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Examining the Effect of a Group-Based Stress Management Course on Empowering the Mental Health of Medical Faculty Students and Resident Physicians: A Randomized Controlled Study (EMPOWER-MD)

25. juni 2026 opdateret af: Imran Gokcen Yilmaz-Karaman, Eskisehir Osmangazi University

EXAMINING THE EFFECT OF A GROUP-BASED STRESS MANAGEMENT COURSE ON EMPOWERING THE MENTAL HEALTH OF MEDICAL FACULTY STUDENTS AND RESIDENT PHYSICIANS: A RANDOMIZED CONTROLLED STUDY

Physicians and medical students have higher rates of depression, anxiety, burnout, and suicide risk than the general population, and this disparity often begins early, even during medical school. Despite substantial distress, help-seeking is frequently limited due to stigma concerns, career fears, and time constraints, which may allow mental health problems to progress unnoticed and become chronic. Preventive interventions during medical education may reduce current distress and help avert more severe disorders later in professional life. Group-based psychoeducation is a cost-effective approach with advantages such as scalability, peer support, and learning benefits without requiring personal disclosure. The WHO Self-Help Plus (SH+) program is an ACT-informed, easily deliverable group stress management course, and randomized controlled trials across settings suggest SH+ can reduce psychological distress and depressive symptoms while improving coping skills and resilience. In Türkiye, evidence on group-based interventions for medical students and resident physicians remains limited and focuses mainly on documenting symptom levels rather than testing interventions; therefore, this study aims to evaluate a group-based stress management course and examine the feasibility and cultural adaptation of SH+-like programs in Turkish medical education.

Studieoversigt

Detaljeret beskrivelse

Rates of depression, anxiety, and burnout are markedly higher among physicians than in the general population, and suicide risk is also significantly elevated (Shanafelt et al., 2012; Mata et al., 2015). This disparity often emerges early in the professional trajectory, even during medical school. The prevalence of depression, anxiety, burnout, and high stress is higher among medical students compared with the general population. For example, a large-scale meta-analysis by Rotenstein et al. (2016) found a 27% prevalence of depression and depressive symptoms among medical students, while Puthran et al. (2016) reported depression prevalence above the general population average.

Nevertheless, when experiencing psychological distress, medical students and physicians often hesitate to seek help and are less likely to pursue professional support due to fear of stigma, career-related concerns, or time constraints (Chew-Graham et al., 2003; Dyrbye et al., 2007). This can allow mental health problems to progress silently and become chronic. Therefore, implementing protective and preventive interventions during medical education may not only reduce current psychological difficulties but also help prevent more severe mental disorders that could emerge later in professional life.

In this context, one cost-effective approach to supporting mental health is group-based psychoeducation programs. Compared with individual counseling or therapy, group-based psychoeducation is less costly, allows participants to benefit without having to share personal experiences, provides social support through peer participation, and facilitates more durable acquisition of knowledge and skills through social learning in a group setting (Yalom & Leszcz, 2005). Such group interventions are particularly prominent for student populations in terms of feasibility and acceptability.

In recent years, the World Health Organization (WHO) Self-Help Plus (SH+) group-based stress management course has emerged as an easily deliverable psychoeducational program grounded in Acceptance and Commitment Therapy (ACT) principles. In randomized controlled trials conducted across different countries and samples, SH+ has been shown to reduce psychological distress, decrease depressive symptoms, improve coping skills, and enhance resilience (Tol et al., 2020). The WHO also recommends this program as a low-cost, brief, and scalable mental health intervention (WHO, 2020).

In Türkiye, only a limited number of studies have examined group-based interventions aimed at strengthening the mental health of medical students and resident physicians. The existing literature has largely focused on identifying levels of depression and burnout, and there is a lack of research developing and testing effective and feasible intervention models. Therefore, by investigating the effects of a group-based stress management course for medical students and resident physicians, this study aims to address an important gap.

Through this research: (i) the effects of a cost-effective and feasible group-based intervention designed to strengthen the mental health of medical students and resident physicians will be evaluated; (ii) the feasibility of implementing structured programs similar to SH+ within the Turkish health education context will be examined, and findings regarding cultural adaptation will be contributed to the literature; and (iii) the results will inform national policies and practices aimed at supporting mental health in medical education and among healthcare workers, while also contributing to the international literature. Accordingly, this study has the potential to contribute not only to strengthening mental health at the individual level but also to fostering a healthier and more sustainable physician workforce within the healthcare system.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

180

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Eskişehir, Tyrkiet (Türkiye), 26040
        • Eskişehir Osmangazi University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Being a medical student or a resident physician at Eskişehir Osmangazi University Faculty of Medicine
  • Being 18 years of age or older

Exclusion Criteria:

  • Individuals with active suicidal ideation
  • Individuals with severe mental disorders such as psychotic disorders or bipolar disorder
  • Individuals with alcohol or substance dependence
  • Students under 18 years of age

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Venteliste
Eksperimentel: intervention group
The group will receive 5 sessions of group based stress management program developed by WHO.
The course is designed to help individuals cope with challenging life events and manage stress. The core components of the SH+ course include focusing attention (grounding), stepping back from distressing thoughts and emotions, acting in line with one's values, practicing kindness (self-compassion), and making space for difficult emotions.
Andre navne:
  • sh+
  • Group based stress management program

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Depression Anxiety Stress Scales - Short Form (DASS-21)
Tidsramme: 1th-30th days
The DASS-21 is a self-report instrument developed to assess respondents' levels of depression, anxiety, and stress (Lovibond & Lovibond, 1995).
1th-30th days
Suicide Probability Scale - SPS
Tidsramme: 1 th - 30 th days
The original form of the scale was developed by Cull and Gill (1982) to measure the likelihood of suicide.
1 th - 30 th days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The World Health Organization-Five Well-Being Index - WHO-5
Tidsramme: 1 th - 30 th days
The 5-item scale is a short and effective screening tool developed by the World Health Organization to assess mental health. The scale, which has a single-factor structure, is a self-report scale consisting of 5 items that assess the past two weeks.
1 th - 30 th days

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maslach Burnout Inventory (MBI)
Tidsramme: 1th - 30 th days
Developed to assess burnout levels, this self-report measure consists of 22 items and comprises three factors: Emotional Exhaustion, Depersonalization, and Personal Accomplishment (Maslach et al., 1997).
1th - 30 th days
The Multidimensional Scale of Perceived Social Support - MSPSS
Tidsramme: 1 th - 30 th days
The scale designed to measure perceived social support has a three-factor structure consisting of 12 items, indicating the source of support as family, friends, and a special person.
1 th - 30 th days

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2026

Primær færdiggørelse (Anslået)

1. februar 2028

Studieafslutning (Anslået)

31. december 2028

Datoer for studieregistrering

Først indsendt

25. juni 2026

Først indsendt, der opfyldte QC-kriterier

25. juni 2026

Først opslået (Faktiske)

1. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • EskisehirOU 04.11.2025/29

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Since our participants will be medical students and residents from the same medical faculty, we anticipate that publicly sharing data may compromise anonymity.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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Kliniske forsøg med Group-based

Kliniske forsøg med self help plus

3
Abonner