of Neural Transmission, 116, 785-790.
[15] Latas, M., Pantic, M. and Obradovic, D. (2010) Analysis of test anxiety in medical students. Medicinski Pregled, 63, 863-866. http://dx.doi.org/10.2298/MPNS1012863L
[16] Alinier, G. (2003) Nursing students’ and lecturers’ perspectives of objective structured clinical examination incorporating simulation. Nurse Education Today, 23, 419-426. http://dx.doi.org/10.1016/S0260-6917(03)00044-3
[17] Jay, A. (2007) Students’ perceptions of the OSCE: A valid assessment tool? British Journal of Midwifery, 15, 32-37.
[18] Brosnan, M., Evans, W., Brosnan, E. and Brown, G. (2006) Implementing objective structured clinical skills evaluation [OSCE] in nurse registration programmes in a center in Ireland: A utilization focused evaluation. Nurse Education Today, 26, 115-122.
[19] Franklin, P. (2005) OSCEs as a means of assessment for the practice of nurse prescribing. Nurse Prescribing, 3, 14-23.
[20] Bakhsh, T.M., Sibiany, A.M., Al-Mashat, F.M., Meccawy, A.A. and Al-Thubaity, F.K. (2009) Comparison of students’ performance in the traditional oral clinical examination and the objective structured clinical examination. Saudi Medical Journal, 30, 555-557.
[21] Dordinejad, F.G., Hakimi, H., Ashouri, M., Dehghani, M., Zeinali, Z., Sadegh Daghighi, M. and Bahrami, N. (2011) On the relationship between test anxiety and academic performance. Procedia Social and Behavioral Sciences, 15, 3774-3778.
[22] Clark, J.W., Fox, P.A. and Sheneider, H.G. (1998) Feedback, test anxiety and performance in a college course. Psychological Reports, 82, 203-208.
[23] Hong, E. and Karstensson, L. (2002) Antecedents of state test anxiety. Journal of Contemporary Educational Psychology, 27, 348-367.
[24] Onyeizugbo, E.U. (2010) Self-efficacy and test anxiety as correlates of academic performance. Journal of Educational Research, 1, 477-480.
[25] Engelhard Jr., G. (1990) Math anxiety, mother’s education, and the mathematics performance of adolescent boys and girls: Evidence from the United States and Thailand. The Journal of Psychology, 124, 289-298.
[26] Cirpar, O.C., Muluk, N.B., Yalcinkaya, F., Arikan, O.K., Uztürk, O. and Aslan, F. (2010) State-Trait Anxiety Inventory [STAI] assessment of mothers with language delayed children. Clinical & Investigative Medicine, 33, E30-E35.
[27] Moaddeli, Z. and Ghazanfari Hesam Abadi, M. (2004) A survey on the students’ exam anxiety in the Fatemeh [PBUH] College of Nursing and Midwifery. Strides in development of medical education. Journal of Medical Education Development Center of Kerman University of Medical Sciences, 1, 65-72.

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