Test anxiety among medical students in Egypt: prevalence, associated factors, and coping strategies - A national cross-sectional study

Background Test anxiety is prevalent among medical students, affecting their mental well-being and academic performance. This study aimed to assess the prevalence, associated factors, and coping strategies of test anxiety among medical students in Egypt. Methods A convenience sample of 2,437 undergraduate medical students from seven Egyptian universities was surveyed online one week before, during, or after their exams. Test anxiety was measured using the Westside Test Anxiety Inventory (WTAI), psychological distress with the ten-item Kessler Psychological Distress Scale (K10), and associated factors and coping strategies through self-reported questions. Logistic regression identified factors associated with test anxiety. Results Test anxiety was prevalent among 46.9% of participants. In the final multivariable model, the factors associated with significantly lower odds of test anxiety included completing the questionnaire during (AOR = 0.75; 95% CI = 0.58, 0.96) or after exams (AOR = 0.65; 95% CI = 0.49, 0.86), being somewhat (AOR = 0.59; 95% CI = 0.47, 0.74) or fully satisfied with academic performance (AOR = 0.35; 95% CI = 0.25, 0.49), attending college once (AOR = 0.59; 95% CI = 0.37, 0.92) or twice per week (AOR = 0.66; 95% CI = 0.48, 0.93), participating in extracurricular activities (AOR = 0.77; 95% CI = 0.60, 0.98), and sleeping more than six hours per night (AOR = 0.71; 95% CI = 0.57, 0.88). Meanwhile, significantly higher odds were associated with group studying (AOR = 1.80; 95% CI = 1.12, 2.92), taking private courses in all subjects (AOR = 2.38; 95% CI = 1.61, 3.54), and having moderate (AOR = 4.65; 95% CI = 1.37, 29.10), high (AOR = 21.62; 95% CI = 6.72, 132.28), or very high psychological distress (AOR = 100.23; 95% CI = 31.21, 612.78). Religious practices were the most common coping strategy (52.8%). Conclusion Test anxiety is highly prevalent among Egyptian medical students and is influenced by academic and lifestyle factors. These findings highlight the need for strategies to mitigate test anxiety and promote student well-being.