Date of Completion


Document Type

Open Access Capstone

Degree Name

Master of Arts (MA)

First Advisor

Robert Ricketts

Second Advisor

Jeremy Szteiter


Stress and anxiety are part of healthcare and are experienced not only by patients but also by clinicians. This work explores an issue prevalent in healthcare education, outlining the detrimental effects of stress-induced anxiety on student performance during practical assessments. Included in this paper are the research and investigative details that elaborate on the process taken towards resolving the issue. Research conducted in the fields of education, law, and medicine is used to explore how these areas address stress with regard to performance. Through the various processes of research and engagement, this action research project uncovers the underlying issue of poor performance on competency testing related to anxiety and stress. Once discovered, a proactive approach is taken to address the issue by designing a Metacognitive Mental Management System (MMMS) for student use while in the assessment process. This cognitive recalibration system addresses the phases of preparation, performance, and reflection to provide students with explicit strategies during the engagement process with competency testing. This paper also includes details of the development of the MMMS system, its implementation within a health science program, performance results and student feedback, and future developments.