Performance anxiety: Helping nurses learn to cope with on-the-job stress

Illustration: Division of Research 

The Texas A&M Health Science Center College of Nursing is looking at ways to combat performance anxiety and ensure that medical professionals and students perform their skills at the highest possible level.

In a series of research studies, College of Nursing faculty members have teamed together to find out what can be done for nursing students to be at their best for optimal learning and performance.

The researchers are Angela Mountain, clinical assistant professor; Brian Holland, assistant professor; Sara Williamson, clinical teaching coordinator; and Kevin Gosselin, associate professor and assistant dean for research and evidence based practice.

These researchers examined performance psychological applications within the simulation experiences of the Texas A&M Health Science Center’s Clinical Learning Resource Center where health professions students learn and practice their skills with simulated patients.

“Previous studies have shown that many students experience high levels of anxiety that can interfere with learning and performance, which is completely contradictive to our goal of creating the best nurses, so we’re trying to help students find ways to control their anxiety levels,” Mountain said.

The goal was to find the best way to prepare students to learn and perform in their optimal performance zone.

Assigned musical therapy, autogenic training, movement meditation and self-selected music therapy were all examined in this series of studies. These techniques are commonly used to reduce anxiety in the field of performance psychology. While these therapies have been applied to other fields, they have not been applied in nursing. Nursing’s unique holistic approach to patient treatment relies heavily on interpersonal relationships, which can be greatly influenced by performance anxiety.

The study, which is in its final phase, has shown that subjects’ anxiety levels are indicative of confidence and higher learning and performance.

So how exactly does this all work? Gosselin explained that two different types of symptoms characterize anxiety: cognitive (mental) and physical. The cognitive symptoms were measured through subject surveys before and after therapy, while physical symptoms were measured by changes in blood pressure and heart rate.
In both cases, the goal of the study was to find how to find the optimal level of anxiety prior to learning or performance evaluations. The various therapies being studied could be self-induced in practical application, which means that in the future, students and professionals can use these techniques themselves.

“In short, we’re combining psychology and education with nursing in hopes of improving how our students learn, and in turn improving how they treat patients in practice,” Holland said.

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