Enhancing Mental Health Nursing Practice Through Leadership Development in Undergraduate Nursing Students Using Standardized Patients

Caring for those with mental illness requires a sophisticated skill set: knowledge of the various disorders, clear and empathetic communication, ability to work within a team across care settings, and proficiency as an advocate whether for individuals, families, groups, or populations. Nursing students often feel anxious when caring for these clients and with fewer clinical placements and increasing patient acuity, they have fewer opportunities to practice assessment and communication skills in real-life settings. Preconceived notions and lack of practice opportunities may further increase anxiety in some students which impacts their ability to process information and retain key concepts learned in didactic courses (Shian, Selvarajan, Chng, Tan, & Yobas, 2016).

As novices, students also have difficulty using leadership skills such as advocacy, conflict management, and interprofessional communication, yet these are among core competencies required of new graduates (American Nurses Association, 2016; QSEN, 2014). Simulation allows students to recall and apply knowledge from their course work in a safe, controlled clinical experience (Shian, et al, 2016; Hermanns, Lilly, & Crawlwy, 2011).

Standardized patients (SPs), community members who are trained to portray a patient case or condition, have been part of simulated learning experiences for several decades. Experiences with SPs have been utilized to promote communication and assessment skills in undergraduate nursing students in a safe, controlled environment (Shian et al, 2016). Engaging in simulation experiences enables students to not only gain knowledge (Haukedal, Reierson, Hedeman, & Bjørk, 2018), but also reduces their anxiety (Sarikoc, Ozcan,, & Elcin, 2017).

Purpose: To evaluate the effectiveness of using SPs in promoting leadership skill development among undergraduate nursing students.

Methods: Current SP scenarios were reviewed and three were chosen for revision to include leadership concepts. A “toolkit” consisting of prework (reading and video vignettes review), reflections, as well as SP scripts were adapted to promote a focus on basic communication and assessment skills, while adding the complexity of specific leadership skills. Working with interprofessional teams and managing conflict were integrated into the enhanced toolkits. Anonymous online survey data on the effectiveness of the toolkits as a teaching strategy were collected. Student performance on pre and post-SPE activities were reviewed by course faculty.

Results: Eighty-eight undergraduate senior nursing students completed two SPs rating them as highly effective in promoting their learning. Students demonstrated increased depth of understanding and ability to use skills in interprofessional collaboration and conflict management as well as skills in mental health nursing. Finally, they reported increased confidence in their overall nursing abilities, as they prepared to enter the workforce.

Conclusion: These innovative strategies allow nurse educators to fully prepare nursing students for the complexities of providing holistic care to mental health clients and their families while practicing leadership skills in a safe environment.