You have to HEAR It to UNDERSTAND It

The Impact of a Simulated Auditory Hallucination Experience on Nursing Students Attitudes toward people with Mental Illness
Debra A. Gottel, MHS, RN; Julie Daugherty MS, NP-C, and the CREATE Scholars

Purpose
Determine effectiveness of Simulated Auditory Hallucination
Experience (SAHE) in changing nursing students attitudes toward people with mental illness who hear voices Explore the correlations between the intensity of the students reaction to the SAHE and their changes in attitude toward people with mental illness who hear voices Hypothesis: Nursing students who complete the simulated auditory hallucination experience will have a positive shift in attitudes towards people with mental illness Students who have a more intense reaction to the simulation experience will experience a greater positive shift in attitude toward people with mental illness than students who report being less affected by the experience

Mean Scores for Items of MCRS

Discussion
Students who underwent a SAHE experienced a positive attitudinal

shift regarding people with mental illness Our findings demonstrate that exposure to the SAHE, not the rating of physical stress, was the primary factor in the change of attitudes toward people with mental illness An interesting and unexpected finding is the increase in students who reported that they would prefer not to work with individuals with mental illness after the SAHE Study limitations: An unevenly distributed sample did not allow for analysis in differences between males and females or program plans. Self-reported physical stress, as measured by the visual-analog scale, may have been influenced due to an ambiguous definition given during the instructions

Background
Stigma and negative attitudes of healthcare professionals contribute to worse outcomes for individuals with mental illness Stigma is a term used for the negative labeling of a person or group as different from accepted societal expectations, and as lower in status than others Nursing students attitudes towards people with psychiatric diagnosis include fear of unpredictable behavior, dislike, distrust, and beliefs that personal weakness cause the mental illness Nurses encounter individuals with mental illness in all specialty areas The results of existing healthcare disparities contribute to the differences win life expectancy between people with and without mental illness The need to improve healthcare to people with mental illness is supported by the national goals set in Healthy People 2020 Classroom instruction alone has been found ineffective in positively shifting attitudes of nursing students towards people with mental illness Simulated experiences have been found to be efficacious in promoting positive attitudes in general healthcare education There is limited data on the effectiveness of SAHE in the context of psychiatric nursing education

1
Strongly Disagree

2
Disagree

3
Not sure, but probably disagree

4
Not sure, but probably agree Agree

6
Strongly Agree

Our results show that inclusion of SAHE into psychiatric mental health nursing curriculum will enhance the educational gains of nursing students More skills training are needed to adequately prepare healthcare professionals working with people with mental illness Simulation lab should be included in nursing curriculum. The results for psychiatric nursing simulation compared to other studies that used a simulation intervention Recommendations for future research include: Expanding the population to include other all health professionals, those who work directly with individuals with mental illness, and law enforcement Testing the efficacy of an abbreviated version of the intervention Include a measure for the amount of active participation in the SAHE Include a control group that would not undergo a SAHE

1 2 3 4 5 6
Working with patients like this is satisfying. Insurance plans should cover patients like this to the same degree that they cover patients with other conditions. There is little I can do to help patients like this. I feel especially compassionate toward patients like this. Patients like this irritate me I wouldnt mind getting up on call nights to care for patients like this Treating patients like this is a waste of medical dollars. Patients like this are particularly difficult for me to work with. I can usually find something that helps patients like this feel better. I enjoy giving extra time to patients like this. I prefer not to work with patients like this. Medical Conditions Regard Scale (Christison, G., Haviland, M., & Riggs, M., 2002).

MCRS Items with Significant Change Post-Test

CREATE Scholars

Results

Methods
Research Design: Non-experimental, quantitative pre- and post-

Results
107 Participants (12 male; 95 female) Student Program: Upper Division = 76 participants Second Degree = 31 participants Findings Nursing students who completed the SAHE experienced a positive shift in attitude toward people with mental illness. There was no correlation between the intensity of physical stress described by anticipants and change in attitude. The amount of change in attitude was not related to the change in visual analog scale. There was a significant increase in self-reported physical stress following exposure to the SAHE. Scores went up by 12.11(t= 5.315, df = 104, p= <0.05).

experience survey Population: Nursing students enrolled in a psychiatric nursing course Setting: University of South Florida College of Nursing Instruments Used Medical Condition Regard Scale (MCRS) Visual Analogue Scale to rate level of physical stress Exclusion Criteria: Student enrolled in the course who cannot or did not wish to participate Intervention Documentary describing challenges experienced by people with mental illness was shown to students Students used a MP3 player that delivered a SAHE for a duration 60 minutes Students completed a variety of tasks while listening to the SAHE: - Mini Mental Status Exam - Memory recall - Reading comprehension - Spatial coordination exercise Debriefing session

Pictured Left to Right: Jessica Nemerovsky, Jaymie McAllister, Janel Canty, Ashley Huesman, Sara Dominic, Larissa Pollock, Debra Gottel MHS, RN, Jerrica Farias, RN, BSN, Ula Armashi, Desiree Monnot, Noor Tamari, Julie Daugherty MS, NP-C, Summer Abukhodeir Not Pictured: Jessica Benette, Brittany Durant MS, Kathryn Garcia, Cintli Jauregui, Maria Klammer

Acknowledgements
Funding was provided by USF College of Nursing GRANT? We would like to thank and acknowledge Cindy L. Munro, PhD, RN, ANP-BC, FAAN, Jason W. Beckstead, PhD, John Orriola for their support and guidance.

University University of of South South Florida Florida College College of of Nursing Nursing

Tampa, Florida Tampa, Florida