Merging Simulation and Standardized Patients: A Model for Teaching Cultural Competence in Mental Health Nursing

Thursday, 15 July 2010: 9:10 AM

Phyllis Eaton, PhD, RN, PMHCNS-BC
Lynn L. Wiles, MSN, RN
Phyllis Barham, RN, MS
Richardean Benjamin, PhD, MPH
Kay Palmer, RN, MSN, CRRN
Carolyn Rutledge, PhD, CFNP
School of Nursing, Old Dominion University, Norfolk, VA

Learning Objective 1: Describe how the use of virtual and standardized patient encounters will enhance the student’s ability to provide culturally appropriate care to mental health clients.

Learning Objective 2: Discuss the implications of virtual and standardized patient encounters has on the stigma related to mental illness.


During the next 20 years, the composition of the U S is projected to shift and the majority of Americans will be people of color. The Surgeon General’s Report on Mental Health (MH) recognizes the inequality of mental health services among minority groups. Families who are members of minority groups have difficulty accessing MH services due to the stigmas related to mental illness. These stigmas include discrimination, fear, mistrust, and stereotyping. Based on Campinha-Bacote’s Model of Cultural Competency, the purpose of this project is to reduce differences in health and mental health care outcomes by providing future nurses a greater cultural awareness.  

Methods: To improve cultural awareness, attitude, and practice, BSN students’ attitudes towards mental illness and understanding of mental illness were assessed using the NAS and MIDUS scales. To increase cultural knowledge, Monarch General Hospital, an online learning platform, and Standardized Patient encounters were utilized to provide simulated cultural clinical experiences. This provided students with the opportunity to interact with culturally diverse virtual MH clients. After the experience students were reassessed using the NAS and MIDUS. Additionally, student’s mental health assessments of standardized and actual patients were evaluated by nursing faculty.

Results: Qualitative results indicated that, based on the simulated experience, the students had less apprehension prior to actual client encounters and an increased sense of confidence in completing the assessment. Quantitative data reveals increased in awareness and a positive understanding of mental illness. Student grades on MH assessments also improved

Conclusion: Combining standardized patients and simulation allowed the students to experience an encounter with a mentally ill client in a controlled clinical setting. The initial results of the experience suggested enhanced comfort interacting with mental health patients which should translate to enhanced ability to provide culturally appropriate care to mental health clients.