State AnxietyMINDEDNCT06842394
Can Increased Medical Competence Reduce State Anxiety in Junior Doctors in the Emergency Department?
A study testing Adaptive E-learning in people with State Anxiety and Psychological Stress, run by Copenhagen Academy for Medical Education and Simulation at 1 site in Denmark.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 months and olderHealthy volunteers can take part
- Conditions the study is for
- State Anxiety, Psychological Stress, Education, Medical
- What is being tested?
- Adaptive E-learning
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 233 participants
- Where
- 1 siteDenmark
- Study dates
- 1 Jan 2025to 1 Sep 2025
- 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 months and older
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- Prior exposure to the adaptive e-learning program.
- Denying participation.
Trial locations and contacts
1 site in 1 country.
Denmark1 site
Emergency Departments in the Capital Region of Denmark
Copenhagen, Capital Region
About this study
Official title: Can Increased Medical Competence Reduce State Anxiety in Junior Doctors in the Emergency Department: A Randomized Controlled Trial
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.
Read the detailed description
The healthcare system is under increasing pressure due to demographic changes, including a growing elderly population and a shrinking workforce. This intensifies the challenges of recruiting and retaining healthcare professionals, particularly in high-stress environments like emergency departments. Junior doctors often face significant anxiety during their early careers, which is associated with higher rates of burnout, decreased job satisfaction, and early career attrition Transitioning from medical education to clinical practice is a critical period marked by high levels of stress and anxiety. Research highlights that new doctors frequently report feeling inadequately prepared for the demands of clinical work, particularly in acute care settings where decision-making is both time-sensitive and impactful. Anxiety during this transition is not only detrimental to individual well-being but also impacts patient safety and care quality.
Prior interventions, including simulation-based training and e-learning programs, have shown promise in reducing stress and improving clinical competence among healthcare professionals. For example, adaptive e-learning platforms have demonstrated efficacy in tailoring content to individual learners' needs, enhancing knowledge retention, and fostering confidence in clinical skills.
Building on this evidence, the MINDED trial (MedIcal juNior Doctors Emergency Department) aims to evaluate the impact of an adaptive e-learning program tailored specifically for junior doctors in emergency medicine. This program is designed to improve their theoretical knowledge and practical competencies, thereby reducing anxiety and enhancing performance during emergency shifts. By addressing both psychological and educational needs, the trial seeks to contribute to a more resilient and competent workforce in acute care.
Objectives
- Primary Objective: To assess the impact of the adaptive e-learning program on reducing state anxiety levels in junior doctors.
- Secondary Objectives: To evaluate improvements in perceived self-efficacy during shifts and competency following the intervention.
Hypotheses
- Participation in the adaptive e-learning program will significantly reduce state anxiety compared to controls.
- The adaptive e-learning program will enhance both objective and subjective medical competence among participants.
- Being tested
- Adaptive E-learning
- Keywords
- Junior Doctors, Emergency Department, Adaptive E-learning, Medical Competence, Medical Education, Healthcare Workforce, state anxiety
- Medical subject headings
- Anxiety Disorders, Stress, Psychological, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Adaptive E-learningOther
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.
| Study group | Role | What they receive |
|---|---|---|
| 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 Receives: Other: Adaptive E-learning |
| Standard onboarding | No intervention | The control group will receive standard onboarding |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in STAI scores
A change in STAI-6 scores from baseline to 6 weeks post-intervention.
Measured: Immediately after the intervention
Secondary outcomes (1)
• E-learning engagement, defined as link activation, chapter completion, and total time spent on the platform.
- E-learning engagement, defined as link activation, chapter completion, and total time spent on the platform.
Measured: Immediately after the intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Feb 2025
- Study start1 Jan 2025
- Primary completion1 Jul 2025
- Study completion1 Sep 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (13)Papers the sponsor has linked to this study.
- Other trials for State AnxietyStudies 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
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 233 participants (actual)
Sponsor and investigators
- Lead sponsor
- Copenhagen Academy for Medical Education and Simulation
- Sponsor type
- University, hospital or other
- Collaborators
- Copenhagen University Hospital, Rigshospitalet
- Responsible party
- Principal investigator, Anna Sofie Mundt, Copenhagen Academy for Medical Education and Simulation
- Investigators
- Jonas P Eiberg, PhD, Principal investigator, Department of Vascular Surgery, The Heart Center, University Hospital of Copenhagen - Rigshospitalet and Copenhagen Academy for Medical Education and Simulation
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06842394
- Sponsor's protocol ID
- F-24053546
- Acronym
- MINDED
- Status last verified
- Jun 2026
- First submitted
- 6 Feb 2025
- Last updated
- 8 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The aim of this study is to generate data on how an e-learning programme may or may not effect STAI on younger doctors in general. Thus, the individual focus is less important and will not be discussed with other researchers.
Publications
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.
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.
PubMed 36331149Piso 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.
PubMed 38471514Stassen 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.
PubMed 35898382Skov 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.
PubMed 39266129Shahsavari 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.
PubMed 28910662Seathu 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.
PubMed 38448230Saffari 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.
