School of Education


Doctor of Philosophy in Education (PhD)


Douglas John Mattson


Healthcare Simulation, Experiential Learning, Standardized Patients, High-Fidelity Simulation, Difficult Topic Simulation, Anxiety


Education | Nursing


Difficult topic healthcare simulation-based learning activities help to prepare healthcare profession students in a manner which is consistent with the experiences they will face in their careers. However, while these types of simulation-based learning activities need to be simulated, little to no research has been conducted regarding the topic of the psychological effect on standardized patients (SP) who participate in these activities within simulation-based learning experiences. The purpose of this study was to provide a quantitative examination, of the anxiety related effects of difficult topic simulation-based learning activities on standardized patients. This study utilized an experimental quantitative post-test only control group design where 66 study participants were randomly sorted into groups. The number of participants sampled was consistent at 66. Participants were made up of standardized patients from simulation programs across the United States. The treatment group participated in a difficult topic simulation-based learning activity and the control group participated in a non-difficult topic simulation-based learning activity. Study participants completed the State Trait Anxiety Inventory (STAI) to assess the s-anxiety and t-anxiety scores of participants. Data analysis illustrated no difference in t-anxiety scores of standardized patients who participate in difficult topic simulation-based learning activities and those who participate in non-difficult topic simulation-based learning activities, when controlling for years of experience. The researcher rejected the null hypothesis for state scores of standardized patients illustrating a significant relationship between standardized patients’ level of state anxiety and difficult topic and non-difficult topic simulation-based learning activities. Recommendations for future research are discussed.