Impact of theatre on nursing students’ perspectives on mental health and psychiatric patients: a metaphor-based qualitative study
This qualitative study demonstrates that theater-based activities significantly enhance nursing students' empathy, knowledge retention, and practical understanding of mental health care by allowing them to embody psychiatric experiences and bridge the gap between theory and practice.
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For nursing students, the path to becoming a healer often involves memorizing vast amounts of biological facts and practicing clinical skills on mannequins. Yet, one of the most difficult parts of their training involves learning to care for people with mental health conditions. In many places, including Turkey, students take a final-year course dedicated to psychiatric nursing. The goal is to teach them how to communicate with patients who are suffering from mental illness, understand the nature of these disorders, and overcome the fear or negative stereotypes that often surround them. Despite these efforts, many students still find the idea of working in a psychiatric ward intimidating. They worry about the unpredictability of patients and feel unsure about their ability to connect with someone whose mind is working differently than their own. This hesitation can lead to a shortage of nurses willing to specialize in mental health, leaving a critical gap in the healthcare system. To bridge this gap, educators are increasingly turning to active learning methods, where students do not just listen to lectures but actively participate in the learning process.
In a recent study, researchers explored whether a specific form of active learning—using theater—could change how nursing students view mental health and psychiatric patients. The study took place at a university in Turkey, where 89 final-year nursing students participated in a unique assignment as part of their psychiatric nursing course. Instead of writing a standard essay or taking a test, the students were asked to create and perform short plays. They worked in groups to research specific mental health conditions, write scripts, and act out scenarios that depicted the lives of patients, their families, and the treatment environments. These performances lasted about 40 to 45 minutes and required the students to use the communication skills they had learned in class, such as observing behavior and speaking therapeutically. After the performances, the class discussed the symptoms, treatments, and challenges they had portrayed. To understand what the students took away from this experience, the researchers asked them to complete a simple sentence: "The theater activity applied in the mental health and psychiatric nursing course is like... because..." This method allowed the students to use metaphors to describe their feelings and insights in their own words.
The researchers collected 89 different metaphors from the students and grouped them into six main themes. The most common theme, appearing in nearly a third of the responses, was about cultivating empathy. Students described the activity as a way to step into someone else's life, with one student noting that trying to understand how a sick person feels helped them realize how difficult that life is. By acting out the roles of patients, the students moved beyond abstract theory and felt a deeper emotional connection to the struggles of mental illness. Another major theme was the idea of embodying the illness itself. Students used metaphors like a mirror or a rainbow to explain how the plays helped them see the different symptoms and realities of mental disorders in a way that reading a textbook could not. They realized that mental illness is not a single thing but a complex experience with many different faces, and that they could encounter these conditions in their own lives.
The study also found that theater helped students bridge the gap between what they learned in the classroom and how they would apply it in real life. Students compared the experience to learning to drive or playing a game, suggesting that they learned by doing rather than just by listening. One student remarked that while lectures might give them the "fish" ready-made, the theater activity taught them how to "fish" for themselves, meaning they learned how to handle situations independently. This hands-on approach made the learning process enjoyable and memorable. Several students described the activity as fun, comparing it to playing games or watching a comedy program, which helped them retain the information for longer. The act of performing and repeating the scenarios seemed to write the knowledge into their minds more permanently than traditional study methods, much like writing something on iron.
Finally, the theater activities gave students a realistic preview of what a psychiatric ward is actually like. Through their performances, they visualized the hospital environment, the behavior of nurses, and the progression of treatment. One student described the experience as reading a psychiatrist's notebook, suggesting they gained a deep, detailed understanding of the clinical process. The study concluded that for these nursing students, theater was more than just a creative exercise; it was a powerful tool that fostered empathy, integrated theory with practice, and made the learning experience both enjoyable and lasting. The researchers noted that while the study was limited to students at one university and relied on self-reported feelings, the results strongly suggest that drama-based methods can help future nurses feel more confident and prepared to care for people with mental health challenges. By bringing the experiences of patients to life, theater helped the students see the humanity behind the diagnosis, potentially encouraging more of them to choose a career in psychiatric nursing.
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