Stress, PsychologicalECOSTRESSNCT05136586
Effects of Relaxing Breathing With Biofeedback or Meditative Stimulation on Performances During OSCE of Medical Students
A study testing Biofeedback and Meditation in people with Stress, Psychological and Stress, Physiological, run by Claude Bernard University at 1 site in France.
Trial summary
Objective Structured Clinical Examination (OSCE) is a newly implemented evaluation standard for medical student and is a determinant part of the national competition they have to undergo. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Stress, Psychological, Stress, Physiological, Exam Stress
- What is being tested?
- Biofeedback and Meditation
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 450 participants
- Where
- 1 siteFrance
- Study dates
- 7 Dec 2021to 10 Jun 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Adult person
- Registered as medical student at the university
- Participating at OSCE examination
- Have signed an informed consent form.
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Two Stress Management Procedures on Performances During Objective Structured Clinical Examination (OSCE) for Medical Students : Relaxing Breathing Combined With Biofeedback or Meditative Stimulation : ECOSTRESS Study
Objective Structured Clinical Examination (OSCE) is a newly implemented evaluation standard for medical student and is a determinant part of the national competition they have to undergo.
Medical studies, especially during examen period, are significantly associated with risk of developping depressions or anxious trouble, wich led to lesser performance, impaired memorization and impaired workload capacities.
Relaxation breathing techniques coupled with heart rate variability (HRV) biofeedback and meditation are procedures used to reduce the stress level.
There is currently no study on the effect of stress management procedures on the performance during OSCE for medical student.
Read the detailed description
This randomized, controlled, monocentric study will take place during mandatory rehearsal of Objective Structured Clinical Examination for third year medical student. For examination purpose, the students will be divided in four groups that will undergo identical exam in the same time in four parallels circuits.
Before entering the circuit, all the students will received information for the study and sign consent.
All the students will be equipped with emWAve® devices that allows us to collect heart rate variability as physiological stress marker during the time of the intervention. Participants will undergo short questionnaires regarding perceived stress.
Then the groups of students will be randomized in four interventions groups for receiving a combination of intervention before and/or after the examination circuit. All the interventions last six minutes long. The randomisation groups are :
- Relaxing breathing exercise coupled with biofeedback before the circuit, no intervention after
- Meditative stimulation audio tape before the circuit, no intervention after
- Standardised video as controlled group before the circuit and a relaxing breathing exercise coupled with biofeedback after
- Standardised video as controlled group before and not intervention after
At the end of the examination circuit, all the students will undergo short questionnaires regarding stress, participants will get equipped with emWAve ® devices again and participants will get the second intervention depending on the randomisation group.
Main objective is to show that relaxing breathing exercise coupled with biofeedback or meditative stimulation is better than an standardised video on performance during OSCE.
The main outcome is student grade at the exam, as determined by university evaluator who is blind to the intervention and with no links to the study.
Secondary objectives are to compare the effects of the interventions on measured physiological stress, psychological stress, and negative rumination.
- Conditions
- Stress, Psychological, Stress, Physiological, Exam Stress, Performance Anxiety, Rumination
- Being tested
- Biofeedback, Meditation, Control and biofeedback post OSCE, Control and control post OSCE
- Keywords
- Stress management and performance, Medical education
- Medical subject headings
- Stress, Psychological, Rumination Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BiofeedbackOther
Also called Relaxing breathing exercise coupled with biofeedback before the circuit, no intervention after
6 minutes of relaxing breathing exercise coupled with hert rate variability biofeedback guided on eMWave Pro software on a computer just before entering the examination circuit.
After the circuit, 6 minutes of free activity where the participants will not be given any instruction.
MeditationOther
Also called Meditative stimulation audio tape before the circuit, no intervention after
6 minutes of listening an audio tape made for the study that inspire mindfulness like meditation associated with psychological stimulation (positive encouragement) just before entering the examination circuit.
After the circuit, 6 minutes of free activity where the participants will not be given any instructions.
Control and biofeedback post OSCEOther
Also called Standardised video before the circuit, relaxing breathing exercise coupled with biofeedback after
6 minutes of standardised neutral video on general topics that generates no modification of affects just before entering the examination circuit.
After the circuit, 6 minutes of relaxing breathing exercise coupled with hert rate variability biofeedback guided on eMWave Pro software on a computer
Control and control post OSCEOther
Also called Standardised video before the circuit, no intervention after
6 minutes of standardised neutral video on general topics that generates no modification of affects just before entering the examination circuit.
After the circuit, 6 minutes of of free activity where the participants will not be given any instruction.
| Study group | Role | What they receive |
|---|---|---|
| Biofeedback | Experimental | Relaxing breathing exercise coupled with biofeedback before the circuit, no intervention after Receives: Other: Biofeedback |
| Meditation | Experimental | Meditative stimulation audio tape before the circuit, no intervention after Receives: Other: Meditation |
| Control and biofeedback post OSCE | Experimental | Standardised video before the circuit, Relaxing breathing exercise coupled with biofeedback after the OSCE Receives: Other: Control and biofeedback post OSCE |
| Control and control post OSCE | Sham comparator | Standardised video before the circuit, no intervention after Receives: Other: Control and control post OSCE |
What is being measured
The primary outcome is the main question the study is designed to answer.
