AI Simulation to Reduce Stigma and Enhance Psychiatric Readiness in Nursing Students

Condition(s) studied

Investigational drug(s) / intervention(s)

AI-Simulation Programme: Five individual AI-simulation cases on a dedicated psychiatric simulation platform, one case per week over five consecutive weeks, each lasting about 15-20 minutes and delivered as a low-stakes, ungraded learning activity after a brief orientation. Cases are delivered in a fixed order from least to most emotionally demanding: major depression with suicide risk, mania/bipolar disorder, schizophrenia with hallucinations, substance use disorder with withdrawal, and borderline personality disorder with self-harm. Each case includes a timed structured interview with a simulated patient in Egyptian colloquial Arabic, a Mental State Examination checklist, a standardized (fixed) stigma-trigger statement, a first-attempt response, automated AI feedback, a retry opportunity, and a performance summary. The platform retains no conversational content.

Standard Psychiatric-Mental Health Nursing Curriculum: The Faculty's usual psychiatric-mental health nursing course for fourth-year students, comprising theoretical instruction, a supervised clinical rotation, and the usual role-play, video-based, and case-study simulation activities, preceded by the Faculty's standard pre-clinical orientation package (a "Myth-or-Fact" stigma-awareness activity and a self-awareness journaling exercise). Delivered to both study arms without modification.

Study summary

Mental illness stigma among nursing students can undermine the quality of care that people with psychiatric conditions receive, and many students feel unprepared for psychiatric practice. This randomized controlled trial will examine whether an AI-based psychiatric simulation programme can reduce stigma and improve readiness for psychiatric nursing practice among fourth-year nursing students at the Faculty of Nursing, Alexandria University, Egypt. It will also test whether these effects are explained by students' sense of psychological safety during simulation-based learning.

Two hundred students will be randomly allocated 1:1 to either the intervention or the control arm. Both arms will receive the standard psychiatric-mental health nursing curriculum. The intervention arm will additionally complete five individual AI-simulation cases (one per week over five weeks, about 15-20 minutes each), covering depression with suicide risk, mania, schizophrenia, substance use disorder, and borderline personality disorder with self-harm. Each case includes a structured interview with a simulated patient, a standardized stigma-trigger statement, automated feedback, and an opportunity to retry.

Mental illness stigma, readiness for psychiatric practice, and psychological safety will be measured online at two time points: baseline and immediately after the fifth case. Intervention-arm students will also answer two open-ended questions, analyzed thematically to help explain the quantitative findings.

Eligibility

Primary outcome measure(s)

• Mental illness stigma: Opening Minds Stigma Scale for Health Care Providers (OMS-HC) total score — Baseline (one week before the first case) and immediately after the fifth simulation case (week 5)
  Stigma towards people with mental illness measured with the Opening Minds Stigma Scale for Health Care Providers (OMS-HC), a 15-item self-report questionnaire with three subscales (attitudes, disclosure and help-seeking, social distance). Items are rated from strongly agree to strongly disagree, with selected items reverse-scored. Minimum total score 15, maximum 75. Higher scores indicate more stigmatizing attitudes (worse outcome). Unit of measure: score on a scale.
• Readiness for psychiatric practice: adapted 21-item Preparedness instrument (Dela Rosa and Maniago, 2018) total score — Baseline (one week before the first case) and immediately after the fifth simulation case (week 5)
  Readiness for psychiatric nursing practice measured with the adapted 21-item Preparedness instrument (Dela Rosa and Maniago, 2018), a self-report questionnaire covering knowledge, skills, and attitude (7 items each). Items are rated from 1 (not prepared) to 4 (very much prepared). Minimum total score 21, maximum 84. Higher scores indicate greater readiness (better outcome). Unit of measure: score on a scale.

Trial sites (1)

More Alexandria University trials in Egypt