PubMed 33986878Montgomery 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.
PubMed 31362957Monrouxe 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.
PubMed 30158236Mathisen 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.
PubMed 34052852Klitgaard 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.
PubMed 33494741Fuster 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.
PubMed 28619199
Study at a glance
From the registry record, last updated by the sponsor on 8 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Can Increased Medical Competence Reduce State Anxiety in Junior Doctors in the Emergency Department: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06842394
- Acronym / sponsor ID
- MINDED / F-24053546
- Keywords
- Junior Doctors, Emergency Department, Adaptive E-learning, Medical Competence, Medical Education, Healthcare Workforce, state anxiety
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 233 participants (actual)
- Lead sponsor
- Copenhagen Academy for Medical Education and SimulationUniversity, hospital or other
- Collaborators
- Copenhagen University Hospital, Rigshospitalet
- Study start
- 1 Jan 2025 (actual)
- Primary completion
- 1 Jul 2025 (actual)
- Study completion
- 1 Sep 2025 (actual)
- First posted
- 24 Feb 2025 (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.
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.
Detailed description
The healthcare system is under increasing pressure due to demographic changes, including a growing elderly population and a shrinking workforce. This intensifies the challenges of recruiting and retaining healthcare professionals, particularly in high-stress environments like emergency departments. Junior doctors often face significant anxiety during their early careers, which is associated with higher rates of burnout, decreased job satisfaction, and early career attrition Transitioning from medical education to clinical practice is a critical period marked by high levels of stress and anxiety. Research highlights that new doctors frequently report feeling inadequately prepared for the demands of clinical work, particularly in acute care settings where decision-making is both time-sensitive and impactful. Anxiety during this transition is not only detrimental to individual well-being but also impacts patient safety and care quality.
Prior interventions, including simulation-based training and e-learning programs, have shown promise in reducing stress and improving clinical competence among healthcare professionals. For example, adaptive e-learning platforms have demonstrated efficacy in tailoring content to individual learners' needs, enhancing knowledge retention, and fostering confidence in clinical skills.
Building on this evidence, the MINDED trial (MedIcal juNior Doctors Emergency Department) aims to evaluate the impact of an adaptive e-learning program tailored specifically for junior doctors in emergency medicine. This program is designed to improve their theoretical knowledge and practical competencies, thereby reducing anxiety and enhancing performance during emergency shifts. By addressing both psychological and educational needs, the trial seeks to contribute to a more resilient and competent workforce in acute care.
Objectives
- Primary Objective: To assess the impact of the adaptive e-learning program on reducing state anxiety levels in junior doctors.
- Secondary Objectives: To evaluate improvements in perceived self-efficacy during shifts and competency following the intervention.
Hypotheses
- Participation in the adaptive e-learning program will significantly reduce state anxiety compared to controls.
- The adaptive e-learning program will enhance both objective and subjective medical competence among participants.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Adaptive e-learning | Experimental | Other: Adaptive E-learningThe intervention group will receive the adaptive e-learning program in addition to standard onboarding within the first six weeks of employment |
| Standard onboarding | No intervention | –The control group will receive standard onboarding |
Who may qualify
- Ages
- 18 months and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (2 listed)
- 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.
Key exclusion criteria (2 listed)
- Prior exposure to the adaptive e-learning program.
- Denying participation.
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 |
|---|---|---|
| Adaptive E-learningAn 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. | Other | Adaptive e-learning |
Primary outcome
Change in STAI scores
Time frame: Immediately after the intervention
A change in STAI-6 scores from baseline to 6 weeks post-intervention.
1 secondary outcome
• E-learning engagement, defined as link activation, chapter completion, and total time spent on the platform.
Time frame: Immediately after the intervention
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 Jun 2026.
- BackgroundRistić, 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: PubMed 36331149Juul 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.
- Background: PubMed 38471514Piso 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.
- Background: PubMed 35898382Stassen 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.
- Background: PubMed 39266129Skov 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.
- Background: PubMed 28910662Shahsavari 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.
- Background: PubMed 38448230Seathu 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.
- Background: PubMed 33986878Saffari 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.
- Background: PubMed 31362957Montgomery 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.
- Background: PubMed 30158236Monrouxe 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.
- Background: PubMed 34052852Mathisen 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.
- Background: PubMed 33494741Klitgaard 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.
- Individual participant dataSharing planned: No. The aim of this study is to generate data on how an e-learning programme may or may not effect STAI on younger doctors in general. Thus, the individual focus is less important and will not be discussed with other researchers.
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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.
Jonas P Eiberg, PhD principal investigator
Department of Vascular Surgery, The Heart Center, University Hospital of Copenhagen - Rigshospitalet and Copenhagen Academy for Medical Education and Simulation
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Adaptive E-learning in people with State Anxiety and Psychological Stress, run by Copenhagen Academy for Medical Education and Simulation at 1 site in Denmark.
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 2 inclusion and 2 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 Jun 2026. 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 Denmark. 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. 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?
Change in STAI scores (time frame: Immediately after the intervention). 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 NCT06842394, which also lists 13 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 Jun 2026.