The Role of Self-Management of Emotions and Test Anxiety in the Academic Performance of Undergraduate Medical Students

Abstract

Background: Medical training is emotionally difficult for students, and anxiety relating to examinations, also known as 'test anxiety,’ is common among medical students. It has been shown to significantly impact academic achievement. Under exam conditions, students may experience intense emotions affecting their learning, performance, and patient interactions. Despite this, the emotions of medical students in stressful situations and potential strategies for emotional regulation have received insufficient attention in the literature.

Aims: This study examines the role of self-management of emotions in test anxiety and academic performance among undergraduate medical students in Saudi Arabia.

Methods: A sequential mixed-methods approach was employed to explore the relationship between test anxiety, self-compassion, and emotion regulation on medical students' academic performance and the medical student’s experience of test anxiety. Initially, a questionnaire was distributed to 2000 medical students, yielding 552 complete questionnaires with a response rate of 27.6%. Then, to explain the survey findings and to explore more about the test-anxiety medical students' experience, qualitative data were gathered through semi-structured interviews with 22 medical students. The qualitative data was then analysed using thematic analysis, enabling a comprehensive interpretation of the data.

Results: Medical students had moderate to high levels of test anxiety compared to the general student population. The overall scores for self-compassion, cognitive reappraisal, and emotion suppression were moderate. Moreover, in the moderation analysis, self-compassion and cognitive reappraisal demonstrated a negative moderating effect on the relationship between test anxiety and the GPA of medical students. Higher levels of self-compassion and cognitive reappraisal decreased test anxiety's effect on medical students' academic performance. The qualitative study yielded six themes. Students experience both negative and positive impacts of test anxiety on their academic performance. They discussed the medical curriculum's challenges and used various emotion regulation strategies.

Conclusion: Test anxiety can have both positive and negative effects on academic performance. Strategies such as cognitive reappraisal and self-compassion mitigate the relationship between test anxiety and GPA in this cohort of medical students in Saudi Arabia.