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actual nurse-patient angry silence anxiety Appendix asks patient Assessment associate degree nursing Banathy behavioral objectives clinical complete the game component as contrasted computed correct response Criterion-Referenced Measurement difference in learning Educational Technology effect of playing evaluation feedback feelings game plays goal analysis inter-rater reliability jim McCormick Journal of Nursing learner learning outcome learning system Macmillan Mann-Whitney U-Test mastery learning mean total scores null hypothesis Nurse-Patient Interaction nurse-patient relation nurse-patient relationship nursing instructors Orientation Round pairs Partscores patient relationship peer mediation peer-mediated playing the game playing the simulation posttest scores pretest effect process recording programmed instruction Programmed Learning psychiatric nursing component region of rejection Relationship in Psychiatric reliability Robert Glaser sample score sheet silence simulation game spontaneous player reactions statistically significant Student groups Student players students played talk Teacher and Student Teacher group Teacher players Teachers College Teaching test this objective tion tryout and revision Twelker W. B. Saunders York