The purpose of this literature review is to provide the readers current mental health nursing simulations that have employed standardized patients (SPs) discussing its benefits for nursing students. Implications for nursing practice, research, education, limitations, and recommendations are included.
Providing nursing students the necessary tools to perform their duties and responsibilities competently is paramount of nursing education.The field of mental health nursing may challenge nursing students due to unpredictable behaviors that may arise and students may have apprehension to interact with psychiatric patients (Thongpriwan et al., 2015; Alexander & Dearsley, 2013). Innovative approaches are needed to disseminate the knowledge in an evolving student body population. Nursing simulations provide a viable approach for faculty to impart knowledge to nursing students. The implementation of nursing simulations is increasing across nursing schools (Foronda, Liu, & Bowman, 2013). While there is a plethora of studies on nursing simulation, the use of mental health nursing simulations in undergraduate programs to enhance student’s skills is limited (Kunst, Mitchell, & Johnston, 2017; Alexander, Sheen, Rinehardt, Hay, & Boyd, 2017). Nursing simulations provide an alternative educational approach to impart knowledge and skills to nursing students (Alexander & Dearley, 2013; Martinez, 2017). According to Brown (2015), a SP is an actor or an actress that has been trained to act out as patient. The use of SPs in nursing simulations may add a realistic experience for the students.
Methods:
Research articles were retrieved using Fusion and CINAHL databases. Selection of the articles were based particularly on mental health simulations with SPs. Limits set included articles written in English, published within 2012 to 2017, and journal articles. Articles that did not meet the desired criteria were discarded. Ten articles were included in the review.
Results:
Implication of Simulations in Students Outcomes
The literature review provided beneficial effects that simulations may have in the nursing students’ learning. Knowledge and skills learned in simulations can be applied in the students’ mental health clinical settings. Oh, Jeon, and Ko (2015) have reported that using SPs in simulations may give the students the ability to have new knowledge, skills, and self efficacy. Another study by Choi et al. (2016) assessed the student’s self-efficacy after a patient simulated-based experience. The authors reported that students demonstrated an enhanced simulated-based self efficacy after their simulation program.
Moreover, communication skills are essential in the field of mental health nursing. Therapeutic communication skills can be learned and practiced in a controlled environment during the simulation with SPs. Nursing simulations with SPs have been shown to enhance communication skills (Oh, Jeon, & Ko, 2015; Choi, 2016). Learning how to effectively communicate with mental health patients can help prepare students to effectively interview patients in their mental health clinical settings.
Confidence is critical for nurses and nursing students in a mental health setting. Using SPs in simulations have the potential to enhance the students’ confidence interacting with mental health patients. Recent research studies have shown that students’ confidence has been enhanced after attending a simulation program (Martinez, 2017, Goh, Selvarajan, Chng, Tan, & Yobas, 2016; Alexander & Dearsley, 2013).
Bringing theory to practice is imperative for nursing faculty. The use of simulations can provide a viable platform to bring theory to practice by exposing students to real life scenarios and measuring the outcomes in a clinical setting. A study by Kunst, Mitchel, Johnston (2017) demonstrated a statistical significance in the nursing students’ confidence, ability and knowledge of providing mental health care in an emergency setting.
Limitations
A small number of articles were found particularly on mental health nursing simulations using SPs. Limited databases were employed for the article search. No randomized controlled settings were found. Small and convenience samples were found in some of the articles.
Conclusion:
Recommendations for Nursing Faculty
Given the large acceptance of nursing simulations in nursing education, it is recommended that faculty use simulations with SPs to further disseminate knowledge to the students. Nursing faculty is encouraged to enhance their knowledge about simulations via journals, trainings, conferences, and seminars. Nursing simulations can be conducted in simulation laboratories. Exposing nursing students to experiences to simulation-based programs with SPs can enhance their clinical competence.
Recommendations for Nursing Education and Research
Innovative approaches are needed to enhance the development of new mental health nursing simulations. Different case scenarios portraying a variety of mental illnesses are recommended. Researchers can further study the impact of simulations on the students’ learning domains. The use of standardized instruments is recommended. There is a need for development of standardized assessment instruments to be used in simulations with SPs. Students’ experiences following a mental health nursing simulation with SPs should be examined in depth to assess their effectiveness as an educational tool.