Examination anxiety in medical students: experiences with the visual analogue scale for anxiety

Medical students' levels of anxiety under different conditions of stress were investigated, as well as the stability of anxiety ratings from one examination to another. After completing an end-of-term psychiatry examination, fourth-year medical students at Monash University were asked to score the Visual Analogue Scale for Anxiety (VASA) for three situational cues; usual day-to-day anxiety, highest anxiety associated with major exams the previous year and anxiety experienced in the end-of-term examination just completed. Twenty-eight weeks later students rated their anxiety in a subsequent end-of-term psychiatry examination. Most students rated themselves toward the lower end of the VASA for day-to-day anxiety and as having significantly, though not markedly higher anxiety in the end-of-term psychiatry examinations. The previous year's examinations, marking the end of pre-clinical training, provoked extremely high anxiety for most students, who achieved academically despite this. Comparison of anxiety ratings for the two end-of-term examinations indicated that VASA ratings shifted substantially for half the class. This variation suggests that students' levels of anxiety are not stable and predictable from one examination to another. Examination anxiety should not be seen necessarily as a consistent response to a specific and recurring situation. It is postulated that a range of situational factors and personal pressures, operating at the time, may determine how much anxiety is experienced as a reaction to the examination.