An Immersive Simulation to Build Empathy for Geriatric Patients with Co-Occurring Physical and Mental Illness



The objective of the study was to explore the effectiveness of an immersive simulation experience using an aging simulation suit for fostering empathy towards geriatric patients with advanced mental illness.


Psychiatry residents were recruited during their clinical rotations at a Canadian mental health hospital. The participants took on the first-person perspective of a geriatric patient with mental illness initially through written reflection, and then physically inhabited this role by wearing an aging simulation suit to perform the task of meeting with a pharmacist to review current medications and prepare a dosette. Concurrently, an audio file was played through headphones to simulate auditory hallucinations. A pre- and post-Jefferson Scale of Empathy (JSE), reflective writing exercise, debrief transcription, and evaluation questionnaire were used to evaluate the intervention. Interviews conducted 3 month post-intervention explored its impact on their clinical practice.


Fifteen psychiatry residents completed the study. There was a significant increase in JSE scores pre (M = 115.5, SD = 13.2) to post (M = 119.2, SD = 12.7) intervention, t(14) = 2.65, p = .02. The qualitative findings of the study demonstrated participants’ improved understanding and awareness of the patient perspective and the ability to communicate this understanding and show intentions to help through practice change.


An aging suit simulation with debriefing may be an effective educational intervention to incorporate into the medical curriculum to foster empathy for this stigmatized population.

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The Simulation Centre at CAMH is supported by the Medical-Psychiatry Alliance, a collaborative health partnership of CAMH, The Hospital for Sick Children, Trillium Health Partners, and the University of Toronto, as well as the Ontario Ministry of Health and Long-Term Care and an anonymous donor. The Simulation scenario design for this project was informed by previous work done by the Baycrest Centre for Learning, Research & Innovation.


This project is funded through a Medical Humanities grant from Post MD Education at the University of Toronto. A matching fund was provided by the Office of Education, at the Centre for Addiction and Mental Health (CAMH).

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Correspondence to Anika Saiva.

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The study was approved by the authors’ hospital and the University of Toronto Research Ethics Board and Quality Project Ethics Review.


On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Saiva, A., Abdool, P.S., Naismith, L.M. et al. An Immersive Simulation to Build Empathy for Geriatric Patients with Co-Occurring Physical and Mental Illness. Acad Psychiatry 44, 745–750 (2020).

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  • Simulation
  • Empathy
  • Aging suit
  • Geriatrics