Mental Health Stigma Reduction Through Simulated Professional Practice

Purpose: Simulation as a tool to teach professional practice in health professions is receiving increased attention. To date, the focus of research has been on the efficacy of simulation in assisting students to acquire professional practice competencies (Medley & Claydell, 2005), often in comparison to learning in “real world” environments. However, literature regarding professional practice in mental health has informed us that real world professional practice isn’t just about competencies, it can also play a key role in reducing stigma (Galletly & Burton, 2011). The potential for stigma reduction through the use of simulated learning environments has not been explored in existing research. Therefore, the purpose of this project was to explore the effect of a simulated professional practice course in mental health nursing on student perceptions of people experiencing mental health challenges.

Three foundational considerations are already addressed within the research literature: Mental health care is one of the most negatively perceived domains of practice by nursing students (Happell & Gaskin, 2013); simulation can assist students in learning the task-based components of mental health care (Bartlett & Butson, 2015; Doolen, et al., 2014); and mental health professional practice in “real world” environments reduces stigma of nursing students towards people experiencing mental health challenges. However, it has been questioned whether there are components of learning that are lost when shifting from practice environments with actual patients to those with standardized patients. We questioned: Does exposure to standardized patients acting out mental health challenges lead to stigma reduction?

Methods: We hypothesized that Nursing students who completed a mental health simulation professional practice course will have reduced levels of stigma towards mental illness upon completion of the course, and have more positive attitudes towards mental illness than those who have not taken the course. Stigma was measured through two standard tools, administered before and after a mental health simulation for the experimental group, and without simulation for the control group. Additionally, five students were interviewed to understand the experience of completing the tools.

Results: Data demonstrates that simulation led to reduced mental health stigma, while no statistically significant reduction was seen within the control group. Therefore, this study demonstrates that simulated mental health practice has the potential to involve both practice improvements and a reduction in stigma.

Conclusion: This adds to the literature demonstrating that simulated professional practice can achieve the same ends as professional practice within hospital environments.