The INSPIRE Study: INvestigation of Swiss Physicians Inner-life, Resilience, and Emotions (INSPIRE)

The goal of this clinical trial, nested within an observational cohort study, is to evaluate whether two positive psychology web-based interventions can reduce emotional exhaustion and improve overall well-being in practicing physicians in Switzerland. The main questions it aims to answer are:

Does participation in positive psychology interventions reduce emotional exhaustion at three months post-intervention? How do these interventions impact physician wellness, job satisfaction, comfort with end-of-life communication and other aspects of physicians' emotional well-being?

Researchers will compare the effects of two intervention arms (general reflection vs. work-specific reflection) to a control group to determine whether focusing on work-specific aspects leads to greater improvements in emotional exhaustion and job-related outcomes.

Participants will:

• Complete an 8-day intervention consisting of positive psychology activities delivered online.
• Complete baseline and follow-up assessments over the study period

Study Overview

• Status: Not yet recruiting
• Conditions: Burnout, Professional; Emotions; Satisfaction, Personal; Wellness, Psychological; Emotional Exhaustion
• Intervention / Treatment: Behavioral: INSPIRE Life Reflection; Behavioral: INSPIRE Work Reflection

Detailed Description

Burnout, emotional exhaustion, and moral distress are widespread among physicians, negatively impacting patient care, job satisfaction, and physician retention in the workforce. While interventions targeting burnout exist, many require significant time commitments or institutional support, limiting accessibility.

Positive psychology interventions, which emphasize strengths-based approaches such as self-reflection, gratitude, and self-compassion, have shown promise in enhancing resilience and well-being.

The INSPIRE study is a randomized controlled trial (RCT) nested within an observational cohort using a Trial within Cohort (TwiC) design. It evaluates two web-based positive psychology interventions aimed at reducing emotional exhaustion and improving physician well-being.

A subset of cohort participants is randomized into one of three arms: a control group, a general life reflection intervention, or a work-focused reflection intervention. The interventions consist of an 8-day structured self-reflection program delivered online.

The study employs automated randomization, triple masking (participants, investigators, and outcome assessors), and longitudinal assessments over one year. Findings will inform the scalability of low-burden interventions for physician burnout prevention.

• Study Type: Interventional
• Enrollment (Estimated): 450
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sofia C Zambrano, PhD; Phone Number: +41 31 684 57 76; Email: sofia.zambrano@unibe.ch
• Study Contact Backup: Name: Robert Staeck, MSc; Email: robert.staeck@unibe.ch

Study Locations

• Switzerland
  • Bern, Switzerland, 3012
    • University of Bern
    • Contact: Robert Staeck, MSc; Email: robert.staeck@unibe.ch
    • Contact: Sofia C Zambrano, PhD; Email: sofia.zambrano@unibe.ch
    • Principal Investigator: Sofia C Zambrano, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Be a practicing physician in Switzerland
2. Working at least 40% in a clinical capacity
3. Be willing and able to provide informed consent
4. Expecting to be professionally active until 2028

Exclusion Criteria:

1. Retired physician or physician seeking retirement within 3 years from first participation in the study
2. Physician unable to participate in one of the study languages: English, German, or French

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention 1 - General Positive Psychology Reflection; Participants engage in an 8-day web-based intervention involving positive psychology exercises focused on general life situations.	Behavioral: INSPIRE Life Reflection; An 8-day web-based positive psychology intervention encouraging participants to reflect on positive aspects of their daily lives. Activities include gratitude exercises, self-compassion writing, and recognizing meaningful moments.
Experimental: Intervention 2 - Work-Specific Positive Psychology Reflection; Participants engage in the same 8-day web-based intervention, but the focus is specifically on positive reflections related to work and patient interactions.	Behavioral: INSPIRE Work Reflection; An 8-day web-based positive psychology intervention encouraging participants to reflect on positive aspects of their work experiences. Activities include gratitude exercises, self-compassion writing, and recognizing meaningful professional interactions.
No Intervention: Control group; Participants complete assessments but do not receive the intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in Emotional Exhaustion	Emotional Exhaustion subscale of the MBI-HSS	3 months post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Emotional Exhaustion	Emotional Exhaustion subscale of the MBI-HSS	Baseline to 2 weeks, 1 month, 6 months, 1 year
Change in Depersonalization	Depersonalization subscale of the MBI-HSS	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Personal Accomplishment	Personal accomplishment subscale of the MBI-HSS	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Physician wellbeing	Physician Wellness Inventory (PWI)	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Job Satisfaction	Physician Job Satisfaction Scale	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in comfort with End-of-Life Communication	Communication about End of Life Survey	Baseline to 1 month, 3 months, 6 months, 1 year
Change in Mindfulness	Mindful Attention Awareness Scale (MAAS-Trait)	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Compassionate Care	Santa Clara Brief Compassion Scale	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Emotion Regulation	Emotion Regulation Questionnaire (ERQ)	Baseline to 1 month, 3 months, 6 months, 1 year
Change in Positive and Negative Affect	Positive and Negative Affect Schedule (PANAS)	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year
Change in Authenticity	Inauthenticity Scale	Baseline to 3 months, 6 months, 1 year
Resilience	2-item Connor-Davidson resilience scale	Baseline to 2 weeks, 1 month, 3 months, 6 months, 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived impact of the INSPIRE Interventions	Qualitative interviews with a subset of trial participants to understand perceived impact of the INSPIRE interventions.	Within 6 months post-intervention
Acceptability of the INSPIRE Interventions	Qualitative interviews with a subset of trial participants to understand acceptability of the INSPIRE interventions.	Within 6 months post-intervention

Collaborators and Investigators

• Sponsor: University of Bern
• Investigators: Principal Investigator: Sofia C Zambrano, PhD, University of Bern

Study record dates

Study Major Dates

• Study Start (Estimated): April 15, 2026
• Primary Completion (Estimated): January 15, 2027
• Study Completion (Estimated): August 15, 2027

Study Registration Dates

• First Submitted: January 31, 2025
• First Submitted That Met QC Criteria: January 31, 2025
• First Posted (Actual): February 3, 2025

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 11, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Positive Psychology; Psychological resilience
• Additional Relevant MeSH Terms: Occupational Stress; Burnout, Psychological; Behavioral Symptoms; Stress, Psychological; Occupational Diseases; Fatigue; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Burnout, Professional; Psychological Well-Being; Personal Satisfaction; Emotional Exhaustion
• Other Study ID Numbers: 2023-00963

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) will be made available for research purposes upon request. Data will include survey responses and outcome measures but will exclude any personally identifiable information
• IPD Sharing Time Frame: 18 months after publication of primary results and will remain accessible for at least 5 years
• IPD Sharing Access Criteria: Researchers can request access by submitting a proposal to the study investigators. Access will be granted to qualified researchers for scientifically valid analyses, subject to data-sharing agreements and ethical considerations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No