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Enwright P, Blank S, Wells BM, Nightingale LM, Torgerud S. Effect of lavender and rosemary aromatherapy on test anxiety in chiropractic students. J Chiropr Educ 2023; 37:26-32. [PMID: 36306254 PMCID: PMC10013597 DOI: 10.7899/jce-21-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/14/2021] [Accepted: 07/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Test anxiety is a debilitating disorder that can impair cognitive performance and affect academic success. Aromatherapy is commonly used for relaxation therapy. The primary aim of the study was to determine if nasal inhaler aromatherapy, utilizing a blend of rosemary and lavender essential oils, could be a useful strategy to reduce testing anxiety in students. METHODS This study recruited first trimester chiropractic students enrolled in both Neuroanatomy I and Biochemistry I. A randomized crossover design was utilized over 2 study days during final exams, with a 2-day wash-out period. Participants were randomly assigned into groups based on results of test anxiety analysis. On each day, students were given a nasal inhaler with either an aromatherapy blend of lavender and rosemary essential oils or distilled water as the control. Students completed pretest surveys and posttest surveys to rate their anxiety levels. Paired sample t-tests were performed to determine group differences in test anxiety. Both intention-to-treat and per-protocol analyses were conducted. RESULTS Forty-five students were randomly assigned into the study, whereas only 38 completed per-protocol. Between group comparisons showed no statistically significant difference between change in anxiety scores between aromatherapy and control for both intention-to-treat (p =.10) and per-protocol (p =.07). CONCLUSION Use of personal inhalers and aromatherapy diffusers were not shown to reduce test anxiety in a chiropractic population under high-stakes examination. Other options should be explored for future research.
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Affiliation(s)
- Paige Enwright
- Paige Enwright is in private practice (58 Dangan Heights Newcastle CO, Galway, Ireland H91 Y49Y; )
| | - Samantha Blank
- Samantha Blank is in private practice (1786 Dry Gulch Dr, Helena, MT 95601; )
| | - Breanne M Wells
- Breanne Wells (corresponding author) is an assistant professor in the Technique Department at Palmer College of Chiropractic (1000 Brady St, Davenport, IA 52803; )
| | - Lia M Nightingale
- Lia Nightingale is a professor in the Life Science Division at Palmer College of Chiropractic (1000 Brady St, Davenport, IA 52803; )
| | - Steven Torgerud
- Steven Torgerud is an associate professor in the Life Science Division at Palmer College of Chiropractic (1000 Brady St, Davenport, IA 52803; )
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Alshammari T, Alseraye S, Alqasim R, Rogowska A, Alrasheed N, Alshammari M. Examining anxiety and stress regarding virtual learning in colleges of health sciences: A Cross-Sectional Study in the Era of the COVID-19 Pandemic in Saudi Arabia. Saudi Pharm J 2022. [PMID: 35498216 PMCID: PMC9051956 DOI: 10.1016/j.jsps.2022.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022] Open
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Wells BM, Nightingale LM, Derby DC, Salsbury SA, Lawrence D. Aromatherapy for test anxiety in chiropractic students. J Chiropr Educ 2021; 35:50-58. [PMID: 32543886 PMCID: PMC7958665 DOI: 10.7899/jce-18-36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/09/2019] [Accepted: 09/30/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction. METHODS This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim. RESULTS Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future. CONCLUSION We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.
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Gómez-Íñiguez C, Rodríguez CG, Cantero FP. State anxiety and cardiovascular activity in an academic examination. Psych J 2020; 10:415-424. [PMID: 33271635 DOI: 10.1002/pchj.411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/24/2020] [Accepted: 11/02/2020] [Indexed: 11/09/2022]
Abstract
Exam is an academic stressor that frequently triggers the affective reaction of anxiety, as well as psychophysiological changes in the autonomic nervous system. Anxiety is a negative affective variable associated with a low level of performance. This study examined the impact of an academic exam on state anxiety (SA) levels and the effects on cardiovascular activity during its performance, as well as its possible influence on the score. The study group was composed of 122 female university students. Cardiovascular responses (heart rate [HR], diastolic blood pressure, and systolic blood pressure) were recorded continuously in three phases (before, during, and after the exam) for each participant. The SA was obtained with the State-Trait Anxiety Inventory (STAI) before the exam. Then, those with extremely low and high SA scores were assigned to the low and high anxiety groups, respectively. The exam score reflected the performance level. The results partially confirmed our hypotheses. The high SA group showed significant fluctuations in cardiovascular activity; in particular, the HRs were higher than in the low SA group during the exam (not in diastolic and systolic pressures, respectively). On the other hand, the high SA group showed lower performance expectations scores than the low SA group, and the level of performance was similar in the two groups. Therefore, the exam confirmed changes in the HR with respect to the SA level, with no significant impact on performance.
