'The character rests heavily within me': drama students as standardized patients in mental health nursing education

WHAT IS KNOWN ON THE SUBJECT?: Standardized patient (SP) simulation is an internationally recognized learning strategy that has proven effective in enhancing nursing students' competencies necessary for mental health practice. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A deeper exploration of the process from the perspective of SPs and more particularly drama students, revealed the complexity they need to navigate and the personal vulnerability they are exposed to when creating an authentic learning opportunity for nursing students. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Their vulnerability justifies deeper consideration of support, as well as research on the ethical implications of SP simulation. Nursing students need to be well grounded in therapeutic communication before engaging with mental health users. This should include opportunities to question personal frames of reference that could hinder therapeutic engagement with diverse others. In future, the drama students can be involved in scenario development to enhance the authenticity of simulations.

ABSTRACT

Introduction The effectiveness of Standardized patient (SP) simulation in enhancing students' mental health nursing competencies is well published. Nevertheless, the believable and accurate portrayal of a patient with a mental health issue during SP simulation is complex. Though vital to the creation of safe authentic learning experiences, the perspectives of SPs and particularly of drama students involved in SP simulation are unknown. Aim The aim of this paper is therefore to explore and describe the experiences of 11 drama students engaged in mental health simulations for nursing students. Method A qualitative approach was taken and data were gathered using various techniques. Findings The content analysis revealed that these SPs negotiated three roles during this interdisciplinary learning experience, namely of a facilitator of learning, a drama student and the person within. Discussion The study provided valuable insight into the world of an SP, including the complexities they navigate and the vulnerability they experience. Implications for Practice Nurse educators are alerted to SP's need for support and the necessity of establishing good interpersonal skills before nursing students enter the practice setting. Involvement of SPs in scenario development could enhance the authenticity of future simulations. The ethical implications of SP simulation requires further exploration.

History of chronic toxicity and animal carcinogenicity studies for pharmaceuticals

During the 20th century, as drug products were being developed to treat both known and emerging human diseases and conditions, determining the safety of these new chemicals became of increasing importance and necessity. For a time, the safety of use in human populations was of question, let alone whether the drug product was truly effective. As such, US and international regulatory agencies have played a major role in establishing standardized testing to evaluate the safety and efficacy of drug products. Pharmacologic and toxicologic evaluation of a new drug in animals is an important part of the pharmaceutical development process prior to its first-time use in humans, as well as its potential chronic use in affected populations. Just as both science and technology have evolved over the past century and further, so have the guidelines that have been put forth to adequately and efficiently evaluate the toxicity of new drugs and their subsequent safety in humans. This review summarizes the historical highlights of the conduct of drug safety evaluations in animals, particularly with regard to chronic toxicity and carcinogenicity assessments, and how we have progressed to our current standards and protocols to ensure safe use of drug products in human populations.

Beliefs of grade six learners' regarding adolescent pregnancy and sex

Escalating adolescent pregnancy and risky sexual behaviour is becoming more common amongst young adolescents and especially amongst black adolescents in South Africa. Statistics confirm that South African adolescents as young as fourteen are already sexually active and become pregnant. The decision to become sexually active with resulting adolescent pregnancy whether planned or not, are directly influenced by the teenager's beliefs. A person's beliefs consist of a person' own individual beliefs or attitude as well as what the individual subjective norm which the individual perceive as other people's beliefs regarding the same object of reason. The aim of the study was to describe the attitude of black grade six learners under the age of fourteen, towards adolescent pregnancy and sex. A quantitative descriptive research design was used. Results were clustered according to demographic variables as well as beliefs that consist of attitude and subjective norm. Findings provided insight into the beliefs of grade six learners regarding sex and adulthood, the roll of peer pressure, relationships of adolescent parents, social interaction of teenage parents, ability of adolescent parent's ability to provide in the needs of the baby, the adequacy of a child support grant to raise a baby as well as the levels of education of adolescent parents. This article provide a detailed reflection on these results and propose off a doll parenting intervention strategy as means of modification of attitude and subjective norms of grade six learners in order to alter sexual behaviour.

