Can Increased Medical Competence Reduce State Anxiety in Junior Doctors in the Emergency Department?

NCT06842394 | Completed

• 1 other identifier: F-24053546
• Study Type: interventional
• Target: 233
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial investigates whether an adaptive e-learning program on acute and time critical medical conditions can reduce state anxiety and improve the competence of junior doctors working in emergency departments. Junior doctors assigned to frontline shifts will be enrolled and randomized into two groups: an intervention group receiving the e-learning program within the first six weeks of employment and a control group receiving standard onboarding with delayed access to the program. The primary outcome is the change in state anxiety levels, assessed using the State-Trait Anxiety Inventory (STAI-6). Secondary outcomes include perceived self-efficacy during shifts and self-assessed competency improvements.

Conditions

State Anxiety; Psychological Stress; Education, Medical; E-learning; Acute Medical Unit

Keywords

Junior Doctors; Emergency Department; Adaptive E-learning; Medical Competence; Medical Education; Healthcare Workforce; state anxiety

Outcome Measures

Primary Outcomes (1)

• Change in STAI scores

  A change in STAI-6 scores from baseline to 6 weeks post-intervention.

  Immediately after the intervention

Secondary Outcomes (3)

• Changes in perceived selfefficacy during shifts, measured through a structured survey.

  Immediately after the intervention

• Qualitative insights from interviews with participants exploring factors influencing anxiety and competency.

  Immediately after the intervention

• • E-learning -based exploratory outcomes, including learning curves, self-assessed competencies to objective competencies, e-learning implementation and user satisfaction.

  Immediately after the intervention

Study Arms (2)

Adaptive e-learning

EXPERIMENTAL

The intervention group will receive the adaptive e-learning program in addition to standard onboarding within the first six weeks of employment

Other: Adaptive E-learning

Standard onboarding

NO INTERVENTION

The control group will receive standard onboarding

Interventions

Adaptive E-learning OTHER

An adaptive e-learning program comprising 13 modules each unfolding and testing the learners knowledge and ability to assess own competence regarding specific acute and time critical medical patient conditions.

Adaptive e-learning

Eligibility Criteria

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

You may qualify if:

• Junior residents in front- or middle-level shifts in emergency departments across the Capital Region of Denmark.
• Employed between January 1, 2025, and April 31, 2025.

You may not qualify if:

• Prior exposure to the adaptive e-learning program.
• Denying participation.

Sponsors & Collaborators

• Rigshospitalet, Denmark: collaborator
• Copenhagen Academy for Medical Education and Simulation: lead

Study Sites (1)

Emergency Departments in the Capital Region of Denmark

Copenhagen, Capital Region, Denmark

Location

Related Publications (13)

• Ristić, I., Runić-Ristić, M., Savić Tot, T., Tot, V., & Bajac, M. B. (2023). The Effects and Effectiveness of An Adaptive E-Learning System on The Learning Process and Performance of Students. International Journal of Cognitive Research in Science, Engineering and Education, 1, 77-92.

  BACKGROUND

• Juul MV, Fast AT, Lassen AT, Laugesen S. Anxiety among medical students and junior doctors in Denmark. Dan Med J. 2022 Sep 29;69(11):A03220162.

  PMID: 36331149 BACKGROUND

• Piso B, Nussbaumer-Streit B, Gartlehner G. [WHO Guidelines on Mental Health at Work]. Gesundheitswesen. 2024 Mar;86(3):216-219. doi: 10.1055/a-2249-5787. Epub 2024 Mar 12. German.

  PMID: 38471514 BACKGROUND

• Stassen P, Westerman D. Novice Doctors in the Emergency Department: A Scoping Review. Cureus. 2022 Jun 23;14(6):e26245. doi: 10.7759/cureus.26245. eCollection 2022 Jun.

  PMID: 35898382 BACKGROUND

• Skov RAC, Lawaetz J, Konge L, Resch TA, Aasvang EK, Meyhoff CS, Westerlin L, Jensen MK, Eiberg JP. Role-reversal simulation training to enhance performance and reduce stress of endovascular scrub nurses in the operating room. Curr Probl Surg. 2024 Oct;61(10):101577. doi: 10.1016/j.cpsurg.2024.101577. Epub 2024 Jul 31. No abstract available.

  PMID: 39266129 BACKGROUND

• Shahsavari H, Ghiyasvandian S, Houser ML, Zakerimoghadam M, Kermanshahi SSN, Torabi S. Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students. Nurse Educ Pract. 2017 Nov;27:151-156. doi: 10.1016/j.nepr.2017.08.006. Epub 2017 Aug 8.

  PMID: 28910662 BACKGROUND

• Seathu Raman SS, McDonnell A, Beck M. Hospital doctor turnover and retention: a systematic review and new research pathway. J Health Organ Manag. 2024 Feb 27;38(9):45-71. doi: 10.1108/JHOM-04-2023-0129.

  PMID: 38448230 BACKGROUND

• Saffari M, Bashar FR, Vahedian-Azimi A, Pourhoseingholi MA, Karimi L, Shamsizadeh M, Gohari-Moghadam K, Sahebkar A. Effect of a Multistage Educational Skill-Based Program on Nurse's Stress and Anxiety in the Intensive Care Setting: A Randomized Controlled Trial. Behav Neurol. 2021 Apr 26;2021:8811347. doi: 10.1155/2021/8811347. eCollection 2021.

  PMID: 33986878 BACKGROUND

• Montgomery A, Panagopoulou E, Esmail A, Richards T, Maslach C. Burnout in healthcare: the case for organisational change. BMJ. 2019 Jul 30;366:l4774. doi: 10.1136/bmj.l4774. No abstract available.

  PMID: 31362957 BACKGROUND

• Monrouxe LV, Bullock A, Gormley G, Kaufhold K, Kelly N, Roberts CE, Mattick K, Rees C. New graduate doctors' preparedness for practice: a multistakeholder, multicentre narrative study. BMJ Open. 2018 Aug 29;8(8):e023146. doi: 10.1136/bmjopen-2018-023146.

  PMID: 30158236 BACKGROUND

• Mathisen J, Nguyen TL, Jense JH, Rugulies R, Rod NH. Reducing employee turnover in hospitals: estimating the effects of hypothetical improvements in the psychosocial work environment. Scand J Work Environ Health. 2021 Sep 1;47(6):456-465. doi: 10.5271/sjweh.3969. Epub 2021 May 30.

  PMID: 34052852 BACKGROUND

• Klitgaard TL, Stentoft D, Skipper M, Gronkjaer M, Nohr SB. Struggling to fit the white coat and the role of contextual factors within a hospital organisation - an ethnographic study on the first months as newly graduated doctors. BMC Med Educ. 2021 Jan 25;21(1):74. doi: 10.1186/s12909-021-02493-2.

  PMID: 33494741 BACKGROUND

• Fuster V. Changing Demographics: A New Approach to Global Health Care Due to the Aging Population. J Am Coll Cardiol. 2017 Jun 20;69(24):3002-3005. doi: 10.1016/j.jacc.2017.05.013. No abstract available.

  PMID: 28619199 BACKGROUND

MeSH Terms

Conditions

Anxiety Disorders; Stress, Psychological; Emergencies

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jonas P Eiberg, PhD

  Department of Vascular Surgery, The Heart Center, University Hospital of Copenhagen - Rigshospitalet and Copenhagen Academy for Medical Education and Simulation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 6, 2025
• First Posted: February 24, 2025
• Study Start: January 1, 2025
• Primary Completion: July 1, 2025
• Study Completion: September 1, 2025
• Last Updated: March 19, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)