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Affiliation(s)
- Consolación Gómez-Íñiguez
- Department of Basic, Clinical Psychology and Psychobiology, Faculty of Health Sciences, University Jaume I of Castellón, Castellón de la Plana, Spain
| | | | - Francisco Palmero Cantero
- Department of Basic, Clinical Psychology and Psychobiology, Faculty of Health Sciences, University Jaume I of Castellón, Castellón de la Plana, Spain
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Elsalem L, Al-Azzam N, Jum'ah AA, Obeidat N, Sindiani AM, Kheirallah KA. Stress and behavioral changes with remote E-exams during the Covid-19 pandemic: A cross-sectional study among undergraduates of medical sciences. Ann Med Surg (Lond) 2020; 60:271-279. [PMID: 33163179 PMCID: PMC7604013 DOI: 10.1016/j.amsu.2020.10.058] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/25/2020] [Indexed: 02/07/2023] Open
Abstract
Emergence of coronavirus disease 2019 (COVID-19) forced the worldwide higher educational institutes to adopt distance learning mode. Further, remote electronic exams (E-exams) were considered as mode of assessment. Objectives: This cross-sectional study evaluated the students' experience of remote E-exams during the COVID-19 pandemic among Medical Sciences students in Jordan. Materials and Methods: A survey of 29 questions was prepared on Google forms and distributed among students at Faculties of Medical Sciences (Medicine, Dentistry, Pharmacy, Nursing and Applied Medical Sciences) at Jordan University of Science and Technology. The questions include students' demographics, stress experience, and factors contributing to stress as well as behavioral changes related to remote E-exams. Responses were analyzed using descriptive, cross tabulation and Chi-square tests. Results: Among 1019 respondents, 32% reported more stress with remote E-exams. This was associated with academic major and gender. Among students with more stress during remote E-exams, the exam duration, mode of questions navigation and technical problems (exam platform and internet connectivity) appeared as the main factors related to stress in 78%, 76% and >60%, respectively. Other factors include concern regarding the teaching methods, exam environment and students' dishonesty. Remote E-exams had negative impact on students' dietary habits (increase consumption of caffeine and high energy drinks, high sugar food, fast food), sleep (reduction in sleeping hours, more consumption of insomnia medications), physical activity (less exercises) and smoking habits (increase). Conclusion: Results suggested a negative impact of E-exams on students within Medical Faculties. Robust exam platform and remote mock E-exams are recommended to reduce students' potential stress. A stress-free environment is very essential to encourage students to adopt remote E-exams, particularly if the pandemic will take longer. Various awareness programs about students' habits related to dietary, sleep quality, physical activity and smoking are highly valuable for students' health benefits. This is of particular importance since the current students at Faculties of Medical Sciences are the future health care providers.
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Affiliation(s)
- Lina Elsalem
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Nosayba Al-Azzam
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Ahmad A. Jum'ah
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Nail Obeidat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Amer Mahmoud Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Khalid A. Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Cardozo LT, Azevedo MARD, Carvalho MSM, Costa R, de Lima PO, Marcondes FK. Effect of an active learning methodology combined with formative assessments on performance, test anxiety, and stress of university students. Adv Physiol Educ 2020; 44:744-751. [PMID: 33205996 DOI: 10.1152/advan.00075.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to evaluate the effect of an active methodology combined with a lecture on undergraduate student learning and levels of stress and anxiety. The active learning methodology consisted of a lecture of 50-min duration, study at home with a textbook, an educational game activity, and three formative assessments on the topic of the cardiac cycle. In a following class, the students provided saliva samples to evaluate their levels of stress, received an anxiety test, and then undertook an exam to assess their understanding of the cardiac cycle. The traditional teaching methodology consisted of two lectures (∼2-h duration) on blood pressure control systems, delivered orally. In the third class, the students provided saliva samples, received an anxiety test, and then undertook an exam to assess their understanding of blood pressure control systems. The level of stress was assessed with the concentrations of the stress biomarkers cortisol and alpha-amylase in saliva. Anxiety was assessed with the State-Trait Anxiety Inventory (STAI) questionnaire. The students achieved significantly higher average scores in exams when the active learning strategy was applied compared with the use of traditional theoretical classes. The active methodology resulted in significantly lower levels of stress and anxiety, as well as improved student performance, compared with the use of traditional lectures.
