Exploring the Relationship Between Examination-Induced Anxiety and Cardiovascular Responses Among PT Students

This study explores the relationship between examination-induced anxiety and cardiovascular responses among physical therapy (PT) students. A quasi-experimental repeated measures design was utilized to examine heart rate (HR), blood pressure (BP), and heart rate variability (HRV) at three stages: before, during, and after high-stakes Objective Structured Clinical Examinations (OSCEs). A total of 120 PT students (60 male, 60 female) were recruited using purposive sampling, with data collection extended over two academic years to ensure balanced gender representation. Anxiety was measured using the State-Trait Anxiety Inventory (STAI), while cardiovascular responses were continuously monitored using wearable devices. Results revealed significant increases in HR and BP, alongside decreases in HRV during the examination, reflecting heightened autonomic stress. Post-exam, cardiovascular markers demonstrated partial recovery but remained elevated compared to pre-exam levels, indicating lingering physiological effects of anxiety. Qualitative data from student interviews revealed cognitive impairments and lingering anxiety post-exam, corroborating the physiological findings. Repeated measures ANOVA indicated significant changes in cardiovascular responses over time, with no significant interaction effects for gender. These findings underscore the impact of examination-induced anxiety on both physiological and psychological outcomes in PT students. The persistent elevation in cardiovascular markers post-exam suggests that students may not fully recover from stress immediately, highlighting the need for targeted interventions, such as mindfulness or biofeedback, to help manage anxiety. Addressing examination stress could enhance both student well-being and academic performance, mitigating the long-term risks associated with chronic stress.