Background Test anxiety has been widely found in medical students. Emotion regulation and psychological resilience have been identified as key factors contributing to anxiety. However, studies on relationships were limited. This study investigated the links between psychological resilience, emotion regulation, and test anxiety in addition to exploring the differences about socio-demographic factors. Methods A sample of 1266 medical students was selected through cross-sectional survey from a medical university in China during 2019. Data were obtained by network technique using designed questionnaire, which assesses the level of test anxiety, emotion regulation and psychological resilience, respectively. Results Medical students experienced test anxiety at different levels, 33.7% of these were seriously. It revealed significant effects of the gender and academic performance on test anxiety. Results of logistic regression indicated that test anxiety was significantly associated with emotion regulation and psychological resilience (p < 0.01). Psychological resilience played a mediating role on the relationship between emotion regulation and test anxiety. Conclusions These findings highlight the importance of psychological resilience and emotion regulation in understanding how psychological resilience relates to test anxiety in medical students. Resilience-training intervention may be developed to support students encountering anxiety during the exam.

Background: Medical students experience a considerable amount of anxiety due to exams. Emotion regulation and psychological resilience are established protective factors of individual mental health, however, the investigations for the effects of anxiety were limited. The goal of the present study was to examine the relationship of psychological resilience and emotion regulation with test anxiety and the associated factors of them among medical students. Methods: In this cross-sectional survey, a simple random sampling methods was used to select the participants. Information from a sample of 1266 medical students was collected by self-reporting questionnaires. Logistic regression was applied to test the associations between test anxiety and emotion regulation, resilience. Bootstrap were conducted to explore the mediating role of resilience. Results: Our important results were that the prevalence of problematic test anxiety among medical students to be 71.4%, 33.7% was high test anxiety. Gender and academic performance correlated significantly with test anxiety, emotion regulation, and psychological resilience. There were correlations between test anxiety and various dimensions of emotion regulation and psychological resilience ( P<0.01 ). Emotion regulation and psychological resilience predicted emerging test anxiety. The mediating role of psychological resilience was identified for the effects of emotion regulation on test anxiety. Conclusions: Findings suggest that emotion regulation affected test anxiety through psychological resilience, which may provide insights for clinical psychologists, raise their awareness of the importance of cultivating and improving medical students' psychological resilience, and prompt them to offer psychological support to students with test anxiety as early as possible. The combination of curing and self-healing can solve the root cause of the problem and truly apply psychological research to improving the mental health of the general public. Keywords: Psychological resilience, Test anxiety, Emotion regulation, Medical student