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Affiliation(s)
- Lais Tono Cardozo
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | | | - Rafaela Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Ramaswamy V, Veremis B, Nalliah RP. Making the case for pass-fail grading in dental education. Eur J Dent Educ 2020; 24:601-604. [PMID: 32107859 DOI: 10.1111/eje.12520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/03/2020] [Accepted: 02/23/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Vidya Ramaswamy
- University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Brandon Veremis
- Department of Pathology, The Mount Sinai Hospital, New York, NY, USA
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Abstract
Objective: The main objective of the present study was to explore the frequency of Depression, anxiety and stress among university students in Sialkot, Pakistan. Method: Survey research method was used to collect data from three universities of Sialkot by using simple random sampling technique from 500 university students. The study was conducted at GC Women University, Sialkot in total duration of five months from February 2019 to June 2019. A demographic sheet and DASS-21 (Depression, Anxiety Stress Scale) were used to measure the level of depression, anxiety and stress. Data was scored according to the standard scoring procedure for each subscale and for further analysis frequency distribution method was applied through statistical package for social sciences (SPSS. 21). Results: The means of Depression, Anxiety and stress are M=15.08, M=18.24 and M=19.02 respectively. The frequency of depression, anxiety and stress among university students was found 75%, 88.4% and 84.4% respectively. The findings of the study showed the prevalence of Depression within the range of normal (25%), mild (16%), moderate (35.8%), severe (14.6%) and extremely severe (8.6%). The prevalence of anxiety was found to be in the range of normal (11.6%), mild (4.4%), moderate (19.4%), severe (17.8%) and extremely severe (46.8%). Stress was normal (15.6%), mild (33.8%), moderate (35.4%), severe (13.2%) and extremely severe (2.8%). Conclusion: It is concluded that symptoms of anxiety and stress are more prevalent with moderate to extremely severe range than depression in the current sample. These findings suggest urgent need of some preventive measures and interventions to improve the mental health of students.
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Affiliation(s)
- Saba Asif
- Ms. Saba Asif, Associate Lecturer, Government College Women University, Sialkot, Pakistan
| | - Azka Mudassar
- Azka Mudassar, Department of Psychology, Government College Women University, Sialkot, Pakistan
| | - Talala Zainab Shahzad
- Talala Zainab Shahzad, Department of Psychology, Government College Women University, Sialkot, Pakistan
| | - Mobeen Raouf
- Mobeen Raouf, Department of Psychology, Government College Women University, Sialkot, Pakistan
| | - Tehmina Pervaiz
- Tehmina Pervaiz, Department of Psychology, Government College Women University, Sialkot, Pakistan
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Ange B, Wood EA, Thomas A, Wallach PM. Differences in Medical Students’ Academic Performance between a Pass/Fail and Tiered Grading System. South Med J 2018; 111:683-687. [DOI: 10.14423/smj.0000000000000884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Macauley K, Plummer L, Bemis C, Brock G, Larson C, Spangler J. Prevalence and Predictors of Anxiety in Healthcare Professions Students. Health Professions Education 2018; 4:176-85. [DOI: 10.1016/j.hpe.2018.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Abstract
Objectives: To assess the frequency of Depression, Anxiety and Stress (DAS) among the undergraduate physiotherapy students. Methods: A descriptive cross sectional study was conducted in various Physiotherapy Institutes in Sindh, Pakistan among undergraduate physiotherapy students. The total duration of this study was 4 months from September, 2016 to January, 2017. Data was collected from 267 students with no physical and mental illness; more than half were female students 75.3%. They were selected through Non probability purposive sampling technique. A self-administered standardized DASS (depression, anxiety and stress scale) was used to collect data and result was analyzed using its severity rating index. Data was entered and analyzed by using SPSS version 21. Descriptive statistics including the frequency of depression, anxiety, stress and demographic characteristic of the participant was collected. Results: The mean age of students was 19.3371±1.18839 years. The Frequency of depression, anxiety and stress found among undergraduates Physiotherapy students was 48.0%, 68.54% and 53.2%, respectively. Conclusions: It was observed that the frequency of depression, anxiety and stress among physiotherapy undergraduates students were high. It suggests the urgent need of carrying out evidence based Psychological health promotion for undergraduate Physiotherapy students to control this growing problem.
