Document Type



Doctor of Philosophy (PhD)


Curriculum and Instruction

First Advisor's Name

M.O. Thirunarayanan

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Maureen C. Kenny

Second Advisor's Committee Title

Committee member

Third Advisor's Name

Haiying Long

Third Advisor's Committee Title

Committee member

Fourth Advisor's Name

Adriana Foster

Fourth Advisor's Committee Title

Committee member


virtual patient, self-efficacy, simulation, pre-health

Date of Defense



The use of simulators and simulation training has become standard practice for students in medical and pre-health programs, including but not limited to, clinical and counseling disciplines in pre-health education. Students train and sharpen their skills using this technology to prepare them for real-life encounters with future patients (Berman, Durning, Fischer, Huwendiek, & Triola, 2016). One possible encounter, a suicidal patient, is a challenge that most counselors or therapists are not prepared for, causing stress and affecting their confidence. The literature describes how treating clients/patients with suicidal ideation and behavior is stressful for even the most experienced mental health professional (Farberow, 2005; Foster & McAdams, 1999; Gulfi et al., 2010; Mirick et al., 2016; Osteen et al., 2014; Smith et al., 2015). This challenge has been addressed by education programs using standardized patients to recreate similar encounters, which can lead to an increase in confidence and self-efficacy (Fallucco, Hanson, & Glowinski, 2010). However, the use of standardized patients is not feasible in all cases. One solution is virtual patient simulation as a complement to traditional face-to-face lectures and training. The purpose of this study is to understand the impact of virtual patient simulation on self-efficacy levels when students are faced with a suicide risk scenario. This quantitative study relied on the collection of data from pre-health professional students (n=111) and involved the testing of hypotheses following published self-efficacy and education literature. The hypotheses were tested using a factorial analysis of variance (ANOVA), a factorial analysis of covariance (ANCOVA), and a bivariate correlation analysis among the intervention groups. The results of the ANOVA and ANCOVA did not indicate a significant result for differences amongst the intervention groups. However, the results of the bivariate correlation analysis indicated a significant relationship (p




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