Is the OSCE more stressful? Examination anxiety and its consequences in different assessment methods in dental education

Objective: To measure the levels of anxiety, self-perception of preparation and expectation for success induced by an objective structured clinical examination (OSCE), a written examination and a preclinical preparation test, and to examine the effects of the three predictive variables on the outcome of the assessments. Materials and methods: Test anxiety was measured with Spielberger's state anxiety inventory. Preparation for the assessment and expectation to succeed were quantified with 4-point Likert scales. The questionnaire was completed during an OSCE, a written examination, a preclinical crown and bridge preparation test and a non-examination situation. Results: The OSCE was a most anxiety-provoking assessment method and students prepared more for the OSCE than for the other examinations. The expectation to succeed was also higher for the OSCE. State anxiety during the OSCE was associated with the level of preparation but not with scores obtained. The state anxiety during a written examination showed a positive relation with the scores obtained, but not with preparation or expectation to succeed. During the preclinical test, state anxiety showed a positive association with the preparation and expectation to succeed, but not with the scores for this test. No significant gender effects were observed for the state anxiety, level of preparation or the expectation to pass the examination. In the written examination female students scored significantly higher than male students. Such a gender effect was not found for the scores of the OSCE or the preclinical test. Conclusion: State anxiety was elevated during all three assessment methods. However, anxiety was not predictive of performance outcome in the OSCE, written examination or preclinical preparation test.