Carcinogenicity testing and the evaluation of regulatory requirements for pharmaceuticals

The results of rat and mouse carcinogenicity studies for 282 human pharmaceuticals in the FDA database were analyzed and compared as part of an International Conference on Harmonization (ICH) evaluation of rodent carcinogenicity studies and their utility for carcinogenicity testing. A majority of the carcinogenicity studies in the FDA database were carried out in Sprague-Dawley-derived rats and Swiss-Webster-derived CD-1 mice in contrast to Fisher 344 rats and B6C3F1 mice employed in National Toxicology Program (NTP) studies. Despite the differences in rodent strains, the relative proportion of compounds with positive findings (44.3%) and the degree of overall concordance between rats and mice (74.1%) in the FDA database were similar to the NTP rodent carcinogenicity database. Carcinogenicity studies in two rodent species are necessary primarily to identify trans-species tumorigens, which are considered to pose a relatively greater potential risk to humans than single species positive compounds. Two-year carcinogenicity studies in both rats and mice may not be the only means of identifying trans-species tumorigens. Sufficient experience is now available for some alternative in vivo carcinogenicity models to support their application as complementary studies in combination with a single 2-year carcinogenicity study to identify trans-species tumorigens. Our analysis of the rodent carcinogenicity studies supports such an approach for assessing carcinogenic potential without compromising the public health.

Multiple-site carcinogenicity of benzene in Fischer 344 rats and B6C3F1 mice

Toxicology and carcinogenesis studies of benzene (CAS No. 71-43-2; greater than 99.7% pure) were conducted in groups of 60 F344/N rats and 60 B6C3F1 mice of each sex for each of three exposure doses and vehicle controls. These composite studies on benzene were designed and conducted because of large production volume and widespread human exposure, because of the epidemiologic association with leukemia, and because previous experiments were considered inadequate or inconclusive for determining carcinogenicity in laboratory animals. Using the results from 17-week studies, doses for the 2-year studies were selected based on clinical observations (tremors in higher dosed mice), on clinical pathologic findings (lymphoid depletion in rats and leukopenia in mice), and on body weight effects. Doses of 0, 50, 100, or 200 mg/kg body weight benzene in corn oil were administered by gavage to male rats, 5 days per week, for 103 weeks. Doses of 0, 25, 50, or 100 mg/kg benzene in corn oil were administered by gavage to female rats and to male and female mice for 103 weeks. Ten animals in each of the 16 groups were killed at 12 months, and necropsies were performed. Hematologic profiles were performed at 3-month intervals. For the 2-year studies, mean body weights of the top dose groups of male rats and of both sexes of mice were lower than those of the controls. Survivals of the top dose group of rats and mice of each sex were reduced; however, at week 92 for rats and week 91 for mice, survival was greater than 60% in all groups; most of the dosed animals that died before week 103 had neoplasia. Compound-related nonneoplastic or neoplastic effects on the hematopoietic system, Zymbal gland, forestomach, and adrenal gland were found both for rats and mice. Further, the oral cavity was affected in rats, and the lung, liver, Harderian gland, preputial gland, ovary, and mammary gland were affected in mice. Under the conditions of these 2-year gavage studies, there was clear evidence of carcinogenicity of benzene in male F344/N rats, female F344/N rats, male B6C3F1 mice, and female B6C3F1 mice. In male rats, benzene caused increased incidences of Zymbal gland carcinomas, squamous cell papillomas and squamous cell carcinomas of the oral cavity, and squamous cell papillomas and squamous cell carcinomas of the skin. In female rats, benzene caused increased incidences of Zymbal gland carcinomas and squamous cell papillomas and squamous cell carcinomas of the oral cavity.(ABSTRACT TRUNCATED AT 400 WORDS)