First Advisor

Cullen, Patricia

Thesis Committee Member(s)

Stoeckel, Pamella


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

66 pages


Abstract Nursing students experience anxiety, uncertainty, and fear when faced with communicating with mentally ill patients, specifically those with auditory hallucinations. Nurse educators are aware that anxiety is a major obstacle in the clinical setting, and may decrease learning (Melincavage, 2011). First year nursing students in a baccalaureate-nursing program at a Midwestern University expressed anxiety and knowledge deficit related to communicating with mentally ill patients. The research question for this study was: In BSN students in their first mental health class how does completing a voice simulation and role-play affect students' perceptions of communication with patients with auditory hallucinations? The qualitative phenomenological study implemented a simulation entitled "Hearing Voices That Are Distressing" followed by a role-play. Forty BSN students completed a written survey about their perceptions of the experience of the simulation and role-play. The data was coded for themes and analyzed with constant comparative analysis. Themes of the research included: Fear of The Unknown, Impressions of Mental Illness, Avoidance, Voices Are Real, Empathy for Patients, New Attitudes, New Skills, Environmental Considerations, Struggle, and Insight. This study revealed that before the simulation and role-play students experienced anxiety, fear, and uncertainty when communicating with the mentally ill hearing voices. After the simulation the students experienced a change in perception; they acknowledged auditory hallucinations as real, with increased empathy for these patients, and identified new attitudes and skills when interacting and communicating with patients who are mentally ill. Key Terms: mental health simulation, auditory hallucination; student nurse, anxiety, therapeutic communication, self-efficacy, empathy, "Hearing Voices That Are Distressing," simulation

Date of Award

Fall 2014

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

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