Clinical empathy has been identified as an essential skill for healthcare workers to provide quality healthcare. One teaching strategy for improving clinical empathy towards people with psychiatric disabilities is the Hearing Voices Simulation. This study used an explanatory sequential mixed methods design to evaluate change in clinical empathy among occupational therapy students after participating in the Hearing Voices Simulation. Participants (N=71) completed the Jefferson Scale of Empathy- Health Professions Student Version (JSE-HPS) prior to and following the simulation. A paired samples t-test compared whether the change in scale scores was equal to zero. Subsequently, focus groups were used to collect qualitative data. This study found that although already high at baseline, mean JSE-HPS scores increased significantly following the simulation experiences (p=0.004). Four main themes emerged from the focus groups: 1) temporary discomfort, 2) improved understanding, 3) reformulating stigmatizing attitudes and sharing with others, and 4) planned changes for fieldwork and future clinical practice. Auditory simulations may increase occupational therapy students' empathy. Occupational therapy programs may consider the Hearing Voices Simulation or other simulations for improving clinical empathy among students.