Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction.


This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim.


Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future.


We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.

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Author notes

Breanne Wells is an assistant professor at the Palmer College of Chiropractic (1000 Brady Street, Davenport, IA 52803; breanne.wells@palmer.edu). Lia Nightingale is an associate professor at the Palmer College of Chiropractic (1000 Brady Street, Davenport, IA 52803; lia.nightingale@palmer.edu). Dustin Derby is the senior director of institutional research and effectiveness at the Palmer College of Chiropractic (1000 Brady Street, Davenport, IA 52803; dustin.derby@palmer.edu). Stacie Salsbury is an assistant professor at the Palmer College of Chiropractic, Palmer Center for Chiropractic Research (741 Brady Street, Davenport, IA 52803; stacie.salsbury@palmer.edu). Dana Lawrence is the associate provost of education and research at Parker University (2500 Walnut Hill Lane, Dallas, TX 75229; dlawrence@parker.edu). Address correspondence to Breanne Wells, Palmer College of Chiropractic, 1000 Brady Street, Davenport, IA 52803; breanne.wells@palmer.edu. This article was submitted December 7, 2018; revised April 9 and August 20, 2019; and accepted September 30, 2019.

Concept development: BMW, DL, LMN, BMW. Design: BMW, LMN, DED, SAS, DL. Supervision: BMW, LMN, DED, SAS, DL. Data collection/processing: BMW, LMN, DED. Analysis/interpretation: BMW, LMN, DED. Literature search: BMW. Writing: BMW, LMN, DED. Critical review: BMW, LMN, DED, SAS, DL.