Test Anxiety: What we can do to help

A common issue I repeatedly see, especially at a heightened level these days, is anxiety in our students.  Even though we returned to the classroom, the anxiety does not seem to be abating for the most part.  Given the nature of our educational program and requirements coupled with a full curriculum over a short period of time, anxiety is no stranger.  I am sure all of us can vividly remember the stress we experienced when we were students, but what I am seeing seems different in some ways.  Although student anxiety comes out in many ways, exams are a frequent dynamic that causes it to really flare.

I would venture to guess that many of you have sat in your office across from a student who told you things like; but I studied really hard, I study all the time, I knew the material, so I don’t know why I didn’t do well, I get so stressed before a test that I feel ill, my mind goes blank, I can’t think, I can’t remember anything.  I am sure some of you have also had students completely decompensate into panic and tears right before the exam starts or immediately upon its conclusion.  From my experience, I know that faculty can sometimes feel ill-equipped with how to help a student “manage” their anxiety.  As educators, we cannot put our white coats on.  They are our students, not our patients.  I know it is hard not to.  But we can’t.  However, that doesn’t mean we can’t do anything.

So, let’s talk about test anxiety, what it is, along with its symptoms and causes, so we can then talk about how we can help our students.  Although most students experience some stress and anxiety around testing taking, test anxiety refers to those students who have extreme physical, emotional, and or cognitive symptoms that prevent them from performing well on exams.  This leads to a poor grade for the student and our inability to accurately assess and determine what the student truly knows (Arana & Furlan, 2015; Eum & Rice, 2011).  Recently, test anxiety has been a frequent topic of research as we know that significant anxiety can impede an individual’s mental and physical health and their educational performance (Chapell et al., 2005; Immordino-Yang, 2016).  In addition, we know that stress in the form of anxiety affects test performance.  Studies have shown that students with low levels of test anxiety achieve higher scores on multiple-choice question (MCQ) examinations than those with high anxiety levels.  In addition, female students have been shown to have higher test anxiety levels than male students (Chapell et al., 2005; Dawood et al., 2016; Reteguiz, 2006).

Test anxiety symptoms

Although each student may experience test anxiety differently, the common symptoms can include:

Feelings related to stress, fear of failure, helplessness, negative thoughts, inadequacy, mind going blank, racing thoughts, difficulty concentrating, procrastination, negative thoughts, feeling dread, constantly comparing oneself to others, and fear can be significant enough to trigger a panic attack.  Headache, nausea, excessive sweating, rapid heartbeat, shortness of breath, and lightheadedness

 Causes of test anxiety

While there are many individual aspects to the causes of test anxiety, research has provided some of the more common ones (Sawchuk, n.d.; Weimer, 2016).  These causes of test anxiety include

      lack of adequate preparation usually related to poor study skills and strategies

      fear of failure

      bad test-taking experiences, history, and outcomes in the past, and

      high-pressure testing, i.e., needing a certain grade to pass.

 Frequently, students have several of these at play.  Additional factors, such as lack of adequate sleep, poor nutrition, and a negative attitude, can also contribute.

Ways to help our students reduce test anxiety

How can we help our students reduce their anxiety around exams seems to rest on their ability to effectively study, so they feel prepared.

A common issue I find when talking with students about their actual study approaches and habits is that they are not using effective or efficient methods (see previous article Study Strategies: How Best to Help Our Students https://www.dremilywhitehorse.com/blog/study-strategies-how-best-to-help-our-students).  The research confirms that students still tend to use passive study approaches rather than active ones, and they still tend to cram for exams.  Using good study habits goes hand-in-hand with being and feeling prepared.  A lack of feeling prepared creates or adds to anxiety (Sawchuk, n.d., Weimer, 2016).

In addition to referring and providing program or institutional resources for students to engage in relative to study approaches and strategies, reviewing and reinforcing the best ways to study at the beginning and periodically through your course can also be helpful.  We assume students know how to study.  I am finding that is not an accurate assumption.

Other aspects that support effective studying and being prepared include encouraging students to create a week-to-week schedule and block out study time.  It helps if students establish a consistent routine and create a “study space” to use.  This consistency can help them focus while studying.  Make sure they take study breaks.  Studying for 3 hours without a break is ineffective.  We know the brain needs time to replenish, so suggest students study in 20-50 minute segments, followed by a 5-10 minute break.  Encourage students to get a good night’s sleep before the exam.  Lack of sleep significantly impacts performance (see Why Sleep is So Important to Learning https://www.dremilywhitehorse.com/blog/why-sleep-is-so-important-to-learning).

If students study effectively, create a consistent schedule, start early, and get a good night’s sleep before the exam, they are likely to feel well prepared, decreasing their anxiety.  And of course, it is a good idea to encourage students to learn relaxation techniques not just for exams but as part of a healthy lifestyle.

Although I suspect much of what I have written here makes sense to most of you as it did to me, I believe it is also important to note that new research is coming to light about test anxiety that challenges some of the information expressed above.  A recent study suggests that test anxiety has two components: an emotional dimension and the worry triggered by it.  It is the worry component that creates anxiety that impedes effective studying and exam performance.  The physical symptoms, although unpleasant, are not what affects performance (Brady et al., 2018).  In their study, the Brady et al. (2018) found that by sending students a supportive, reassuring message the night before an exam with information about how the new research on anxiety shows it doesn’t hurt performance, and so there was no need to be anxious had a positive effect on lessening student worry and increasing performance.  This study suggests that how we address and respond to student concerns about test anxiety, including the advice we offer, can affect how students see and respond to test anxiety and their performance.


Arana, F., & Furlan, L. (2015).  Groups of perfectionists, test anxiety, and pre-exam coping in Argentine students.  Science Direct.  https://sciencedirect.com/science/article/ppi/S0191886915300222

Brady, S. T., Hard, B. M., & Gross, J. J. (2018).  Reappraising test anxiety increases academic performance of first-year college students.  Journal of Educational Psychology, 110(3), 395-406.  doi.org/10.1037/edu0000219

Chapell, M.S., Blanding, M. E., Silverstein, M. T., Newman, A. G & McCann, N. (2005).  Test anxiety and academic performance in undergraduate and graduate students.  Journal of Educational Psychology, 97(2), 268-274.

Dawood, E., Ghadeer, H. A., Mitsu, R., Almutary, N., & Alenezi, B. (2016).  Relationship between test anxiety and academic achievement among undergraduate nursing students.  Journal of Education and Practice, 7(2).  57-65.

Eum, K., & Rice, K. G. (2011).  Test anxiety, perfectionism, goal orientation and academic performance.  Anxiety, Stress and Coping, 24(2), 167-178

Immordino-Yang, M. H. (2016). Emotions, learning and the brain: Exploring the educational implications of affective neuroscience. New York, NY: W.W. Norton & Company, Inc.

Reteguiz J. A. (2006).  Relationship between anxiety and standardized patient test performance in the medicine clerkship. Journal of general internal medicine21(5), 415–418.  Doi.org/10.1111/j.1525-1497.2006.00419.x

Sawchuk, C. N. (n.d.).  Is it possible to overcome test anxiety.  https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195

The Princeton Review.  (n.d.).  10 ways to overcome test anxiety.  https://www.princetonreview.com/college-advice/test-anxiety

Weimer, M. (2016).  Test anxiety: Causes and remedies.  The Teacher Professor. https://www.teachingprofessor.com/?p=53738


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