Test Anxiety and Academic Procrastination Among Pre-licensure Nursing Students

194 Pages·2017·1.72 MB·English

Indiana University of Pennsylvania
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Theses and Dissertations (All)
Spring 5-2016
Test Anxiety and Academic Procrastination Among
Pre-licensure Nursing Students
Nicole R. Custer
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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
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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
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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.
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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.

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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.

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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
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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
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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

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