Examination Stress and Its Correlation with Blood Pressure, Pulse Rate and Respiratory Rate in First-Year Mbbs Students

Abstract

Background: Examination stress is a common acute psychological stressor in medical education. It can activate autonomic and neuroendocrine pathways and produce measurable changes in cardiovascular and respiratory function. First-year MBBS students are exposed to a major transition in academic workload and repeated examinations.

Methods: A hospital-based cross-sectional observational study was conducted in the Department of Physiology, Shyam Shah Medical College, Rewa, during April 2024 to June 2025. Two hundred first-year MBBS students were included. Stress was assessed using the 40-item Medical Student Stressor Questionnaire (MSSQ). Blood pressure, heart rate and respiratory rate were recorded using standardized procedures. The results presented in the thesis compare measurements 15 days before examination with those obtained 30 minutes before examination.

Results: Of 200 participants, 91 (45.5%) had slight stress and 109 (54.5%) had moderate stress. No participant was classified as having no stress or high/extreme stress. SBP >120 mmHg increased from 73.5% to 100%, DBP >80 mmHg from 77.0% to 97.0%, heart rate >80 bpm from 76.5% to 100%, and respiratory rate >16/min from 77.0% to 91.5%. Mean SBP increased from 119.72 ± 14.06 to 144.88 ± 9.10 mmHg, DBP from 78.71 ± 9.13 to 89.61 ± 6.03 mmHg, heart rate from 79.31 ± 10.10 to 96.50 ± 7.39 bpm, and respiratory rate from 16.72 ± 2.78 to 18.94 ± 2.05/min; all reported comparisons were p<0.001.

Conclusion: Examination-related stress was associated with significant acute cardiovascular and respiratory changes. The findings support early recognition of examination stress and institution-based stress-management strategies.