Abstract
This study aimed at assessing the value of heart rate variability (HRV) as a stress indicator before and after a final re-sit exam among healthy sixth grade medical students. Fifty participants were recruited for the study (test group, n = 30; control group, n = 20). Each participant was examined for 5 minutes pre and post exam periods using the Heartmath proprietary protocol. EmWave equipment was used to detect, record and analyze the HR and to plot out the variability in discrete percentages for low, medium and high coherences. Results indicated that mean percentage coherence score was significantly higher in the test group (p < 0.05) at low cardiac coherence domain, but lower (p < 0.05) at the high coherence domain, compared with the control. Coherence score was significantly higher (p < 0.05) after the exam indicating release from stress, as compared to before the examination when stress was observable among the exam candidates. There were no significant gender differences observed in cardiac coherence scores before and after examination. Our findings indicate that HRV is a reliable indicator of real-time exam stress and supports future clinical use of HRV as a non-invasive and simple stress test.
Highlights
Stress can be defined as a physical response or condition usually characterized by the symptoms of mental and physical tension or strain, resulting from a reaction to a situation in which an individual feels pressured or threatened or sometimes both [1]
These findings suggest that in both cardiac coherence domains, the pre-exam period indicated a condition of lower heart rate variability (HRV), higher sympathetic outflow and higher level of mental stress, anxiety and worry compared with the post exam condition, which is considered as a relaxation period and characterized by a restoration of the parasympathetic dominance and HRV augmentation
During the mental stress stimulation, components of the sympathetic nervous system increased as shown by an increase in LF score and with a decrease in the values of parasympathetic activity as shown by a decrease in HF scores among the test group
Summary
Stress can be defined as a physical response or condition usually characterized by the symptoms of mental and physical tension or strain, resulting from a reaction to a situation in which an individual feels pressured or threatened or sometimes both [1]. The exam induced stress is reported to be associated with increased level of anxiety, depressiveness and negative emotional states which students experience at such times [2]-[5]. These negative conditions are often triggered by fear of failure, heavy workload, lack of time to do revision, having difficulty understanding course content, anxiety over teacher’s evaluation of performance, unpreparedness, and high expectations from family members, friends and teachers, as well as previous unfavorable examination experiences. It is normal to feel some degree of stress before exams; a small level of stress and anxiety can help a student perform well.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
