Stress and Clinical Reasoning in Medical Students

NCT01061255 | Completed

• 1 other identifier: BRD/09/08-M
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

Solving a problem in ambulatory setting may contain peripheral stress due to socio-evaluative stressors (patient's expectations about explanations) and task contingent stress due to time pressure, the necessity to take into account patient's mood, to deal with uncertainty of their own data collection and with complex clinical situations. In France, excepted for family medicine, undergraduate medical students and residents are currently not trained to perform consultations and are never exposed to ambulatory patients during training. The investigators postulate that this lack of practice may generate a significant state of stress during the first consultations and consequently modify or even impair clinical reasoning. The primary objective of this study is to compare subjective and physiological levels of acute stress in ambulatory versus hospitalization setting in medical students confronted to a real patient with a diagnostic problem. Measures: The French version of the Anxiety Spielberger test is administered just before and after each problem solving session. Cortisol salivary samples are taken before and after each problem solving session. Salivary cortisol levels have been shown to be correlated to stressful situations and some personality traits but with some difference according to gender. Cognitive appraisal (threat/challenge) is assessed before and after the tasks by the ratio of primary appraisal to secondary appraisal according to Tomaka et al.

Conditions

Stress

Keywords

Stress; Cortisol; Clinical reasoning; Ambulatory setting; Medical students; Year 6 medical students

Outcome Measures

Primary Outcomes (1)

• Increase in salivary cortisol and in Spielberger score

  one hour

Secondary Outcomes (1)

• Difference in the cognitive appraisal (challenge or threat)

  one hour

Interventions

Evaluation of the stress OTHER

Medical Students having to solve a medical problem in ambulatory setting (studied group) vs. in hospitalisation setting (control group). Measures: The French version of the Anxiety Spielberger test is administered just before and after each problem solving session. Cortisol salivary samples are taken before and after each problem solving session. Salivary cortisol levels have been shown to be correlated to stressful situations and some personality traits but with some difference according to gender.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Year 6 medical students who attend a one-month full-time course in an Internal Medicine Department

You may not qualify if:

• Student who repeats his year 6 of medicine
• Student treated with corticoids

Sponsors & Collaborators

• Nantes University Hospital: lead

Study Sites (1)

Nantes University Hospital

Nantes, France

Location

Study Officials

• Pierre POTTIER, Dr

  Nantes University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 2, 2010
• First Posted: February 3, 2010
• Study Start: November 9, 2009
• Primary Completion: April 12, 2010
• Study Completion: April 12, 2010
• Last Updated: September 17, 2021

Record last verified: 2021-09

Locations

FR (1)