{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:01:50Z","timestamp":1790359310105,"version":"4.1.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The MPS Foundation","award":["REF:TMPSF2024001"],"award-info":[{"award-number":["REF:TMPSF2024001"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Medical students experience high rates of burnout and mental health distress, with approximately half reporting burnout, one-third experiencing depression, and one-tenth having suicidal thoughts. These issues are exacerbated during clinical placements and contribute to workforce attrition after qualification. Existing interventions are largely generic and show limited effectiveness. Thumos, a cognitive-behavioural therapy-based intervention specifically tailored for healthcare professionals and medical students, addresses the stressful situations intrinsic to medical training and practice. This randomised controlled trial will evaluate whether Thumos improves psychological resilience, confidence in dealing with stressful situations, burnout, and depression in medical students compared with services as usual (SAU).<\/jats:p>\n <\/jats:sec>\n \n Methods\/design<\/jats:title>\n Two hundred and twenty UK medical students in a year that contains a clinical placement of a week or longer will be recruited nationally from UK medical schools. Participants will be randomised 1:1 to receive either Thumos (two online group workshops and one individual video\/phone call) or SAU. Assessments will occur at baseline, post-intervention, 4-month, and 9-month follow-up. The primary outcome is psychological resilience measured by the Brief Resilience Scale at 4-month follow-up. A mixed-methods process evaluation will assess acceptability and feasibility.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n To our knowledge, this is the first randomised controlled trial of an intervention specifically designed to prepare medical students for stressful clinical events. If effective, Thumos could potentially be adapted for medical students in other countries.<\/jats:p>\n <\/jats:sec>\n \n Trial identifier and registry name<\/jats:title>\n \n ISRCTN12744098:\n https:\/\/www.isrctn.com\/ISRCTN12744098<\/jats:ext-link>\n ; An evaluation of a cognitive-behavioural intervention for medical students\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0355371","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:41:18Z","timestamp":1790358078000},"page":"e0355371","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["ACTIVATE: A protocol for a randomised controlled evaluation of Thumos: A cognitive-behavioural intervention for medical students"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6820-9789","authenticated-orcid":true,"given":"Lucy","family":"Pointon","sequence":"first","affiliation":[{"name":"School of Health Sciences, University of Manchester","place":["Manchester, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-445X","authenticated-orcid":true,"given":"William","family":"Lea","sequence":"additional","affiliation":[{"name":"York and Scarborough Teaching Hospitals NHS Foundation Trust","place":["York, United Kingdom"]},{"name":"Hull York Medical School","place":["York, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1989-883X","authenticated-orcid":true,"given":"Christopher D. 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