Effects of a Psychiatric Mental-Health Clinical Simulation Experience Using Standardized Patients on Prelicensure Nursing Students', Therapeutic Communication and Psychiatric Assessment Knowledge, Skills and Attitudes

Students enrolled in their junior year of a baccalaureate nursing program at a large California public university will participate in a simulation activity with standardized patients.  The research will use a repeated measures design to investigate the effects of a formative simulation experience with standardized patients on the students’ (a) knowledge of psychiatric assessment and therapeutic communication, (b) performance of therapeutic communication and psychiatric assessment skills, and (c) perceived anxiety related to a clinical rotation in psychiatric mental-health.  The simulations designed for this research will use unfolding scenarios that follow the patient from admission to discharge. Scenarios will include patients with depression and anxiety. Patients with passive suicidal ideation without a plan for self-harm, as well as patients with suicidal ideation and a plan for self-harm.  The simulation scenarios are written to represent patients with diverse cultural, age, gender, and social economic backgrounds. The researchers will use in-simulation debriefing, as well as, a post-simulation debriefing to facilitate student learning.  Each student group will participate in 3 different simulations over the course of two weeks.  

Data will be collected pre and post-simulation.  Qualitative data related to student anxiety about participating in a psychiatric clinical rotation will be collected using reflective questions. Quantitative data on student knowledge will be assessed using a 30-item criterion-referenced Psychiatric Assessment and Therapeutic Communication test.  Student skill levels will be tracked using a psychiatric assessment and therapeutic communication rubric developed by the researcher.  Data collection will begin in November of 2013 and conclude in February of 2014.  Pre- and Posttest data will be analyzed using a paired t-test. The qualitative data will be analyzed for recurrent themes. Simulation using standardized patients has the potential to address and narrow the gap between theory and practice.