The impact of multiple factors on medical students' test anxiety: the mediating role of psychological resilience

Background: This study examined the influence of academic stress, social support, and perfectionism on test anxiety among medical students, as well as the mediating role of psychological resilience. Drawing on Control-Value Theory and Resilience Theory, the study explored how internal protective resources respond to academic, environmental, and personality-related factors. Methods: A structured questionnaire was administered to medical students from three medical universities in China through a convenience sampling approach. A total of 1,067 valid responses were collected. SPSS 26.0 was utilized to perform statistical analyses and explore the associations among the variables. Result: The results showed that academic stress and maladaptive perfectionism were significantly positively related to test anxiety, whereas social support and adaptive perfectionism were significantly negatively related to it. Psychological resilience was found to mediate the relationships between the predictor variables and test anxiety. Specifically, the mediation effect accounted for 18.889% (academic stress), 56% (social support), 30.588% (adaptive perfectionism), and 12.658% (maladaptive perfectionism) of the total effects, respectively. Conclusion: The findings highlighted the central role of psychological resilience in mitigating the negative impact of academic stress and maladaptive perfectionism on test anxiety, while also strengthening the positive influence of social support and adaptive perfectionism. These outcomes suggested that strategies designed to cultivate resilience may help alleviate test anxiety and enhance both psychological health and academic performance among medical students.