title: Critical Aspects of Stress in a High-Stakes Testing Environment: A Phenomenographical Approach.
abstract: BACKGROUND
  A high-stakes examination is any examination used for tracking or determining promotion or graduation. Therefore, when used as a basis for progression or graduation in nursing, standardized examinations become high stakes for students. High-stakes testing in nursing is a focal stimulus that has been shown to contribute to the negative consequences associated with stress. The adverse effects of stress have the potential to result in unhealthy coping behaviors such as isolation, withdrawal, decreased motivation, and decreased self-efficacy.
  
  
  METHODS
  Phenomenography was used to capture the various ways in which students experience stress.
  
  
  RESULTS
  Six major categories of description emerged. All students experienced stress in relation to high-stakes testing. However, student interviews revealed that students experienced the stress in myriad ways, ranging from fear of not graduating to social isolation and withdrawal.
  
  
  CONCLUSIONS
  Although it is known that high-stakes testing contributes to the development of stress, this study provides evidence of the need for nursing programs to consider the implementation of supportive measures as a means to mitigate student stress and foster student success.
authors.forename: Catherine Gannon
authors.initials: CG
authors.lastname: Tagher
authors.forename: Erin M
authors.initials: EM
authors.lastname: Robinson
mesh_terms: D004506:Education, Nursing; D004521:Educational Measurement; D006801:Humans; D013315:Stress, Psychological / Q000209:etiology*