Indiana University of Pennsylvania Knowledge Repository @ IUP Theses and Dissertations (All) Spring 5-2016 Test Anxiety and Academic Procrastination Among Pre-licensure Nursing Students Nicole R. Custer Follow this and additional works at:http://knowledge.library.iup.edu/etd Part of theEducation Commons, and theNursing Commons Recommended Citation Custer, Nicole R., "Test Anxiety and Academic Procrastination Among Pre-licensure Nursing Students" (2016).Theses and Dissertations (All). 1415. http://knowledge.library.iup.edu/etd/1415 This Dissertation is brought to you for free and open access by Knowledge Repository @ IUP. It has been accepted for inclusion in Theses and Dissertations (All) by an authorized administrator of Knowledge Repository @ IUP. For more information, please [email protected], [email protected]. TEST ANXIETY AND ACADEMIC PROCRASTINATION AMONG PRE-LICENSURE NURSING STUDENTS A Dissertation Submitted to the School of Graduate Studies and Research in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Nicole R. Custer Indiana University of Pennsylvania May 2016 © 2016 Nicole R. Custer All Rights Reserved ii Indiana University of Pennsylvania School of Graduate Studies and Research Department of Nursing and Allied Health Professions We hereby approve the dissertation of Nicole R. Custer Candidate for the degree of Doctor of Philosophy ____________________ ________________________________________________ Kristy Chunta, Ph.D. Associate Professor of Nursing and Allied Health Professions, Chair ____________________ ________________________________________________ Michele Gerwick, Ph.D. Professor of Nursing and Allied Health Professions ____________________ ________________________________________________ Riah Hoffman, Ph.D. Assistant Professor of Nursing and Allied Health Professions ACCEPTED ____________________________________________ _______________________ Randy L. Martin, Ph.D. Dean School of Graduate Studies and Research iii Title: Test Anxiety and Academic Procrastination Among Pre-licensure Nursing Students Author: Nicole R. Custer Dissertation Chair: Dr. Kristy Chunta Dissertation Committee Members: Dr. Michelle Gerwick Dr. Riah Hoffman Test anxiety in nursing education remains a growing concern among nurse educators. Test anxiety acts as a factor that may cause nursing students to cope poorly with strenuous academic demands, resulting in lower academic performance levels, high attrition rates, and possibly failures on the NCLEX-RN®. Test-anxious nursing students may engage in avoidance behaviors, such as academic procrastination, as a coping mechanism. Understanding the nature of the relationship between test anxiety and academic procrastination among nursing students may assist nurse educators in identifying and augmenting test-anxious students’ time management, academic study habits, and academic preparatory skills. The purpose of this study was to describe the relationship among test anxiety and academic procrastination among pre-licensure nursing students, determine the frequency of test anxiety and academic procrastination among undergraduate nursing program types, and identify factors that may predict academic procrastination. This research study utilized a quantitative descriptive correlational design. The Test Anxiety Inventory (TAI) and the Procrastination Assessment Scale for Students (PASS) were administered to a convenience sample of 202 pre- licensure nursing students from diploma, associate, and baccalaureate nursing programs in southwestern Pennsylvania. Descriptive statistics, Pearson’s product-moment correlation, analysis of variance, and multiple regression were performed to examine the research variables of test anxiety, academic procrastination, and nursing education program type. iv The study results identified a statistically significant moderate correlation between test anxiety and academic procrastination among pre-licensure students, and that associate degree nursing students experienced significantly higher levels of test anxiety than those enrolled in diploma and baccalaureate nursing programs. Additionally, this study’s results indicated that the majority of pre-licensure nursing students report procrastinating most on keeping up with weekly reading assignments, followed by writing term papers, and studying; however, nursing students with higher self-reported GPAs tended to procrastinate less on academic tasks. This study’s findings provide insight on the relationship of test anxiety and academic procrastination among pre-licensure nursing students across nursing education program types. The implications of this study may be used to aid nurse educators in the development and implementation of strategies to identify and decrease test anxiety and academic procrastination among pre-licensure nursing students. v ACKNOWLEDGEMENTS There are several people without whom this dissertation would not have been written and to whom I am greatly thankful. To my chair, Dr. Kristy Chunta, thank you for your thoughtful and prompt feedback and reviews of my work. Thank you for being a role model for me since I was an associate degree nursing student quite a few years ago. Words cannot express my gratitude to you for guiding me through this doctoral program and the dissertation process. To my committee members Dr. Riah Hoffman and Dr. Michele Gerwick, I know your time is precious and I appreciate your attention to detail and insightful feedback on my work. Your expertise was crucial to my success. To my cohort friends Amy, Brenda, and Taylor, and my good friend Joan, getting through this doctoral program is largely due to you - your advice and support was what inspired me to press on. This dissertation is the culmination of four years of coursework that I could never have completed without each of you who were going through the process right along with me. From exchanging ideas to chatting about course loads and teaching strategies, without you this would have been a very lonely process. To my husband Greg, your support, patience, and confidence in me is what kept me moving forward. There aren’t enough words to express how much your belief in my success means to me. To my son Collin, thank you for understanding all the times you had to hear, “not right now I have to work.” I can’t wait to spend more time with you and your future baby sister who will make her appearance very soon. To my parents Lou and Diane, you never doubted me, thank you for that. I would never have been completed this doctoral program without the support of all of my loving family members. This dissertation is dedicated to each of you. vi TABLE OF CONTENTS Chapter Page ONE INTRODUCTION ...................................................................................................1 Background ..............................................................................................................3 Testing in Nursing Education ..............................................................................3 Test Anxiety ..........................................................................................................4 Academic Procrastination .....................................................................................5 Statement of the Problem .........................................................................................5 Purpose .....................................................................................................................6 Research Questions ..................................................................................................6 Conceptual Framework ............................................................................................7 Definitions of Terms ................................................................................................7 Assumptions .............................................................................................................9 Delimitations ............................................................................................................9 Significance............................................................................................................10 Chapter Summary ..................................................................................................11 TWO LITERATURE REVIEW .....................................................................................13 Search Methods ......................................................................................................13 Cognitive Avoidance Theory of Worry .................................................................14 Overview of the Cognitive Avoidance Theory of Worry ...................................14 Application of Cognitive Avoidance Theory of Worry to the Current Study ............................................................................................15 Cognitive Avoidance Theory of Worry in Higher Education .............................17 Summary .............................................................................................................20 Gaps in the Literature.............................................................................................20 Test Anxiety ...........................................................................................................20 Historical Context of Test Anxiety in Higher Education ................................................................................................21 Test Anxiety Correlates and Consequences in Higher Education ......................23 Summary .............................................................................................................32 Gaps in the