Analysis Analysis of Factors Influencing Student Anxiety in Facing the OSCE Exam: A Study on Diploma Among Nursing Students at STIKES Kamus Arunika
Abstract
Anxiety in facing the Objective Structured Clinical Examination (OSCE) remains a significant challenge for nursing students. Recent studies show that anxiety among nursing students facing the OSCE is high. The report shows that 75.5% of students experienced moderate anxiety when facing the OSCE. This study aimed to analyze the influence of self-efficacy, academic readiness, academic motivation, and social support on students’ anxiety. A cross-sectional correlational design was used, involving 94 Diploma in Nursing students at STIKES Kamus Arunika. Data were collected using structured questionnaires and analyzed using Pearson correlation and multiple linear regression. The results showed that anxiety levels were categorized as moderate in 62 students (66.0%), high in 27 students (28.7%), and low in 5 students (5.3%). All independent variables were significantly negatively correlated with anxiety, with self-efficacy showing the strongest relationship (r = -0.345, p < 0.01). Regression analysis revealed that self-efficacy (β = -0.312; p = 0.001), academic readiness (β = -0.224; p = 0.024), academic motivation (β = -0.215; p = 0.032), and social support (β = -0.162; p = 0.045) were significant predictors, explaining 37.4% of the variance in anxiety (R² = 0.374). These findings highlight the integrated role of psychological, academic, and social factors in shaping student anxiety, with self-efficacy as the most influential determinant. This study contributes an integrative perspective and suggests that targeted interventions, including self-efficacy enhancement, structured OSCE preparation, and supportive learning environments, are essential to reducing anxiety and improving student performance.
References
Marchewka, W., Samborska, U., Drojewski K., et al. (2022). Assessment of Stress Load and Its Causes Among Medical Students. Medical Rehabilitation, 26(4), 11-19. DOI: https://doi.org/10.5604/01.3001.0015.9776.
Bandura, A. (1997). Self-efficacy: The exercise of Control. W.H. Freeman.
Magdalena, N., & Siagian, I. O. (2023). Pengetahuan dan Self Efficacy Mahasiswa D3 Kebidanan dengan Tingkat Kecemasan dalam Menghadapi Objective Structured Clinical Examination (OSCE). Jurnal Keperawatan Jiwa (JKJ), 11(2), 465–476. DOI: https://doi.org/10.26714/jkj.11.2.2023.465-476
Nojima, K., & Morimoto, M. (2024). Changes in the Professional Identity and Self-Efficacy of Nursing Students Engaged in the Objective Structured Clinical Examination Using Simulation Learning. Cureus Journal of Medical Science, 16(9). DOI: https://doi.org/10.7759/cureus.68568
Rahman, N. I. A., Goyal, R. K., & Haque, M. (2020). Relationship Between Readiness for Clinical Practice and Perceived Stress Among Final-Year Medical Students. Advances in Medical Education and Practice, 1–7.
Judha, M. (2022). The Correlations Between One’s Readiness and the Level of Anxiety When Facing the OSCE Exam among the Students of Nursing Undergraduate Program, Respati University Yogyakarta. Jurnal Studi Keperawatan, 3(1), 1-7. DOI: 10.31983/j-sikep.v3i1.7849
Deci, E. L., & Ryan, R. M. (2017). Intrinsic Motivation and Self-Determination in Human Behavior. Springer.
Rafii, F., Saeedi, M. & Parvizy, S. (2019). Academic Motivation in Nursing Students: A Hybrid Concept Analysis. Iranian Journal of Nursing and Midwifery Research, 24(5); 315-322. DOI: 10.4103/ijnmr.IJNMR_177_18.
