Table 4. MAVAS statements without statistically significant changes pre- and post-simulation.

MAVAS: Management of Aggression and Violence Attitude Scale.

Statement	Pre-sim	Post-sim	P-value
Other people make patients aggressive or violent	2.72	2.75	.840
Gender mix on the wards is important in the management of aggression	2.68	2.76	.536
Patients from particular cultural groups are more prone to aggression	1.97	2.16	.122
There appear to be types of patients who frequently become aggressive toward staff	2.72	2.75	.840
Cultural misunderstandings between staff and patients can lead to aggression	2.93	3.00	.458
Patients who are aggressive toward staff should try to control their feelings	2.78	2.63	.170
When a patient is violent, seclusion is one of the most effective approaches to use	2.15	2.24	.422
Patients who are violent are often restrained for their own safety	2.73	2.78	.685
The practice of secluding violent patients should be discontinued	2.28	2.33	.584
Aggressive patients will calm down automatically if left alone	2.10	2.02	.436
Restrictive care environments can contribute toward patient aggression and violence	2.99	2.98	.987
Physical restraint is sometimes used more than necessary	2.61	2.73	.326
Alternatives to the use of containment and sedation to manage patient violence could be used more frequently	2.86	2.97	.326
Improved one to one relationships between staff and patients can reduce the incidence of patient aggression and violence	3.28	3.35	.447
Prescribed medication could be handled more effectively on this ward	2.83	2.97	.137
Prescribed medication can in some instances lead to patient aggression and violence	2.97	2.97	.975
Seclusion is sometimes used more than necessary	2.46	2.48	.909
The use of de-escalation is successful in preventing violence	3.12	3.30	.108
If the physical environment were different, patients would be less aggressive	2.47	2.54	.552