The purpose of this presentation is to explain the development, implementation, and results obtained from an evidence-based mental health nursing simulation using a standardized patient (SP).
It is imperative to teach nursing students evidence-based skills and knowledge to manage and prevent incidents of WPV. The simulation was developed specifically for nursing students to supplement knowledge and skills aiming to manage and prevent WPV in clinical settings.
Methods:
Design: The pilot study had qualitative and quantitative descriptive design.
Participants and Procedure
Kolb’s (1984) experiential learning theory was the theoretical framework guiding the simulation; the theory emphasizes the knowledge is gained through practice. The simulation was implemented in the simulation laboratory of a large public university in the United States’ West Coast. Participants were pre-licensure nursing students (N=15), male (N=3) and female (N=15).
Students were provided information about the phenomenon of WPV and the assault cycle developed by Kaplan and Wheeler (1983). This writer was the main facilitator of th pilot study. The use of a SP constituted a vital part of the program. The SP was trained by the facilitator to display agitated and challenging behaviors. A scenario about a schizophrenic patient hearing voices and being agitated was developed by the facilitator. Each encounter was timed for ten minutes with a two minute feedback from the SP. Each encounter was also video-taped and used in the debriefing process. The recordings were useful for the facilitator to highlight areas of improvement and to engage the students in the discussion process.
Instruments
The mental health nursing clinical confidence scale (MHNCSS) developed by Bell et al., (1998), and pre and post open-ended surveys to assess knowledge, and a qualitative survey developed by the facilitator.
Results:
Quantitative Results
All participants completed the required encounters and a response rate from the surveys was 100%. Confidence was enhanced among all participants. Pre assessment results showed (Mean= 30.20, SD= 7.876) and post assessment (M=45.13, SD= 6.906). A paired t-test was performed using mean values from the participants’ responses from the pre and post assessment surveys using the MHNCCS. The paired t-tests calculations showed a statistical significance in increased confidence level among the participants from pre and post measures (t= 5.68) and a p value of <0.0001. Their responses from the open-ended knowledge assessment surveys were tabulated and percentage values were assigned to score their responses. Overall, the participants reported an increase in knowledge in most questions ranging from 6% to 53% in various questions. Students reported the application of evidence-based skills during the simulation. Among some examples included verbal de-escalation skills, therapeutic communication skills, limit setting, deep-breathing techniques.
Qualitative results
Students reported an overwhelming positive experience. All students stated comments about their experience by completing qualitative surveys. Among those comments about the simulation were “it was useful experience” “applicable”, “it gave me the ability to apply knowledge learned”. Students’ perspectives included that the simulation provided them the ability to “practice skills”.
Conclusion:
The pilot study was in line with the components of Kolb’s experiential learning theory. It demonstrated the feasibility to implementing a simulation in a mental health nursing curriculum. The use of SP provided a level of realism and experiential experience to the students. The results obtained were concurrent with other studies stating that simulations may enhance the students’ confidence, competency, self-efficacy skills, and the attainment of positive acceptance from the participants (Kunst et al., 2017; Goh et al., 2016; Alexander & Dearsley, 2013). Recommendations for future researches include the development of standardized instruments to be used in simulations. The implementation of simulations with SPs focusing on WPV can teach vital skills to nursing students to prepare them for the clinical settings and to combat this unwanted phenomenon. This pilot study supports the use of simulations in mental health nursing curricula to enhance the students’ preparation for their clinical rotations.
See more of: Research Sessions: Oral Paper & Posters