(l to r) R Mansfield, Mary Rodgers and Ife Kehinde.
Three students combine to carry out the psychology department's largest human-subject study ever
This past November, there were some Lipscomb University nursing students with some heavy bags under their eyes, acquired from staying up all night for science.
The student nurses were part of a research project by three psychology students to explore how sleep deprivation affects the physical, emotional and mental state of working nurses.
In a highly unusual approach, Master of Psychology students R. Mansfield, Ife Kehinde and Mary Rodgers banded together to carry out their master’s thesis project, and the result is likely the largest and most comprehensive human subjects study ever completed by the department, said Shanna Ray, chair of the Department of Psychology, Counseling and Family Science.
The three students are in the same cohort (which graduated in December) and all three planned to pursue Ph.D. degrees in psychology, so they wanted to carry out an impressive master’s thesis project that showed their ability to think innovatively and to coordinate a large-scale study, said Mansfield, who came to Lipscomb’s graduate program in 2014 from Atlanta, Ga., with a bachelor’s in neuropsychology.
Each student is writing about one of three aspects of how sleep deprivation may affect the performance of nurses – physical effects, emotional memory recall and declarative memory recall – and combining their work into one thesis.
The idea sparked from Mansfield’s observations of his wife, a nurse who struggled with long shifts without sleep during her career. Newly graduated nurses often have to take night-shift jobs, which can be a big biological shift for many people, said Mansfield.
“A lot of people have studied the physiological responses to sleep deprivation, but I wanted to use the nursing population to make it more of an occupational or industrial psychology approach. We wanted to make it so it really hit home with one particular group,” he said.
The students contacted Lipscomb’s School of Nursing, which proved enthusiastic about cooperating on the venture. They provided access to equipment and to one of their nursing labs for the experiment and allowed the trio to recruit participants from among the junior and senior student nurse population.
“When the team first approached our department with their research proposal we were excited about the possibility of collaborating with the Department of Psychology. Many of our nursing students work hard to graduate with a minor in psychology and often specialize in psychology in their clinical practice,” said Mary Hesselrode, interim associate dean of the Lipscomb School of Nursing. “Their team was extremely professional and did a great job communicating.
“Decisions about patient care are based on the most current evidence,” Hesselrode said. “What a great opportunity for our students to be a part of a study that could pave the way for changes in the current practice of long 12-hour shifts.”
In one weekend in November, the students took baseline measurements of the participants’ heart rate, blood pressure, pulse and skin conductivity (a physical symptom of stress); memory recall; and emotional responses to stimuli. Then after a period of 24 hours of sleeplessness, the student nurses were asked to quickly treat a mock patient who is coding, involving two minutes of CPR, use of a breathing device and checking charts for patient information.
After the “patient emergency,” the students then took the same physiological, memory recall and emotional response measurements again.
Kehinde, a Nigerian native who worked at Vanderbilt University as a neuropsychology research aide before coming to Lipscomb, chose to study the effect of sleep deprivation on emotional memory, the ability to recall memories that relate to emotions. Participants in her portion of the study were asked to watch videos designed to stress them emotionally during the night of sleeplessness and then asked to recall details about those videos after the “emergency.”
“As nurses, they are experiencing extremely traumatic instances that most people don’t see. If they are asked to remember things that have an emotional content, will they remember those things more vividly or less vividly,” Kehinde said. “Does it make the incident they are responding to more or less traumatic?”
Caffeine was a major part of the study for Rodgers, a native of Nolensville, Tennessee, who came to Lipscomb with a bachelor’s degree from the University of Tennessee-Chattanooga. Some of the participants received caffeine one hour before the coding crisis and the rest received a placebo. They were able to review the patient chart 10 minutes before the crisis, and then Rodgers tested their declarative memory of the chart during the crisis.
Rodgers said the subject interested her because of her own personal experience pulling all-nighters to study as an undergraduate. “If an average student has a negative impact from these factors, then it is imperative to see how these conditions affect those in the health care industry,” Rodgers said.
To ensure that their human subjects research study was approved by the Institutional Review Board, the students had to ensure that every safety precaution was taken, from being aware of what medications their subjects were taking to making sure they had safe rides home after 24 hours without sleep, Mansfield said.
“It’s all 20 times more complicated than we thought it would be,” Mansfield said.
Although the scope of the project was complex, the final number of participants did not allow for statistically significant results, Mansfield said. But the experiment certainly made an impact on the participants, showing them “how dangerous and scary it is to work while you are sleep-deprived,” he said.
“Part of doing a thesis is working with data collection sites, so when you do a human subjects research study, you have to work with those participants and get them motivated, as well as working with the organizations those people are involved in,” said Shanna Ray, chair of the Department of Psychology, Counseling and Family Science. “It required a lot of cooperation to pull this off.”