Differences in Performance
The performance is student grade at the exam, as determined by university evaluator
Measured: During the first 2 hours of the inclusion
Secondary outcomes (8)
Differences of Physiological stress
Heart rate variation collected by emWave® devices
Measured: During the first 2 hours of the inclusion
Differences of Psychological stress
Numerical Visual analog scales (VAS) on perceived stress from zero to 100: maximum Numerical VAS on resourcefulness nedeed an avalaible perceived from zero to maximum
Measured: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Difference of Resourcefulness
Numerical VAS on resourcefulness needeed an available perceived from zero to 100: maximum
Measured: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Characterisation of stress
Numerical VAS on characterisation of stress perceived from negative to positive
Measured: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Differences of Self confidence
Numerical VAS on self confidence perceived from zero to 100: maximum
Measured: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Differences of Psychological stress consequences
Activation-Deactivation Adjective Check List: for the four subscales: Energy, Tiredness, Tension , and Calmness
Measured: Three times : before first intervention, before OSCE circuit, just after second intervention
Differences of Ruminations
Brief rumination scale questionnaire
Measured: Just after second intervention at the end of the OSCE
Individual psychological characteristics
Personality traits (Big-5)
Measured: Just after second intervention at the end of the OSCE
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Nov 2021
- Study start7 Dec 2021
- Primary completion9 Dec 2021
- Study completion10 Jun 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Stress, PsychologicalStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 4 parallels groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 450 participants (actual)
Sponsor and investigators
- Lead sponsor
- Claude Bernard University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Lilot Marc, Claude Bernard University
- Investigators
- Gilles Rode, M.D., Ph.D., Study chair, Claude Bernard University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05136586
- Sponsor's protocol ID
- ECOSTRESS
- Acronym
- ECOSTRESS
- Status last verified
- Nov 2022
- First submitted
- 4 Nov 2021
- Last updated
- 8 Nov 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Depoorter J, Hoorelbeke K, Guillaumee T, Cortet M, Lilot M, Rode G, De Raedt R, Schlatter S. Impact of a brief HRV-biofeedback intervention on emotion regulation following a real-life stressful event: A randomized controlled study. Behav Res Ther. 2026 Apr;199:104979. doi: 10.1016/j.brat.2026.104979. Epub 2026 Jan 26.
PubMed 41702143Le Saux O, Canada B, Debarnot U, Haouhache NEH, Lehot JJ, Binay M, Cortet M, Rimmele T, Duclos A, Rode G, Lilot M, Schlatter S. Association of Personality Traits With the Efficacy of Stress Management Interventions for Medical Students Taking Objective Structured Clinical Examinations. Acad Med. 2024 Jul 1;99(7):784-793. doi: 10.1097/ACM.0000000000005714. Epub 2024 Mar 25.
PubMed 38534105
Study at a glance
From the registry record, last updated by the sponsor on 8 Nov 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Two Stress Management Procedures on Performances During Objective Structured Clinical Examination (OSCE) for Medical Students : Relaxing Breathing Combined With Biofeedback or Meditative Stimulation : ECOSTRESS Study
- ClinicalTrials.gov ID
- NCT05136586
- Acronym / sponsor ID
- ECOSTRESS / ECOSTRESS
- Conditions
- Stress, Psychological, Stress, Physiological, Exam Stress, Performance Anxiety, Rumination
- Keywords
- Stress management and performance, Medical education
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 450 participants (actual)
- Lead sponsor
- Claude Bernard UniversityUniversity, hospital or other
- Study start
- 7 Dec 2021 (actual)
- Primary completion
- 9 Dec 2021 (actual)
- Study completion
- 10 Jun 2022 (actual)
- First posted
- 29 Nov 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Objective Structured Clinical Examination (OSCE) is a newly implemented evaluation standard for medical student and is a determinant part of the national competition they have to undergo.
Medical studies, especially during examen period, are significantly associated with risk of developping depressions or anxious trouble, wich led to lesser performance, impaired memorization and impaired workload capacities.
Relaxation breathing techniques coupled with heart rate variability (HRV) biofeedback and meditation are procedures used to reduce the stress level.
There is currently no study on the effect of stress management procedures on the performance during OSCE for medical student.
Detailed description
This randomized, controlled, monocentric study will take place during mandatory rehearsal of Objective Structured Clinical Examination for third year medical student. For examination purpose, the students will be divided in four groups that will undergo identical exam in the same time in four parallels circuits.
Before entering the circuit, all the students will received information for the study and sign consent.
All the students will be equipped with emWAve® devices that allows us to collect heart rate variability as physiological stress marker during the time of the intervention. Participants will undergo short questionnaires regarding perceived stress.
