Test Anxiety Hits Most Preclinical Medical Students in Vietnamese Study

More than two-thirds of preclinical medical students at a Vietnamese university experienced clinically significant test anxiety during their first major examination period, and the burden was not evenly spread across doctor-training programmes. A cross-sectional study of 800 second-year students at Can Tho University of Medicine and Pharmacy, published in BMC Medical Education, found an overall prevalence of clinically significant test anxiety of 70.0 percent (95 percent CI: 66.8–73.1), measured with the 20-item Spielberger Test Anxiety Inventory during the Preclinical I examination period from December 2024 to March 2025.

The prevalence differed significantly across the four programmes (χ² = 21.30; p < 0.001). Dental Medicine students reported the highest rate at 79.0 percent, followed by Traditional Medicine at 76.3 percent and Preventive Medicine at 74.5 percent, while General Medicine students recorded the lowest at 62.3 percent. Traditional Medicine stood out most sharply at the severe end of the distribution: 52.6 percent of those students scored in the very high anxiety range, defined as a Test Anxiety Inventory score of 62 or above.

Total anxiety scores also differed significantly across programmes (F(3,796) = 12.23; p < 0.001). Traditional Medicine students had the highest mean total score at 61.10 (standard deviation 12.91), while General Medicine students had the lowest at 54.76 (standard deviation 12.79). The same ordering held for the two subscales of the inventory: Traditional Medicine showed the highest Worry and Emotionality scores, and General Medicine the lowest. The researchers assessed these subscale differences using multivariate analysis of variance, and examined programme-specific effects with multivariable logistic regression, reporting the work according to the STROBE guidelines for observational studies.

A methodological strength of the study was its attention to fair comparison. Because the researchers wanted to contrast anxiety levels across programmes rather than within a single group, they first tested whether the instrument measured the same construct in the same way in each programme. Multi-group confirmatory factor analysis demonstrated that the two-factor structure of the Test Anxiety Inventory achieved scalar invariance across the four programmes, supporting valid cross-programme comparisons of the Worry and Emotionality subscales.

The authors frame the findings as evidence of discipline-specific patterns of test anxiety in a Vietnamese preclinical setting, a dimension they note has been underexamined because most prior research has focused on general medical students rather than the other doctor-training pathways that operate in multidisciplinary Asian medical education systems, including Dental Medicine, Traditional Medicine, and Preventive Medicine. The observation that all three non-General-Medicine programmes clustered above 74 percent prevalence, while General Medicine sat more than 12 percentage points lower, suggests that the structure and demands of different preclinical curricula may shape how students experience high-stakes testing, though a cross-sectional design of this kind documents associations at one point in time and cannot establish why the differences arise.

The study’s conclusions are deliberately measured. The authors state that the findings provide a rationale for the future evaluation of discipline-tailored interventions, rather than recommending any specific programme of support now. As a single-institution cross-sectional survey conducted during one examination period, the study captures one cohort at one Vietnamese university, and the reported figures describe that population rather than preclinical medical students generally. Within those limits, the results add a quantified, measurement-validated picture of how common and how severe test anxiety is among early-stage doctor trainees, and they identify which disciplines carry the heaviest burden in this setting.

Subject of Research: Prevalence and discipline-specific patterns of test anxiety among preclinical medical students in Vietnam

Article Title: Test anxiety across four preclinical medical disciplines: a cross-sectional comparative study in Vietnam

Article References: Dang, T. H., Nguyen Thi, H. D., & Nguyen, G. T. (2026). Test anxiety across four preclinical medical disciplines: a cross-sectional comparative study in Vietnam. BMC Medical Education. https://doi.org/10.1186/s12909-026-10658-0

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10658-0

Keywords: test anxiety, medical education, preclinical students, Vietnam, Spielberger Test Anxiety Inventory, dental medicine, traditional medicine, preventive medicine, cross-sectional study, measurement invariance, Test, anxiety