title: The effect of guided reflection on test anxiety in nursing students.
abstract: BACKGROUND
  Anxiety disorders are common and test stress affects many students. Guided reflection is a new and effective method for reducing stress.
  
  
  OBJECTIVE
  To assess the effect of guided reflection on test anxiety in second and third-year nursing students of Fatima Nursing and Midwifery College, Shiraz University of Medical Sciences, Shiraz, Iran.
  
  
  METHODS
  This study was designed to assess the effect of guided reflection on test anxiety among nursing students of second and third year of education in Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Data was collected using demographic data questionnaires and the Sarason and Abolghasemi test anxiety scale. Based on the latter questionnaire, of the 147 participants, 100 had test anxiety with scores ranging from 13-63 (mild-severe anxiety), of which 80 students were randomly selected and divided into case and control groups. We used Johns's 9-stage guided reflection model through Q and A, lecture, and discussion. The case group participated in a 2-day guided reflection workshop for six hours each day. The control group received no intervention. Sarason and Abolghasemi's test anxiety questionnaire was completed by the students at the beginning of the first session, immediately after and three months after intervention.
  
  
  RESULTS
  The test anxiety mean scores were 35.34 ± 9.50 and 35.47 ± 10.66 before the intervention in the control and intervention groups respectively. No significant difference was found between the two groups with respect to socio-demographic characteristics. The Mean ± SD of test anxiety scores increased to 36.48 ± 9.34 three months after the intervention in the control group (P = 0.1). However, in the intervention group, the Mean ± SD test anxiety scores reduced immediately after (16.31 ± 8.61) and three months after (27.72 ± 10.09) the intervention, compared to before the intervention (35.47 ± 10.66) (P < 0.001, paired T-test).
  
  
  CONCLUSIONS
  Guided reflection is effective in reducing test anxiety in nursing students. This method can be used for reducing test anxiety and increasing learning and academic progress among students.
authors.affiliation: Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Farkhondeh
authors.initials: F
authors.lastname: Sharif
authors.affiliation: Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Dehbozorgi
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Mani
authors.affiliation: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Vossoughi
authors.affiliation: Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Pouran
authors.initials: P
authors.lastname: Tavakoli
keywords: Anxiety; Guided reflection; Nursing students; Test