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 randomized controlled trial

Table 1 Psychophysiological adaptations depending on challenge and threat

Students in challenge state		Students in threat state
	Psychological adaptations
Perceived coping resources higher than perceived task demands	Resources-demands differential	Perceived coping resources lower than perceived task demands
	Neuroendocrine adaptations
Higher	Anabolic balance (DHEA/Cortisol)	Lower
Higher	sAA	Lower
	Cardiovascular adaptations
Lower	TPR	Higher
Higher	CO	Lower
Better BBN communication	Performance	Worse BBN communication

Note. DHEA = dehydroepiandrosterone; sAA = salivary alpha-amylase; TPR = total peripheral resistance; CO = cardiac output

ISSN: 2050-7283