‘Bruised’ Egos

Theater students act as patients for CNHS

By Pam Cangelosi and Tara Laskowski

My doctor just told me I have cancer,” Mrs. Martin, a tearful, middle-aged-appearing woman, tells nursing students gathered in the campus lab. “Should I believe him?”

Participants in the accelerated pathway for second degree students in the College of Nursing and Health Science (CNHS) listen to Mrs. Martin’s unfolding story of her illness. Her question startles them. How should they answer her?

Last fall in their campus lab, these students were taught skills not only with the college’s recently acquired high-tech mechanical simulated patients, but also with living and breathing simulated patients, such as Mrs. Martin. “Mrs. Martin” was actually Christina Borders, a theater major at Mason (and not middle-aged), who practiced her improvisational skills and makeup while helping CNHS students practice hands-on nursing skills. The exercise was part of an interdisciplinary pilot project between CNHS and the College of Visual and Performing Arts.

Funded by a grant from the National League for Nursing, the project recruited theater students Dan Guy, Sarah Innamorato, Anthony Flowers, and Borders to assume the roles of four different patients with serious illnesses. They received 1 credit toward their degree for participating.

Each week, one of the four theater students would act as a patient, relaying their symptoms and illnesses according to case studies that CNHS faculty member Pam Cangelosi and her teaching assistant Tonia Parker developed. The patients’ conditions and other health-related issues changed based on the nursing skills taught in the lab. Prior to each encounter, the latest developments in each case were posted on WebCT for the nursing students, along with learning objectives and activities. The theater students received updates on their roles, with a description of the symptoms, actions, and communication required of them in light of their characters and illnesses.

 “Some of the nursing students had never even been in a hospital room before,” says Cangelosi. “If anything, this taught them how to break the ice and communicate with real patients.”

“The student I worked with was really great in keeping with character,” says nursing student Debra Gerner. “This was my first time interacting with patients as a nursing student. It was nice to know I could learn patient communication in a safe environment where when I made mistakes, I could talk about them and learn from them.”

The theater students were enthusiastic about their experience as well, saying that they learned a lot. “The biggest challenge was trying to stay in character the whole time, especially while people were asking me questions,” says Guy.

Innamorato, a senior, says the experience helped boost her confidence. “I was reminded again of the terror and the thrill of performing impromptu work,” she says. As Mrs. Janson, an elderly woman suffering from congestive heart failure, Innamorato says she also learned something practical: “The nurses showed me how to change bandages!”

The theater students not only used their acting skills, but also incorporated their skills in costume design, makeup, and props by creating realistic looking incisions, blood, and bruises as needed. Guy, who portrayed an overweight man with a blood clot in his leg, says that his makeup was so realistic once, the students actually thought he had gotten bruised from their IVs.

This spring, Cangelosi is using an interpretive phenomenological approach to gather data about the project through interviews with the nursing students. During these interviews, students will be encouraged to reflect on connections between learning the practice skills and implementing them, as well as the role of the case studies and the simulated patients.

Even though Cangelosi is still collecting data on the experience, she feels that the project was a success. She says it enhanced the nursing students’ active learning, interviewing abilities, and awareness of the role of their education as they prepare for clinical practice.

Cangelosi notes that students in the accelerated pathway program have an added edge.

“Many second degree nursing students demonstrate the ability to quickly assimilate new information and transfer skills from a previous career into a new field,” she says. “They come to nursing programs with life experiences that they can effectively integrate into learning new practice skills, making innovative teaching strategies essential in helping these students effectively and efficiently integrate prior learning into new practice skills.” The accelerated pathway program allows students who already have a bachelor’s degree to earn a second undergraduate degree in nursing in 12 months.

Cangelosi hopes to include more theater students in a similar project in the future.

Nursing students Jocelyne Weaver (right) and Kristen Caldwell (left) assess their “patient,” College of Visual and Performing Arts student Dan Guy in the Toups Nursing Clinical Simulation Lab.