The effect of a stress and anxiety coping programme on objective structured clinical exam performance in medical students, a randomised clinical trial

Abstract

Aim/background: To investigate the effect of a stress and anxiety coping programme on anxiety and objective structured clinical exam (OSCE) performance in medical students. Material and methods: First-year medical students about to sit their first OSCE were randomised into experimental (n = 75) and control (n = 78) groups at the Ondokuz Mayıs University Medical Faculty in 2009–2010. Before the study, the state-trait anxiety inventory (STAI) was applied to both groups (pre-tests). The volunteer medical students in the experimental group received nine sessions (one 30 min session per week for 9 weeks) of an anxiety- and stress-coping programme. At the end of the programme (post-test) and 3 months later, following an overview session with the experimental group, the STAI was readministered to both groups (1st follow-up test). One month later, the experimental group performed deep diaphragmatic breathing and listened to gentle classical music in the test room while waiting to sit the OSCE, while the control group waited in a silent room. Both groups retook the STAI (2nd follow-up) just before sitting the OSCE. The groups’ pre-, post-, 1st and 2nd follow-up STAI scores and the relations with OSCE performance and anxiety were investigated within the groups. Results: Although there was no difference in the pre-test STAI results between the experimental and control groups (state p = .213, trait p = .122), the experimental group had lower post-test, 1st and 2nd follow-up STAI scores (p < .001, respectively). The OSCE results of the experimental group were higher than those of the control group (p < .001). In a linear regression model, post-test, 1st and 2nd follow-up trait anxiety (p = .023, p = .014 and p < .0001, respectively) and state anxiety (p = .032, p = .026 and p < .001, respectively) were identified as independent factors for higher OSCE scores. Conclusion: Our results indicate that the participants in the experimental group achieved lower scores on post-STAI and improved OSCE performance.