Abstract
Problem- The first semester is a critical time when students decide whether to persist or leave a nursing program.
Purpose- To evaluate a) students’ responses on exam wrappers during the first semester, b) the relationship between demographic characteristics and exam grades, and c) if there was a change in students’ level of test anxiety as measured by the Westside Test Anxiety Scale (Driscoll, 2007) at three points in time during the first semester and if there was any change in relation to demographic characteristics.
Research Questions: 1) What are nursing students’ exam wrapper responses during the first-semester? 2) What is the relationship between demographic characteristics and exam grades during the first semester? 3) Is there a change in nursing students’ level of test anxiety during the first semester and does that change, if any, relate to demographic characteristics?
Method- A descriptive correlational design was used to evaluate nursing students’ responses on exam wrappers, demographic characteristics, exam grades, and test anxiety during the first semester. Students aged 18 and older enrolled in two nursing courses were recruited during spring 2025. The Westside Test Anxiety Scale was administered at three points in time during the semester. Faculty provided resources on study strategies, self-care, how to manage test anxiety, and test-taking skills. Pre-and-post exam wrappers were administered after the first exam, for each subsequent exam, and prior to the final exam. Faculty provided feedback in exam wrapper responses. Exam grades were collected at the end of the semester. A 15-item demographic survey included items on age, gender, race/ethnicity, and level in the nursing program, and if English was their first language.
Theoretical/Conceptual Framework- Jeffreys’ (2012, 2020) Nursing Universal Retention and Success (NURS) Model and Lovett’s (2013) research on metacognitive exam wrappers provided a conceptual framework.
Statistical Analysis- Descriptive statistics will summarize demographic characteristics and quantitative data relating to exam wrapper responses, GEE will be computed to examine the relationship between demographic characteristics and exam grades, a within-between repeated measures ANOVA and GEE will be computed to describe a change in level of test anxiety as well as the change in relation to demographic characteristics. Qualitative data will be analyzed using thematic analysis (Braun & Clarke, 2006; Braun et al., 2022).
Notes
References:
Braun,V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3:77-101. https://doi.org/10.1191/1478088706qp063oa
Braun,V., Clarke, V., & Hayfield, N. (2022). ‘A starting point for your journey, not a map’: Nikki Hayfield in conversation with Virginia Braun and Victoria Clarke about thematic analysis. Qualitative Research in Psychology,19(2):424-445. https://psycnet.apa.org/doi/10.1080/14780887.2019.1670765
Driscoll, R. (2007). Westside Test Anxiety Scale Validation. https://files.eric.ed.gov/fulltext/ED495968.pdf
Jeffreys, M. R. (2012). Nursing student retention: Understanding the process and making a difference (2nd ed.). Springer Publishing Company.
Jeffreys, M. R. (2020). Nursing Universal Retention and Success (SURS) Model: A holistic, discipline-focused framework. Journal of College Student Retention: Research, Theory, & Practice. 24(3),1-26. https://www.doi.org/10.1177/1521025120939254
Lovett, M. C. (2013). Make exams worth more than the grade: Using exam wrappers to promote metacognition. In: Kaplan, M., Silver, N., Lavaque-Manty, D.
L., Meizlish, D. (Eds.). Using reflection and metacognition to improve student learning: Across the disciplines, across the academy (pp. 18-52). Stylus.
Sigma Membership
Xi Pi
Lead Author Affiliation
Illinois State University, Normal, Illinois, USA
Type
Poster
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Quantitative Research
Keywords:
Teaching and Learning Strategies, Nursing Students, Student Attitudes, Test Taking, Student Dropouts, Student Retention
Recommended Citation
Pence, Patricia L.; Kim, MyoungJin; and Trost, Robin Rochelle, "Exam Wrappers, Test Anxiety, Demographics, and Exam Grades in First-Semester Nursing Students" (2026). International Nursing Research Congress (INRC). 61.
https://www.sigmarepository.org/inrc/2026/posters_2026/61
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-05
Funder
Mennonite College of Nursing, Illinois State University
Exam Wrappers, Test Anxiety, Demographics, and Exam Grades in First-Semester Nursing Students
Toronto, Ontario, Canada
Problem- The first semester is a critical time when students decide whether to persist or leave a nursing program.
Purpose- To evaluate a) students’ responses on exam wrappers during the first semester, b) the relationship between demographic characteristics and exam grades, and c) if there was a change in students’ level of test anxiety as measured by the Westside Test Anxiety Scale (Driscoll, 2007) at three points in time during the first semester and if there was any change in relation to demographic characteristics.
Research Questions: 1) What are nursing students’ exam wrapper responses during the first-semester? 2) What is the relationship between demographic characteristics and exam grades during the first semester? 3) Is there a change in nursing students’ level of test anxiety during the first semester and does that change, if any, relate to demographic characteristics?
Method- A descriptive correlational design was used to evaluate nursing students’ responses on exam wrappers, demographic characteristics, exam grades, and test anxiety during the first semester. Students aged 18 and older enrolled in two nursing courses were recruited during spring 2025. The Westside Test Anxiety Scale was administered at three points in time during the semester. Faculty provided resources on study strategies, self-care, how to manage test anxiety, and test-taking skills. Pre-and-post exam wrappers were administered after the first exam, for each subsequent exam, and prior to the final exam. Faculty provided feedback in exam wrapper responses. Exam grades were collected at the end of the semester. A 15-item demographic survey included items on age, gender, race/ethnicity, and level in the nursing program, and if English was their first language.
Theoretical/Conceptual Framework- Jeffreys’ (2012, 2020) Nursing Universal Retention and Success (NURS) Model and Lovett’s (2013) research on metacognitive exam wrappers provided a conceptual framework.
Statistical Analysis- Descriptive statistics will summarize demographic characteristics and quantitative data relating to exam wrapper responses, GEE will be computed to examine the relationship between demographic characteristics and exam grades, a within-between repeated measures ANOVA and GEE will be computed to describe a change in level of test anxiety as well as the change in relation to demographic characteristics. Qualitative data will be analyzed using thematic analysis (Braun & Clarke, 2006; Braun et al., 2022).
Description
Participants will gain a better understanding of the phenomenon of prelicensure nursing students’ experience in the first-semester of a nursing program—a critical time for attrition.