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Background/objective: Cognitive test anxiety (CTA) significantly impacts academic performance and well-being in health professions education. While research demonstrates CTA’s adverse effects on learning outcomes and mental health, medical curricula rarely include evidence-based interventions addressing this challenge. At our institution, we sought to understand the prevalence of exam anxiety in medical students and, depending on the results, develop a targeted workshopbased support programme co-created between students and faculty members.

Methods: We used the German Cognitive Test Anxiety Scale (G-CTAS) [1], a validated 27-item adaptation of the English CTAS (4-point Likert scale; 27-108 points) [2], to assess CTA levels in medical students at Charité – Universitätsmedizin Berlin. Subsequently, a co-design team of students, psychotherapists, and medical educators developed a workshop based on cognitivebehavioural principles addressing identified anxiety patterns. Students participated in prototype testing and completed evaluations using Likert-scale items, free-text responses and open feedback rounds.

Results: 546 students participated in the survey (partial response rate: 16%). 35% of the students reached high anxiety levels (CTAS 71-101; M=66.8, SD=12.4, range: 39-101). Female students (M=68.0) scored significantly higher than male students (M=62.6) (t(299)=3.49, p<.001, d=0.45). The co-designed intervention comprised two in-person workshop sessions and an intermitted online phase, integrating cognitive restructuring, growth mindset theory, peer support and embodied mindfulness practice. Students with faculty support delivered the intervention. Thirteen students participated in the prototype implementation. Participant satisfaction ratings were high (Session 1: M=4.0, n=11; Session 2: M=4.3, n=7; 5-point Likert). Qualitative feedback particularly valued the practical cognitive restructuring tools, peer-support opportunities, and self-efficacy-enhancing exercises. Participants requested additional time to share individual CTA experiences.

Discussion: Our work suggests the need for systematically uncovering and addressing CTA levels in undergraduate student populations. Our co-design approach for developing targeted and theory-based interventions showed promising results in the target group’s feedback, providing a solid base for upscaling the intervention. Institutions and their students might benefit from systematic CTA screening and offering low-level support in test-anxiety workshops co-designed with and led by students.

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