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Managing Test Anxiety

Strategies for Students in the Colleges of Applied Health Sciences, Dentistry, Medicine, Nursing, Pharmacy, and Public Health

Symptoms: If you have test anxiety, you may experience physical symptoms, such as an upset stomach, sweaty palms, a racing heart, etc. You may also have trouble recalling information and thinking clearly. If test anxiety is interfering with your performance or your quality of life, try some of the suggestions below. If the problem persists or if you’re unsure whether you have test anxiety, call ACE to schedule an individual consultation: 312-413-0032. If you are experiencing a high level of more generalized anxiety, call the Counseling Center at 312-996-3490.
Note: It is important to address test anxiety promptly. Otherwise, you may find that on subsequent exams you are anxious not only about the content of the test but also about the possibility that your test anxiety may return.

Possible Causes of Test Anxiety:
Think about the nature of your fears and come up with an answer to the fear -- either a change in behavior or a change in thinking (reframing the situation). Possible answers are listed below, but you can also come up with your own.

Realistic Fears:

  • I'm not ready for this test. Answer: Work on your time management and perhaps your perfectionism (see below).
  • If I fail this exam, I might have to repeat the year. Answer: Talk to your advisor, dean, or counselor and try to be as realistic as you can about your options. In most cases, second chances are built into the system.
Unfounded Fears:

  • My family, classmates, and professors will think that I'm not very bright. Answer: At this level of education, everybody is smart, and intelligence is not the primary factor separating top performers from lower ones. After you graduate you will be judged on your work performance, so you will have plenty off opportunities to distinguish yourself.
  • I used to think I was smart, but now I'm no longer sure. Answer: Almost all graduate and professional students experience this kind of doubt. It's perfectly normal.

Letting Go of Perfectionism:

Before entering your professional program you may have been a perfectionist who went into exams feeling that you had studied everything you needed to know. It can be emotionally difficult to let go of perfectionism, but you must try. In a health professional program it is virtually impossible to learn every detail, so you need to focus on the most important concepts and learn those well enough to teach them. Remind yourself that your understanding of the major concepts will help you guess well on some of the details that you are unable to recall during the test.
To help curb your perfectionism, try this: Set a time limit and then go through a set of lecture notes with the goal of pulling out only the most important concepts and facts. Tell yourself that if you have time later on you will return to “gather” the less important information. (Knowing that you can return will make it emotionally easier to leave minor details behind for now.)

Before the Exam:

  1. Put things in perspective. Remind yourself that your upcoming exam is important, but your entire future doesn't depend on this exam. (Many successful medical professionals have a few academic struggles in their past.) Also, it might be helpful to tell yourself that regardless of your performance on the test you will not be diagnosed with a terminal illness at the end of it.
  2. Remind yourself of past successes. It’s easy to lose perspective when you find that you are no longer the top student in the class. Intellectually, you understand that you're competing against the best students from several undergraduate programs, but you may need to remind yourself of that. Also, bring to mind your past successes on exams and remind yourself that UIC admissions officers know what they’re doing and they have “bet” on your success.
  3. Don't give a test the power to define you. An exam won't tell you whether you're the most brilliant (or least brilliant) student in your program. Your performance on an exam mostly depends on how effectively you studied for the test, the quality of your prior education, and the test-taking strategies you use.
  4. Visualize completing the test successfully despite your anxiety. Using vivid images, play the entire "tape" in your mind – from the moment you wake up on the day of the exam to the moment you finish the exam.
  5. Remind yourself that a certain level of anxiety is actually helpful in performing your best. And remember: you can always use anxiety control strategies to moderate your anxiety level if it becomes excessive.
  6. Give yourself practice tests and use them not only to work on your test-taking but also to practice controlling your anxiety level. Deliberately induce anxiety by saying negative things to yourself and then practice the Anxiety Control Procedure. If you're afraid of not being able to finish the exam in time, do timed sets of practice questions.
  7. Get a good night's sleep for several days before the exam. With adequate sleep, your ability to think clearly and to deal with anxiety will both improve. You might try imagining yourself as a professional athlete: ask yourself how you would prepare yourself mentally and physically for an important game. Doing a moderate workout early in the evening (5:00 or 6:00) may help you sleep more soundly at night. If you often have trouble sleeping, consult your physician.
  8. High anxiety can increase the impact of caffeine, so on test days, reduce your intake.
During the Exam:

  1. Get to the test site a little early, but try to avoid talking with other students right before the exam. (Their anxieties may increase your own.) Instead, take a walk around the building and silently talk to yourself or pray. Moving your body can help rid you of some of the nervous energy you are experiencing.
  2. If possible, choose a seat in a place with few distractions (probably near the front). You might also want to bring earplugs to limit distractions.
  3. Remind yourself that you don’t know all the material that could possibly appear on the test and nobody else does either. Still, you can do your best to get some “mileage” out of what you do know.
  4. Expect a few curve balls on the exam. Remind yourself that you're not expecting to get 100% on the exam; you're expecting an A (or a Pass). Also, your sense of what questions should appear on the test is not going to match perfectly with what the writer of the test had in mind. Therefore, when you encounter a curve ball on the exam, don’t get upset and lose your concentration. Instead, you can either make an intelligent guess now or mark the question and return later.
  5. No tricky questions: Don’t tell yourself that questions requiring a judgment call are tricky (for example, questions that ask for the first test you should administer or the most appropriate action to take). Remember, medical professionals do need to know a lot of facts, but more importantly, they need to make good judgment calls. Judgment questions are perfectly legitimate, and you can learn to answer them well by practicing this skill with sets of practice questions.
  6. If the exam is more difficult than you expected, it is probably tough for everyone, and you can always hope that the scores will be curved.
  7. If you begin to have negative thoughts, say STOP to yourself and remind yourself of past successes.
  8. If you continue to feel overly anxious, do the following ANXIETY CONTROL PROCEDURE to reduce your tension. This exercise is so simple that you may be skeptical about its effectiveness. However, many students have found that it really helps lower their anxiety to a level that is helpful rather than harmful.
    • Close your eyes.
    • Breathe in slowly to the count of seven and exhale to the count of seven.
    • Continue this slow breathing until you actually feel your body begin to relax. (Most people find that it takes 2 to 4 sequences.)
    • Open your eyes and give yourself a positive, very specific self-talk (ie. "You're sure to do well. You studied hard. And remember, you’re the same person who aced organic chem.") This whole procedure should take only about a minute and it's well worth the time.
  9. Move your body. Roll your shoulders, stretch your legs, get up for a bathroom break if it's allowed.
  10. Banish all thoughts of how well or poorly you might be doing on the exam. It's hard to guess accurately, and thinking about your score will only increase your anxiety.
  11. Most students prefer to carefully work through the questions once rather than rushing through the exam and leaving time at the end for checking. (Nervous test-takers are especially prone to changing correct answers to incorrect when they go back to check their answers.)
  12. Do not obsess about running out of time on the test. Check the time periodically, but avoid checking too frequently, as this will only distract you and make you more anxious. It can be a better strategy to sacrifice a few points by not quite finishing the test than to rush through the last several questions and thus miss many points.
  13. HERE’S THE MOST IMPORTANT TIP: Approach your studying seriously, but think of the test as a game. Your goal is to collect as many points as you can in the time available. Don't obsess about a particularly difficult question. If you're unsure of the answer, guess and move on. Remind yourself that you can miss several questions and still do well.

Written by Cecelia Downs
UIC’s Academic Center for Excellence

1200 W. Harrison, Chicago, IL 60607

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