Peer-Led Mentoring Intervention for Test Anxiety Reduction among Medical Students: Development, Implementation, and Prospective Evaluation

Background and objectives: Medical students face significant test anxiety due to academic pressure and limited mental health support. Peer led interventions offer a promising alternative, but evidence in medical education is limited. This study was aimed to develop a validated mental health intervention module and evaluate the impact of peer-led mentoring program on test anxiety among undergraduate MBBS students in India. Methods: A structured, evidence-based peer-led mentoring module was developed using ADDIE model and validated by experts (Content Validity Index > 0.78). A prospective pre-and post-intervention cohort study involved 100 second-year MBBS students of a public medical college. Peer mentors, trained using a validated module, provided group and individual mentoring before high-stakes examinations (Mock Boards). The primary outcome was test anxiety scores measured using Westside Test Anxiety (WTA) Scale. Secondary outcomes included academic performance and qualitative assessments of acceptability and feasibility through focus group discussions. Results: At baseline, 40% of students had test anxiety (WTA ≥ 3) (32% moderate-high, 8% severe), with a median WTA score of 2.7 (IQR: 2.25-3.25). Post-intervention, median WTA scores significantly decreased to 2.35 (difference: -0.35; 95% CI: -0.5 to -0.2; P < 0.001). The proportion of students with normal/high-normal anxiety (WTA score <3) increased from 60% to 79%, and no students had severe anxiety post-intervention (P = 0.002). Students with moderate-high anxiety showed ~22% reduction, while those with severe anxiety showed ~30% reduction in median WTA scores. Academic performance showed no significant differences among anxiety groups. Students reported high satisfaction (median score: 7/10), and the intervention was deemed highly acceptable and feasible. Conclusions: The peer-led mentoring program effectively reduced test anxiety among medical students during high stakes examination. While academic performance did not significantly improve, integration of such programs into formal support systems could enhance sustainability and impact in medical education settings.