Literature..........................................................................................32 Test Anxiety in Health-related Majors ..................................................................33 Pharmacy Education ...........................................................................................34 Medical Education ..............................................................................................36 Summary .............................................................................................................39 Gaps in the Literature..........................................................................................39 Test Anxiety in Nursing Education ........................................................................40 Qualitative Studies ..............................................................................................40 Summary .............................................................................................................42 Quantitative Studies ............................................................................................42 Summary .............................................................................................................49 Gaps in the Literature..........................................................................................49 vii Chapter Page Academic Procrastination ......................................................................................50 Historical Context of Academic Procrastination in Higher Education ................................................................................................50 Academic Procrastination and Associated Correlates ........................................51 Qualitative Studies ..............................................................................................51 Summary .............................................................................................................56 Gaps in the Literature..........................................................................................57 Quantitative Studies ............................................................................................57 Summary .............................................................................................................87 Gaps in the Literature..........................................................................................90 Academic Procrastination in Health-related Majors ..............................................91 Academic Procrastination in Nursing Education ...................................................91 Gaps in the Literature.............................................................................................91 Instruments .............................................................................................................91 Measurement Tools for Test Anxiety .................................................................92 Test Anxiety Inventory ....................................................................................92 Test Anxiety Inventory in nursing education research ....................................94 Measurement Tools for Academic Procrastination.............................................95 Procrastination Assessment Scale for Students ...............................................95 Chapter Summary ..................................................................................................98 THREE METHODOLOGY ...............................................................................................99 Study Design ..........................................................................................................99 Setting ...............................................................................................................100 Sample...............................................................................................................100 Population and Sample ........................................................................................100 Ethical Considerations for Human Subjects ........................................................100 Eligibility Criteria ................................................................................................101 Inclusion criteria ...............................................................................................101 Exclusion criteria ..............................................................................................101 Sample Size and Power Analysis .........................................................................101 Recruitment ..........................................................................................................102 Incentive ...............................................................................................................103 Instruments ...........................................................................................................103 Demographic Questionnaire .............................................................................104 Spielberger Test Anxiety Inventory ..................................................................104 Test Anxiety Inventory coding and scoring ...................................................105 Reliability and validity ...................................................................................106 Procrastination Assessment Scale for Students ................................................106 Procrastination Assessment Scale for Students coding and scoring ...................................................................................107 Reliability and validity ...................................................................................108 Procedures ............................................................................................................109 viii Chapter Page Data Analysis ....................................................................................................110 Demographic Data .........................................................................................111 Research Question One ..................................................................................111 Research Questions Two and Three ..............................................................111 Research Question Four .................................................................................112 Research Question Five .................................................................................112 Chapter Summary ................................................................................................112 FOUR RESULTS ...........................................................................................................114 Sample Description .............................................................................................114 Research Question One .......................................................................................120 Research Questions Two and Three ...................................................................122 Research Question Four ......................................................................................124 Research Question Five .......................................................................................125 Chapter Summary ...............................................................................................126 FIVE DISCUSSION AND IMPLICATIONS ..............................................................127 Discussion ...........................................................................................................127 Demographic Characteristics ...........................................................................127 Test Anxiety and Academic Procrastination ....................................................129 Cognitive Avoidance Theory of Worry ...........................................................133 Differences in Test Anxiety and Academic Procrastination Among Nursing Program Type .........................................................................135 Factors Predicting Pre-licensure Nursing Students’ Academic Procrastination .................................................................................................137 Types of Academic Procrastination among Pre-licensure Nursing Students ........................................................................138 Additional Findings .........................................................................................140 Limitations ..........................................................................................................142 Implications .........................................................................................................143 Test Anxiety ......................................................................................................143 Worry ...............................................................................................................145 Academic Procrastination ................................................................................147 Faculty implications ......................................................................................147 Student implications ......................................................................................148 Recommendations for Future Research ..............................................................149 Conclusions .........................................................................................................151 REFERENCES ...........................................................................................................................153 ix