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

March 17, 2026 updated by: Anna Sofie Mundt, Copenhagen Academy for Medical Education and Simulation

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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

  1. Primary Objective: To assess the impact of the adaptive e-learning program on reducing state anxiety levels in junior doctors.
  2. Secondary Objectives: To evaluate improvements in perceived self-efficacy during shifts and competency following the intervention.

Hypotheses

  1. Participation in the adaptive e-learning program will significantly reduce state anxiety compared to controls.
  2. The adaptive e-learning program will enhance both objective and subjective medical competence among participants.

Study Type

Interventional

Enrollment (Actual)

233

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Denmark
    • Capital Region
      • Copenhagen, Capital Region, Denmark
        • Emergency Departments in the Capital Region of Denmark

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 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.

Exclusion Criteria:

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Adaptive e-learning
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
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.
No Intervention: Standard onboarding
The control group will receive standard onboarding

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in STAI scores
Time Frame: Immediately after the intervention
A change in STAI-6 scores from baseline to 6 weeks post-intervention.
Immediately after the intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in perceived selfefficacy during shifts, measured through a structured survey.
Time Frame: Immediately after the intervention
The participants report self assesment on how they experience their selfefficacy after the interventions has been completed
Immediately after the intervention
Qualitative insights from interviews with participants exploring factors influencing anxiety and competency.
Time Frame: Immediately after the intervention
Individual interviews with participants in the intervention group
Immediately after the intervention
• E-learning -based exploratory outcomes, including learning curves, self-assessed competencies to objective competencies, e-learning implementation and user satisfaction.
Time Frame: Immediately after the intervention
The e.learning system extratcs data on learning curves, self-assessed competencies to objective competencies, which is combined with a survey on e-learning implementation and user satisfaction
Immediately after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Copenhagen Academy for Medical Education and Simulation

Collaborators

Rigshospitalet, Denmark

Investigators

  • Principal Investigator: Jonas P Eiberg, PhD, Department of Vascular Surgery, The Heart Center, University Hospital of Copenhagen - Rigshospitalet and Copenhagen Academy for Medical Education and Simulation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2025

Primary Completion (Actual)

July 1, 2025

Study Completion (Actual)

September 1, 2025

Study Registration Dates

First Submitted

February 6, 2025

First Submitted That Met QC Criteria

February 19, 2025

First Posted (Actual)

February 24, 2025

Study Record Updates

Last Update Posted (Actual)

March 19, 2026

Last Update Submitted That Met QC Criteria

March 17, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • F-24053546

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

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.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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