AbstractThe debilitation score from the Alpert‐Haber Anxiety Achievement Test was used to identify students suffering from exam anxiety. Principal component Analysis was then used to show that the debilitation score was strongly related to short‐term and long‐term anxiety and self‐image and not, as expected, to study skills, problem‐solving skills, or avoidance to engage in solving difficult problems. Required workshops to help students address low self‐image and high short‐term and long‐term anxiety were introduced, but they had modest short‐term success. However, significant improvement in student performance occurred when faculty included measures of student performance other than the final exam (such as term work, projects, and self‐assessment) and when students contracted for the weighting that the final exam would contribute to their final grade. The use of self‐assessment was effective for all students regardless of their level of exam anxiety.