An examination of state anxiety and computer attitudes related to achievement on paper-and -pencil and computer-based mathematics testing of nursing students

The purpose of this study was to examine the relationships among computer attitudes, state anxiety, and testing formats related to mathematics achievement. All areas of nursing practice are inundated with computer technology, even home health care; therefore, the preparation of students to function in a highly technical climate is imperative. In addition, licensure examination is evolving from the computer-adaptive format to an interactive clinical simulation format. Concern over the potential for anxiety and computer attitudes to impact student performance in the health care setting and in computer-based testing provided the impetus for this study. One hundred and eighty-eight nursing students participated in the quasi-experimental study. Participants were randomly assigned to paper-and-pencil or computer-based mathematics test groups. The Computer Attitude Scale and State Anxiety Scale were completed by all participants. Demographic characteristics were examined. T-tests were used to examine the differences in state anxiety and computer attitudes between participants who passed the mathematics test and those who did not. Multiple regression was performed to examine the combined influence of state anxiety, computer attitudes, and testing format on achievement. Use of non-nursing computer software was positively correlated with computer attitudes and achievement on the mathematics test. Gender was significantly related to computer attitudes. Females had lower computer attitudes than males. Consistent with computer attitudes, females who took the mathematics test using the computer-based format had lower achievement. Regardless of testing format, there was no difference in achievement for males. The higher the state anxiety, the lower the achievement on the mathematics test. The format of the mathematics test was significantly related to achievement. This was an unexpected finding. Format, state anxiety, and computer anxiety accounted for 14% ($p\u3c.05$) of the variance in explaining achievement on the mathematics test. While more research examining computer-based testing, state anxiety, and computer attitudes is needed, nursing faculty must respond to unwanted influences on student achievement and intervene effectively