title: Metacognitions, worry and attentional control in predicting OSCE performance test anxiety.
abstract: OBJECTIVE
  This study investigated the applicability of the self-regulatory executive functioning (S-REF) model to performance test anxiety (PTA) in objective structured clinical examinations (OSCEs). Specifically, it examined the relative contributions of metacognitive beliefs, trait worry and attentional control to PTA.
  
  
  METHODS
  A cross-sectional design was used. Immediately prior to their formative Communication for Clinical Practice OSCE, 240 Year 1 medical students completed the following self-report questionnaires: the Metacognitions Questionnaire-30 (MCQ-30); the Penn State Worry Questionnaire (PSWQ); the Attentional Control Scale (ACS), and the Performance Test Anxiety questionnaire (PTA).
  
  
  RESULTS
  Univariate analysis indicated that female students scored significantly more highly than male students on the MCQ-30 subscale for negative beliefs about the uncontrollability and danger of worry, the MCQ-30 subscale for cognitive confidence and the PSWQ subscale for trait worry. Partial correlations (controlling for gender) showed that metacognitions, worry and attentional control were significantly correlated with PTA. Multiple regression analyses showed that worry and negative beliefs about the uncontrollability and danger of worry were independent predictors of PTA in both male and female students, whereas attention focus was an independent predictor only in male students.
  
  
  CONCLUSIONS
  The findings support predictions derived from the S-REF model that metacognitive beliefs, trait worry and attentional control processes underlie the onset and maintenance of PTA.
authors.affiliation: Division of Clinical Psychology, University of Liverpool, Liverpool, UK. p.ocarroll@liv.ac.uk
authors.forename: Pierce J
authors.initials: PJ
authors.lastname: O'Carroll
authors.forename: Peter
authors.initials: P
authors.lastname: Fisher
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001288:Attention; D001291:Attitude of Health Personnel; D003071:Cognition; D003430:Cross-Sectional Studies; D004501:Education, Medical; D004521:Educational Measurement; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D060805:Performance Anxiety / Q000523:psychology*; D012044:Regression Analysis; D057566:Self Report; D017678:Sex Distribution; D013337:Students, Medical / Q000523:psychology*; D013732:Test Anxiety Scale / Q000706:statistics & numerical data; D055815:Young Adult