NCT05037318: BPSM

Breaking Bad News - Optimizing Stress Response and Communication Performance in Medical Students

Completed NA Last updated 5 March 2024

What this trial tests

NA trial testing Stress arousal reappraisal in Stress Reaction in 229 participants. Completed in 29 February 2024.

Timeline

21 April 2022

Primary endpoint
29 February 2024

29 February 2024

Quick facts

Lead sponsor	University of Bern
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	factorial
Masking	double
Primary purpose	basic science
Enrollment	229
Start date	21 April 2022
Primary completion	29 February 2024
Estimated completion	29 February 2024
Sites	1 location across Switzerland

Drugs / interventions tested

• Stress arousal reappraisal
• Worked examples

Conditions studied

• Stress Reaction — all drugs for Stress Reaction →

Sponsor

University of Bern

Who can join

18 and older, any sex, with Stress Reaction. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Breaking bad news (e.g., telling patients that they have cancer) is not only very stressful for the patients concerned, but also for the physicians delivering the diagnosis. It is unclear how this burden and the associated communication performance can be optimized. The project contributes to this goal.

The main goal of the project is to scientifically analyze to what extent the stress reaction and communication performance of medical students can be optimized when breaking bad news. Two strategies will be employed and tested for their effectiveness: First, "stress arousal reappraisal", which consists in reinterpreting physiological arousal (e.g., increased heart rate) as adaptive and beneficial for task performance. Second, medical students can be well prepared for breaking bad news by learning from worked examples (step-by-step demonstrations of how to break bad news).

The investigators hypothesize that both strategies will shift the interpretation of breaking bad news from a threat to a challenge state. This will lead to better communication performance during the task.

To test the hypothesis, about 200 medical students' communication performance, cardiovascular activity, stress hormone release, and subjective stress perception when communicating a serious cancer diagnosis to a simulated patient (actor) will be measured.

The results of the study provide a first comprehensive picture of the psychophysiological stress patterns of medical students who are entrusted with a stressful communication task. Ultimately, this may promote stress management and communication skills in future physicians.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

1. From threat to challenge-Improving medical students' stress response and communication skills performance through the combination of stress arousal reappraisal and preparatory worked example-based learning when breaking bad news to simulated patients: study protocol for a randomi
   Bosshard M, Schmitz FM, Guttormsen S, Nater UM, et al · · 2023 · cited 9× · PMID 37165406 · DOI 10.1186/s40359-023-01167-6
2. Improving breaking bad news communication skills through stress arousal reappraisal and worked examples.
   Bosshard M, Guttormsen S, Nater UM, Schmitz F, et al · · 2025 · cited 5× · PMID 40074561 · DOI 10.1111/medu.15658
3. A randomized controlled trial evaluating stress arousal reappraisal and worked example effects on psychophysiological responses during breaking bad news.
   Bosshard M, Guttormsen S, Nater UM, Schmitz F, et al · · 2025 · cited 1× · PMID 40604103 · DOI 10.1038/s41598-025-06995-7
4. Optimizing stress in breaking bad news: a randomized controlled trial on the psychophysiological effects of stress arousal reappraisal and worked-example interventions among medical students
   Bosshard M, Guttormsen S, Nater UM, Schmitz F, et al · · 2025 · DOI 10.1101/2025.01.21.25320844