Abstract
INTRODUCTION: Test anxiety has a deleterious effect on the academic performance of medical students. Medical educators shifted the focus of students' assessment from high-stakes examinations to low-stakes assessments to address the negative impacts of test anxiety on learning. Nevertheless, it is still uncertain whether low-stakes tests are an effective means of eliminating medical students' anxiety. METHODS: The study's objective was to examine the degree to which medical students experience anxiety in the context of an extremely low-stakes test conducted in a group-based clinical reasoning class. A total of 75 students participated in the study, and their emotional responses during the clinical reasoning session and following the test session were assessed and compared using the Japanese version of the medical emotion scale. RESULTS: The results demonstrated a decrease in self-reported anxiety levels toward the test compared with anxiety levels toward the clinical reasoning exercises conducted prior to the test (2.21 to 1.96). However, no changes were observed in the levels of other emotions. DISCUSSION: Test anxiety experienced by medical students was found to diminish when the test was conducted in an extremely low-stakes format. This finding lends support to the efficacy of programmatic assessment from the perspective of medical students' well-being. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-025-02468-8.