Assessment of Stress Level of Young Undergraduates Before and After a Degree Examination Using Heart Rate Variability Analysis

This study aimed at assessing the value of heart rate variability (HRV) as a stress indicator before and after a final re-sit exam among healthy sixth grade medical students. Fifty participants were recruited for the study (test group, n = 30; control group, n = 20). Each participant was examined for 5 minutes pre and post exam periods using the Heartmath proprietary protocol. EmWave equipment was used to detect, record and analyze the HR and to plot out the variability in discrete percentages for low, medium and high coherences. Results indicated that mean percentage coherence score was significantly higher in the test group (p < 0.05) at low cardiac coherence domain, but lower (p < 0.05) at the high coherence domain, compared with the control. Coherence score was significantly higher (p < 0.05) after the exam indicating release from stress, as compared to before the examination when stress was observable among the exam candidates. There were no significant gender differences observed in cardiac coherence scores before and after examination. Our findings indicate that HRV is a reliable indicator of real-time exam stress and supports future clinical use of HRV as a non-invasive and simple stress test.