Faculty Innovation Spurs Creative Nursing Curriculum

Actors Bring Mental Illnesses to Life

Professional nurses routinely encounter difficult and stressful situations while on the job. But thanks in part to a new initiative orchestrated by Professor of Nursing Nancy Brauhn, Mount Mercy nursing students have a leg up on their counterparts.

The Standardized Patient (SP) teaching strategy, first utilized in the spring 2008, equips students with the skills, knowledge, and firsthand experiences to provide effective nursing care to patients with a mental illness. Serious mental illnesses such as schizophrenia and bipolar disorder typically require hospitalization to achieve stabilization of symptoms. Even experienced nurses may find it challenging to work with patients to achieve stabilization.

The SP program is not a typical nursing simulation or course, however. With this program, Mount Mercy nursing students directly interact with volunteer actors who are trained to exhibit symptoms of a mental illness, which allows faculty to teach and evaluate students without risk to actual patients.

The spring 2008 pilot program offered students experience interacting with a “patient” who realistically portrayed bipolar disorder. The students were required to conduct an admission intake interview on the actors, which was video recorded and viewed later by students and faculty to assist them in evaluating their communication and assessment skills.

The SP program is a cutting-edge teaching method that provides real-world experience in a safe and secure learning environment, and prepares students for their future career. “This gives each student a safe, controlled, consistent, and challenging experience that supplements their clinical patient assignments,” says Brauhn. “An admission intake interview is not something students would typically do in the clinical setting, yet would be an expected skill for a beginning staff nurse.”

The SP program was financed by a Title III grant, which provided Brauhn and nursing faculty with the technology to carry out the program, including wall-mounted cameras, microphones, and camera monitors. The grant also provided the means to pay the actors who portrayed the mental illnesses. Brauhn personally consulted with the actors and educated them about bipolar disorder and the characteristics that accompany the disease: elevated mood and energy, rapid speech, racing thoughts, little need for sleep, religious delusion and impulsive spending. Brauhn also utilized the talents of the Mount Mercy Speech/Drama Department, which provided a senior drama major to help coach the actors during dress rehearsals.

Based on feedback from students in the SP program, Brauhn feels that her goals for the program were fulfilled. “I wanted students to experience what it is like to encounter a challenging patient and to assess the signs and symptoms of a mental illness while both meeting the needs of the patient and managing their own anxiety,” she says. “One student said, ‘It was just so real!’” says Brauhn.

The success of the program has motivated Brauhn to incorporate it during the spring 2009 semester. The SP program has also strengthened the nursing curriculum. “This program adds a human dimension to the state-of-the-art nursing simulation lab in the nursing department,” says Brauhn. “By adding SP’s to existing simulation scenarios with the mannequins, even more reality can be presented to students, challenging them to handle difficult situations in a safe, controlled environment, where they are free to learn and even make mistakes in the process, without doing harm to the patient.”

 Nursing Alumni Give Back to Current Students

Lecturers of Nursing Amy Lippert and Julie McIntosh wanted students in their Holistic Human Assessment course to gain as much realworld experience as possible in order to prepare them for the work they would embark upon following graduation. The faculty found an innovative way to give students the valuable therapeutic and communications skills needed to relate to their future patients on a professional level.

Lippert and McIntosh arranged for their nursing students to interview a volunteer about their personal health history. The assignment, however, had a unique twist: the interview was recorded and the students would watch the video and evaluate their behavior. The assignment was designed to give the students an opportunity to practice their listening, communications, and clinical assessment skills on a person with whom they did not have a previous relationship. “We didn’t want the students to know the person they were interviewing,” says Lippert.

To find volunteers for the project the faculty tapped into one of Mount Mercy’s strongest resources — its alumni. With the help of Mount Mercy’s Alumni Services Office, Lippert and McIntosh recruited more than 100 alumni volunteers, most of whom were former nursing majors. The response they received from alumni was overwhelming and showcased the strength of the College’s alumni base. “We really wanted to pull alumni back in,” says McIntosh. “Their participation shows how much they value their Mount Mercy education, and they were very excited to be back on campus.”

The alumni volunteers ranged in age and experience from new graduates to those who had recently retired. “We found that the alumni wanted to participate,” says Lippert. “And they want the opportunity to participate again.”

One alumna, Jill Hoeger ’05, immediately recognized the benefit such an assignment would have for current nursing students preparing to enter the health care field. “Mount Mercy’s nursing program is well known to prepare its nursing students to become well-rounded nurses,” Hoeger says. “Starting these students off early by making them interact with strangers to conduct a health history is a great way to help them become great nurses.”