Community Mental Health Clinical Experiences Utilizing High Fidelity Simulations with Baccalaureate Nursing Students

Historically nursing students have a fear of clients encountered in health care settings that have a mental health diagnosis.    Unfortunately, this fear is often the result of the stigmatization present within society and the media related to individuals diagnosed with a mental health issue.  Students for the most part have little experience with mental health care facilities and the populations who seek services at these sites.  Additionally, there is a lack of mental health clinical sites that offer students the ability to interact with clients and there are more nursing programs competing for these few sites.  Due to these reasons, the use of high fidelity simulation was implemented in the didactic portion of the mental health course. The overall goals of using simulations during the mental health course was to:  address the fears students experience when interacting with clients with a mental health problem prior to clinicals;   improve the ability and confidence to respond appropriately when faced with emergent mental health needs;   decrease the stigmas students might have regarding someone diagnosed with a mental health problem; and improve the use of therapeutic communication skills to ensure safety. The high fidelity simulation utilized was developed to mimic a real-life emergent mental health situation that a student could possibly encounter within the clinical setting. Examples of some of the salient points included in the simulation were:   recognizing signs and symptoms of depression,   assessing for suicidal ideations and the importance of asking direct questions related to intent, how to deal with the asking of personal information and the expression of sexual advances, how to respond if a patient cries or becomes emotional, and how to respond to a patient who asks the student to keep a secret.  Students were provided a de-briefing time immediately after the simulation to discuss perceived performance and feelings surrounding the scenario.  During the debriefing session students were provided with immediate feedback from faculty surrounding their responses during the simulation. Overall, the majority of the students felt this was a positive learning experience.