Hamaideh, S., Abu Khait, A., Al Modallal, H., Malak, M., Masa’deh, R., Hamdan-Mansour, A., & AL Bashtawy, M. (2024). Relationships and Predictors of Resilience, Social Support, and Perceived Stress among Undergraduate Nursing Students. The Open Nursing Journal, 18(1). DOI: https://doi.org/10.2174/0118744346238230240103055340
Yosep, I., Mediani, H. S., & Lindayani, L. (2021). Working Alliance Among Mental Health Nurses in Indonesia: A Comparative Analysis of Socio-Demographic Characteristics. Belitung Nursing Journal, 7(2), 125–130. DOI: https://doi.org/10.33546/bnj.1259
Hayat, A. A., Soltani, R., Tazangi, T. B., Baradaranfar, F., Zareh, A., Norouzi, A., & Keshavarzi, M. H. (2025). Relationship Between Mindfulness, Test Anxiety, and Academic Performance Among Nursing Students. Journal of Education and Health Promotion, 14(1). https://doi.org/10.4103/jehp.jehp_1501_23
Senosy, A., Sallam, G., Magzoub, M.E., Fattah, H.A., Sharkawi, S.E., Ahmed, Z., Maki, S., & Awar, S.A. (2025). Relationship Between Anxiety Levels and Objective Structured Clinical Examination among Undergraduate Nursing Students. Research Square; DOI: https://doi.org/10.21203/rs.3.rs-6931280/v1
Surbakti, R., Mutiasari, D., Sugiono, Y.N, Jelita, H., Tindaon, D., & Kusuma, W. (2024). The Relationship between Anxiety Level and Cognitive Function of Students Class of 2022 Medical Faculty of Universitas Palangka Raya in Dealing with OSCE. Journal of Medicine and Health (JMH), 6(2), 1-8; DOI: https://doi.org/10.28932/jmh.v6i2.7778
Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019). The Influence of Anxiety on Student Nurse Performance in a Simulated Clinical Setting: A Mixed Methods Design. International Journal of Nursing Studies, 98: 57-66, DOI: https://doi.org/10.1016/j.ijnurstu.2019.06.006.
Boursicot, K., Kemp, S., Wilkinson, T., Findyartini, A., Canning, C., Cilliers, F., & Fuller, R. (2021). Performance Assessment: Consensus Statement and Recommendations from the 2020 Ottawa Conference. Medical Teacher, 43(1), 58–67. DOI: https://doi.org/10.1080/0142159X.2020.1830052
Badrian, M., Bazrafkan, L. & Shakour, M. (2022). Medical Science Students’ Experiences of Test Anxiety: A Phenomenological Study. BMC Psychology, 10(187). DOI: https://doi.org/10.1186/s40359-022-00896-4
Honicke, T. & Broadbent, J. (2016). The Influence of Academic Self-Efficacy on Academic Performance: A Systematic Review. Educational Research Review, 17; 63-84, DOI: https://doi.org/10.1016/j.edurev.2015.11.002.
Putwain, D., Sander, P. and Larkin, D. (2013), Academic Self-Efficacy in Study-Related Skills and Behaviours: Relations with Learning-Related Emotions and Academic Success. British Journal of Educational Psychology, 83; 633-650. DOI: https://doi.org/10.1111/j.2044-8279.2012.02084.x
Mega, C., Ronconi, L., & De Beni, R. (2014). What Makes a Good Student? How Emotions, Self-Regulated Learning, and Motivation Contribute to Academic Achievement. Journal of Educational Psychology, 106(1), 121–131. DOI: https://doi.org/10.1037/a0033546
Ryan, E., & Deci, E. (2020). Intrinsic and Extrinsic Motivation from a Self-Determination Theory Perspective: Definitions, Theory, Practices, and Future Directions. Contemporary Educational Psychology, 61. DOI: https://doi.org/10.1016/j.cedpsych.2020.101860
Thoits, P. A. (2011). Mechanisms Linking Social Ties and Support to Physical and Mental Health. Journal of Health and Social Behavior, 52(2), 145-161. DOI: https://doi.org/10.1177/0022146510395592
Wilks, S. E., & Spivey, C. A. (2010). Resilience in Undergraduate Social Work Students: Social Support and Adjustment to Academic Stress. Social Work Education, 29(3), 276–288. DOI: https://doi.org/10.1080/02615470902912243
Moreira-Morales, Denny & García-Loor, María. (2024). Motivation in Academic Performance. International Research Journal of Management, IT and Social Sciences. 11; 30-38. DOI: https://doi.org/10.21744/irjmis.v11n1.2403
Pekrun, R. (2006). The Control-Value Theory of Achievement Emotions: Assumptions, Corollaries, and Implications for Educational Research and Practice. Educational Psychology Review, 18, 315–341. DOI: https://doi.org/10.1007/s10648-006-9029-9
Artino, AR. (2012). Academic Self-Efficacy: From Educational Theory to Instructional Practice. Perspective Medical Education; 1(2):76-85. DOI: 10.1007/s40037-012-0012-5
Cant, R.P. & Cooper, S.J. (2017). Use of Simulation-Based Learning in Undergraduate Nurse Education: an Umbrella Systematic Review. Nurse Education Today, 49; 63-71. DOI: https://doi.org/10.1016/j.nedt.2016.11.015.
Labrague, L. J., McEnroe-Petitte, D. M., Papathanasiou, I. V., Edet, O. B., Tsaras, K., Leocadio, M. C., Velacaria, P. I. T. (2018). Stress and Coping Strategies Among Nursing Students: An International Study. Journal of Mental Health, 27(5), 402–408. https://doi.org/10.1080/09638237.2017.1417552
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