Then the groups of students will be randomized in four interventions groups for receiving a combination of intervention before and/or after the examination circuit. All the interventions last six minutes long. The randomisation groups are :
- Relaxing breathing exercise coupled with biofeedback before the circuit, no intervention after
- Meditative stimulation audio tape before the circuit, no intervention after
- Standardised video as controlled group before the circuit and a relaxing breathing exercise coupled with biofeedback after
- Standardised video as controlled group before and not intervention after
At the end of the examination circuit, all the students will undergo short questionnaires regarding stress, participants will get equipped with emWAve ® devices again and participants will get the second intervention depending on the randomisation group.
Main objective is to show that relaxing breathing exercise coupled with biofeedback or meditative stimulation is better than an standardised video on performance during OSCE.
The main outcome is student grade at the exam, as determined by university evaluator who is blind to the intervention and with no links to the study.
Secondary objectives are to compare the effects of the interventions on measured physiological stress, psychological stress, and negative rumination.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 4
- Model description
- 4 parallels groups
| Arm | Type | Receives |
|---|---|---|
| Biofeedback | Experimental | Other: BiofeedbackRelaxing breathing exercise coupled with biofeedback before the circuit, no intervention after |
| Meditation | Experimental | Other: MeditationMeditative stimulation audio tape before the circuit, no intervention after |
| Control and biofeedback post OSCE | Experimental | Other: Control and biofeedback post OSCEStandardised video before the circuit, Relaxing breathing exercise coupled with biofeedback after the OSCE |
| Control and control post OSCE | Sham comparator | Other: Control and control post OSCEStandardised video before the circuit, no intervention after |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adult person
- Registered as medical student at the university
- Participating at OSCE examination
- Have signed an informed consent form.
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BiofeedbackAlso: Relaxing breathing exercise coupled with biofeedback before the circuit, no intervention after6 minutes of relaxing breathing exercise coupled with hert rate variability biofeedback guided on eMWave Pro software on a computer just before entering the examination circuit. After the circuit, 6 minutes of free activity where the participants will not be given any instruction. | Other | Biofeedback |
| MeditationAlso: Meditative stimulation audio tape before the circuit, no intervention after6 minutes of listening an audio tape made for the study that inspire mindfulness like meditation associated with psychological stimulation (positive encouragement) just before entering the examination circuit. After the circuit, 6 minutes of free activity where the participants will not be given any instructions. | Other | Meditation |
| Control and biofeedback post OSCEAlso: Standardised video before the circuit, relaxing breathing exercise coupled with biofeedback after6 minutes of standardised neutral video on general topics that generates no modification of affects just before entering the examination circuit. After the circuit, 6 minutes of relaxing breathing exercise coupled with hert rate variability biofeedback guided on eMWave Pro software on a computer | Other | Control and biofeedback post OSCE |
| Control and control post OSCEAlso: Standardised video before the circuit, no intervention after6 minutes of standardised neutral video on general topics that generates no modification of affects just before entering the examination circuit. After the circuit, 6 minutes of of free activity where the participants will not be given any instruction. | Other | Control and control post OSCE |
Primary outcome
Differences in Performance
Time frame: During the first 2 hours of the inclusion
The performance is student grade at the exam, as determined by university evaluator
8 secondary outcomes
Differences of Physiological stress
Time frame: During the first 2 hours of the inclusion
Differences of Psychological stress
Time frame: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Difference of Resourcefulness
Time frame: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Characterisation of stress
Time frame: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Differences of Self confidence
Time frame: Four times : before first intervention, before OSCE circuit, just after OSCE circuit, just after second intervention
Differences of Psychological stress consequences
Time frame: Three times : before first intervention, before OSCE circuit, just after second intervention
Differences of Ruminations
Time frame: Just after second intervention at the end of the OSCE
Individual psychological characteristics
Time frame: Just after second intervention at the end of the OSCE
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Nov 2022.
- Derived from this study: PubMed 41702143Depoorter J, Hoorelbeke K, Guillaumee T, Cortet M, Lilot M, Rode G, De Raedt R, Schlatter S. Impact of a brief HRV-biofeedback intervention on emotion regulation following a real-life stressful event: A randomized controlled study. Behav Res Ther. 2026 Apr;199:104979. doi: 10.1016/j.brat.2026.104979. Epub 2026 Jan 26.
- Derived from this study: PubMed 38534105Le Saux O, Canada B, Debarnot U, Haouhache NEH, Lehot JJ, Binay M, Cortet M, Rimmele T, Duclos A, Rode G, Lilot M, Schlatter S. Association of Personality Traits With the Efficacy of Stress Management Interventions for Medical Students Taking Objective Structured Clinical Examinations. Acad Med. 2024 Jul 1;99(7):784-793. doi: 10.1097/ACM.0000000000005714. Epub 2024 Mar 25.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gilles Rode, M.D., Ph.D. study chair
Claude Bernard University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Biofeedback and Meditation in people with Stress, Psychological and Stress, Physiological, run by Claude Bernard University at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Differences in Performance (time frame: During the first 2 hours of the inclusion). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05136586, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Nov 2022.