Abstract
This presentation reports outcomes of a quasi-experimental study of the educational benefits of simulated auditory hallucinations (SAH). Data were gathered from 109 students and analyzed using qualitative and quantitative methods. Outcomes show that the SAH activity enhanced learning by increasing understanding that hallucinations affect occupations differently based on activity demands. Outcomes also show students' increase in empathy toward people with schizophrenia.
Primary Author and Speaker: Bernard Austin Kigunda Muriithi
This presentation reports outcomes of a quasi-experimental study of a learning activity for occupational therapy students. The exploration of the educational benefits of simulated auditory hallucinations (SAH) paired with performance of a series of occupations of varying degrees of difficulty, was done after approval was granted by the university's Institutional Review Board (IRB). In a laboratory experience, 109 students used portable devices to listen to Hearing Voices, an audio recording by Patricia Deegan which simulates auditory hallucinations, while performing six selected student-relevant occupations. After the 45-minute laboratory experience, participants used Q1 forms to rate their level of difficulty for each of the six activities on a Likert scale (1 = very high, and 5 = very low). The Q1 forms, which did not have participant names on them, were collected at the end of activity. Participants also wrote 2-3-page reflective papers on how SAH impacted their performance and how this experience influenced their perception of individuals living with schizophrenia. After the assignment was graded and results posted, in accordance with IRB requirements, participants who agreed to be study participants signed consent forms and provided their reflective papers for analysis. Data from Q1 forms was statistically analyzed revealing that SAH made performance of occupations more difficult, with overall mean (M = 2.73) representing moderate to high difficulty. Pairwise analysis of variance (ANOVA) showed significant variations in difficulty when occupations were compared with one another. A difference was noted between library search and taking a test (p = 0.037), whereas library search was about the same in difficulty as socializing (P = 1.0). Attending a lecture was significantly different from library search (p = 0.00), whereas, library search and comedy show were different but comparable (P = 0.048). The most difficult activities included lecture attendance and test taking (M = 1.99 and M = 2.33 respectively). Results show that tasks considered easier by most participants included watching a comedy show and variable ADL tasks (M = 3.10 and M = 3.63 respectively). Themes emerging from qualitative analysis show high variability in experience or explanations made for the varied levels of difficulty between individuals and/or tasks. However, some similarities in experiences or explanations were also noted and include the following: First, participants expressed increased empathy toward people living with schizophrenia because of better understanding how auditory hallucinations affected people's daily lives; Secondly, participants noted that performance of certain tasks was easier than that of others because it was easier to tune out SAH doing some activities than others; Third, the relevance of content communicated by voices relative to what a participant was doing at a particular time, or experiencing personally even outside this class, influenced the degree of difficulty with a specific task; Lastly, some participants reported that activities performed later were harder simply because they came after participants were mentally exhausted from doing other tasks. This study shows that pairing SAH with occupations that differ in difficulty enhanced student learning and improves empathy towards people living with schizophrenia and related disorders. It also indicates that mixing qualitative and quantitative methods enhanced understanding of this experience much more than exclusively utilizing methods of either paradigm. While statistics revealed similarities and differences between participants' experiences, the personal, variable, and unquantifiable data revealed subjective experiences that could not otherwise have been recognized at all.
Bunn, W & Terpstra, J. (2009). Cultivating empathy for the mentally ill using simulated auditory hallucinations. Academic Psychiatry, 33(6), 457-460. https://doi.org/10.1176/appi.ap.33.6.457
Fossen, P. & Stoeckel, P. R. (2016). Nursing students’ perceptions of a hearing voices simulation and role play: Preparation for mental health clinical practice. Journal of Nursing Education, 55(4), 203-208. https://doi.org/10.3928/01484834-20160316-04
Kepler, B. B., Lee, H., Kane, I., & Mitchell, A. M. (2016). Voice simulation in nurse education. Nurse Educator, 41(2), 66-69. https://doi.org/10.1097/NNE.0000000000000213
Skoy, E.T., Eukel, H.N., Frenzel, J.E., Werremeyer, A., & McDaniel B. (2016). Use of an auditory hallucination simulation to increase student pharmacist empathy for patients with mental illness. American Journal of Pharmaceutical Education, 80(8), 1-6. https://doi.org/10.5688/ajpe808142