University of Texas at Tyler Scholar Works at UT Tyler Nursing Teses and Dissertations School of Nursing Spring 5-1-2015 Live Model Simulation: Improving Nursing Students' Atitudes and Knowledge of Alzheimer's Disease Teresa Maharaj Follow this and additional works at: htps://scholarworks.utyler.edu/nursing_grad Part of the Nursing Commons Recommended Citation Maharaj, Teresa, "Live Model Simulation: Improving Nursing Students' Atitudes and Knowledge of Alzheimer's Disease" (2015). Nursing Teses and Dissertations. Paper 50. htp://hdl.handle.net/10950/293 Tis Dissertation is brought to you for free and open access by the School of Nursing at Scholar Works at UT Tyler. It has been accepted for inclusion in Nursing Teses and Dissertations by an authorized administrator of Scholar Works at UT Tyler. For more information, please contact LIVE MODEL SIMULATION: IMPROVING NURSING STUDENTS’ ATTITUDES AND KNOWLEDGE OF ALZHEIMER’S DISEASE by Teresa Maharaj A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy School of Nursing Beth Mastel-Smith, Ph.D., Committee Chair College of Nursing and Health Science The University of Texas at Tyler May 2015 The University of Texas at Tyler Tyler, Texas This is to certify that the Doctoral Dissertation of TERESA MAHARAJ has been approved for the dissertation requirement on April 23, 2015 for the Doctor of Philosophy of Nursing degree Approvals: __________________________________ Dissertation Chair: Beth Mastel-Smith, Ph.D. __________________________________ Member: Danita Alfred, Ph.D. __________________________________ Member: Constance Ayers, Ph.D. __________________________________ Member: Sandra Petersen, Ph.D. __________________________________ Chair, Department of Nursing __________________________________ Dean, College of Nursing and Health Sciences Copyright © 2015 by Teresa Maharaj All rights reserved. Dedication This dissertation work is dedicated to my wonderful grandmother, Anne, and friend, Dr. Shirley Hutchinson. Acknowledgements I would like to acknowledge my family especially my husband Mike and son Liam for their support and perseverance in helping me get through this journey…it’s been a long four years and I could not have done this without you two. Thank you. I am also thankful to my other children George, Charlotte, and daughter-in-law Irene along with my parents Toni and Walter and in-laws Sylvia and Chris for their support and willingness to help keep the family on track. I also wish to thank my committee chair Dr. Beth Mastel-Smith for reading my work, critiquing my work, keeping me focused (not an easy thing to do), letting me talk things out when my mind was too confused to write and prodding me to do more. You have been a true mentor and friend. I would like to thank all of my committee members Dr. Alfred, Dr. Sandra Peterson, and Dr. Connie Ayers for their time and commitment in reviewing this portfolio. Thank you Dr. Connie Ayers for giving me the inspiration to come up with this study, like you, your integrated simulation idea is amazing. Thank you to my many friends and colleagues who have also helped me and encouraged me to meet the end of this road Barb Baudler, Rochelle Schultz, Dr. Michelle Kimzey, Dr. Nina Fredland, Dr. Brenda Binder, and Dr. Lynn Wieck. I am also grateful to Texas Woman’s University for giving me time when needed to work on my PhD. Table of Contents List of Tables ................................................................................................................ iv Abstract .......................................................................................................................... v Chapter 1 Overview of the Research Study ................................................................... 1 Overall Purpose of the Study ............................................................................. 1 Introduction to the Articles ................................................................................ 2 Chapter 2 Abstract ......................................................................................................... 4 Changing Attitudes and Improving Gerontological Knowledge: Is Nursing Education Making a Difference? ....................................................................... 5 Scope of the Problem: Why Negative Attitudes towards Older Adults? ...........6 Literature Review ............................................................................................... 7 Nursing Education Curriculum .......................................................................... 7 Learning Experiences Including Simulation .................................................... 10 Theoretical Frameworks for Simulation in Nursing Education ....................... 14 Conclusions .................................................................................................................. 16 References .................................................................................................................... 18 Chapter 3 Abstract ....................................................................................................... 23 Live Model Simulation: Improving Nursing students’ Attitudes and Knowledge of Alzheimer’s Disease .................................................................................... 24 Background and Significance .......................................................................... 24 Review of the Literature .................................................................................. 24 Geriatric Nursing Education ............................................................................ 25 Gerontology in Nursing Education .................................................................. 27 Simulation ........................................................................................................ 29 Theoretical Model ........................................................................................................ 32 Conceptual and Operational Definitions of Outcomes ................................................ 34 Alzheimer’s Knowledge .................................................................................. 34 i Attitude toward the ADRD Person .................................................................. 34 Hypotheses ................................................................................................................... 35 Design and Methods .................................................................................................... 35 Design .............................................................................................................. 35 Sample .............................................................................................................. 36 Setting .............................................................................................................. 37 Ethical Considerations ..................................................................................... 37 Instruments ....................................................................................................... 38 Data Collection and Procedures ................................................................................... 39 Intervention ...................................................................................................... 39 Data Collection Procedures .......................................................................................... 41 Data Collection ................................................................................................ 41 Data Analysis ................................................................................................... 41 Results .......................................................................................................................... 42 Sample .............................................................................................................. 42 AD Knowledge .................................................................................... 43 AD Attitudes ........................................................................................ 44 Discussion .................................................................................................................... 45 Strengths and Limitations ................................................................................ 47 Conclusions and Recommendations ............................................................................ 48 References .................................................................................................................... 50 Chapter 4 Evaluation of the Project ............................................................................. 55 References .................................................................................................................... 59 Appendix A. Theory Schematic ................................................................................... 60 Appendix B. Sample Flow Chart ................................................................................ 61 Appendix C. UT Tyler IRB ......................................................................................... 62 Appendix D. TWU IRB ................................................................................................ 63 Appendix E. ADKS ..................................................................................................... 64 Appendix F. ADKS Permission to Use Instrument ..................................................... 67 Appendix G. DAS ........................................................................................................ 68 ii Appendix H. DAS Permission to Use Instrument ...................................................... 69 Appendix I. Demographic Information ........................................................................ 70 Appendix J. Control Patient Script .............................................................................. 72 Appendix K. AD Patient Script ................................................................................... 74 Appendix L. Moulage Guide ....................................................................................... 76 Appendix M. Faculty Debriefing Guide ...................................................................... 77 Appendix N. ADKS Group Statistics .......................................................................... 78 Appendix O. DAS Group Statistics ............................................................................. 79 Appendix P4A. Demographics by Group .................................................................... 79 iii List of Tables Table 1. Simulation Scripts ............................................................................................... 39 Table 2. Results Paired T-Tests for Within Group Differences ........................................ 44 Table 3. Results of Independent T-Test for Between Group Differences ........................ 45 iv