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Affiliation(s)
- Annosha Syed
- Annosha Syed, PP-DPT Student, Institute of Physical Medical & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Shazad Ali
- Syed Shazad Ali, Assistant Professor, Institute of Physical Medical & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Khan
- Muhammad Khan, Director, Department of Physiotherapy & Rehabilitation, Lady Reading Hospital, Peshawar, Pakistan
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Abstract
Medical education is a time of high stress and anxiety for many graduate students in medical professions. In this study, we sought to investigate the effect of academic stress on cortical excitability and plasticity by using transcranial magnetic stimulation (TMS). We tested two groups (n = 13 each) of healthy graduate medical students (mean age 33.7 ± 3.8 SE). One group was tested during a final exam week (High-stress group) while the other group was tested after a break, during a week without exams (Low-stress group). Students were required to fill the Perceived Stress Scale-10 (PSS) questionnaire. We investigated resting motor threshold (RMT), motor evoked potential (MEP) amplitude and cortical silent period (CSP). The paired-pulse stimulation paradigm was used to assess short interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Long-term potentiation (LTP)-like plasticity was evaluated with paired associative stimulation (PAS-25). There was no between-group difference in cortical excitability. On the contrary, during examination period, levels of perceived stress were significantly higher (p= .036) and the amount of cortical plasticity (60 min after PAS) was significantly lower (p = .029). LTP-like plasticity (60 min after PAS) was inversely correlated with perceived stress in the High-stress group. The present study showed LTP-like plasticity was reduced by examining stress in graduate students. Our results provide a new opportunity to objectively quantify the negative effect of academic and examination stress on brain plasticity.
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Affiliation(s)
- Carmen Concerto
- a Department of Interprofessional Health Sciences & Health Administration , School of Health and Medical Sciences, Seton Hall University , NJ , USA
| | - Dhaval Patel
- b Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania
| | - Carmenrita Infortuna
- b Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania
| | - Eileen Chusid
- b Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania
| | - Maria R Muscatello
- c Division of Pre-clinical sciences , New York College of Podiatric Medicine , New York, NY , USA
| | - Antonio Bruno
- c Division of Pre-clinical sciences , New York College of Podiatric Medicine , New York, NY , USA
| | - Rocco Zoccali
- c Division of Pre-clinical sciences , New York College of Podiatric Medicine , New York, NY , USA
| | - Eugenio Aguglia
- d Department of Biomedical and Dental Sciences and Morphofunctional Imaging , Psychiatry Unit, University of Messina , Messina , Italy
| | - Fortunato Battaglia
- a Department of Interprofessional Health Sciences & Health Administration , School of Health and Medical Sciences, Seton Hall University , NJ , USA
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Hahn H, Kropp P, Kirschstein T, Rücker G, Müller-Hilke B. Test anxiety in medical school is unrelated to academic performance but correlates with an effort/reward imbalance. PLoS One 2017; 12:e0171220. [PMID: 28182781 PMCID: PMC5300107 DOI: 10.1371/journal.pone.0171220] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/17/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE During their early years at medical school, students repeatedly criticize their workload, time constraints and test associated stress. At the same time, depressiveness and anxiety among first and second year medical students are on the rise. We therefore hypothesized that test anxiety may be related to depressiveness and considered cognitive and academic performances as confounders for the former and psychosocial distress for the latter. METHODS A whole class of 200 second year students was invited to participate in the study. Anxiety as a trait, depressiveness, crystallized intelligence, verbal fluency and psychosocial distress were assessed using validated tests and questionnaires. Acute state anxiety and sympathetic stress parameters were measured in real life situations immediately before an oral and a written exam and paired tests were used to compare the individual anxieties at the various time points. Previous academic performances were self-reported, the results of the impending exams were monitored. Finally, correlations were performed to test for interrelatedness between academic performances and the various personal, cognitive and psychosocial factors. RESULTS Acute test anxiety did not correlate with depressiveness nor did it correlate with previous nor impending academic performances nor any of the expected confounders on academic performance. However both, depressiveness and test anxiety strongly correlated with the perceived imbalance between efforts spent and rewards received. Moreover, anxiety as a trait not only correlated with acute state anxiety before an exam but was also significantly correlated to the feeling of over-commitment. CONCLUSION Depressiveness during the early years of medical school seems unrelated to test anxiety and academic performance. Instead, it strongly correlated with the psychosocial distress emanating from attending medical school and points at a perceived imbalance between efforts spent and rewards received.
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Affiliation(s)
- Henry Hahn
- Institute of Immunology, University Medical Center Rostock, Rostock, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, University Medical Center Rostock, Rostock, Germany
| | - Timo Kirschstein
- Oscar Langendorff Institute of Physiology, University Medical Center Rostock, Rostock, Germany
| | - Gernot Rücker
- Clinic for Anesthesiology and Intensive Care Medicine, University Medical Center Rostock, Rostock, Germany
| | - Brigitte Müller-Hilke
- Institute of Immunology and Dean of study research group, University Medical Center Rostock, Rostock, Germany
- * E-mail:
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