Education

Developing Awareness and Empathy for Person’s Hearing Distressing Voices in Entry Level Nursing Students

Thursday, June 15, 2023

4:30 PM – 5:15 PM EDT

Location: Junior Ballroom

Lead Author(s)

Sharon R. Jackson, DNP, MSN, RN, PMH-BC (she/her/hers)

Assistant Professor
UNC Chapel Hill School of Nursing
Garner, NC, United States

Co-Author(s)

Carol F. Durham, EdD, FAAN, ANEF, FSSH

Professor
UNC Chapel Hill School of Nursing
Chapel Hill, NC, United States
Theresa Raphael-Grimm, PhD, PMHCNS-BC

Professor
University of North Carolina-Chapel Hill
Chapel Hill, NC, United States
BR

Brandy Reardon, PhD, RN

Nurse Specialist
The University of North Carolina at Chapel Hill
Pikeville, North Carolina, United States

Disclosure(s):

Sharon R. Jackson, DNP, MSN, RN, PMH-BC: No financial relationships to disclose

Carol F. Durham, EdD, FAAN, ANEF, FSSH: No financial relationships to disclose

Theresa Raphael-Grimm, PhD: No financial relationships to disclose

Abstract :

Introduction: Nursing students are apprehensive about engaging with patients experiencing hallucinations. There is a critical need for students to develop empathy for, and understanding of, the hallucinating person’s experience.

Conceptual framework: Kolb’s Experiential learning model. Concepts were applied at each stage of the learning cycle; simulation (Concrete Experience), debriefing (Reflective Observation), essay (Abstract Conceptualization), and application of new knowledge in clinical experience (Active Experimentation). Instructional methods accommodated all learning styles outlined within the framework.

Description: Attendees viewed an instructional video that described experiences of patients with auditory hallucinations. Students then listened to a recording of distressing voices via MP3 player while completing a series of cognitive and interpersonal tasks intended to simulate common activities (job application, mental status exam, etc.). Debriefing was conducted immediately afterwards using formalized prompts. A reflective essay assignment allowed students to conceptualize their experiences and process the knowledge, skills, and attitude that they obtained. Finally, students attended their clinical rotations with psychiatric patients and employed this knowledge.

Learners: Approximately 115 undergraduate nursing students from traditional and accelerated baccalaureate programs at a large, southeastern public university participated in the simulation.

Results: During debriefing, students reported perceptual shifts towards, and increased empathy for, patients experiencing auditory hallucinations. Essays described newfound insight and plans to implement changes into nursing care. During clinical rotations, students expressed increased comfortability during patient interactions.

Discussion: Use of recordings that mimic patients’ experiences of auditory hallucinations gave students true insight. Hearing Distressing Voices continues to be a groundbreaking, empathy-building experience.

Learning Objectives:

develop an understanding of how to implement the simulation to assist learners to consider how to have an increased awareness of the cognitive load their clients have while hearing voices.
identify key points for debriefing the simulation to assist students to be reflective about their experience and to transfer their learning to care of patients with mental health challenges.
develop a safe container for the learners before, during and after the simulation, given that the simulation experience can be a trigger for many learners.