Elsevier

Clinical Simulation in Nursing

Volume 14, January 2018, Pages 8-14
Clinical Simulation in Nursing

Special Issue: DNP and PhD project
Article
Mental Health Simulation With Student Nurses: A Qualitative Review

https://doi.org/10.1016/j.ecns.2017.09.003Get rights and content

Highlights

  • Mental health simulation with simulated patients provides an authentic and realistic experience and assists in reducing preclinical mental health placement anxiety in undergraduate Bachelor of Nursing students.

  • Simulation in mental health nursing provides an effective means for bridging theory-to-practice gap evident in many undergraduate nurses today.

  • Stigmatising attitudes towards persons with mental illness exist in undergraduate Bachelor of Nursing cohorts, and simulation is an effective modality for addressing attitudes and poor personal responses to those with mental illness.

Abstract

Background

Research indicates that nursing undergraduates demonstrate negative attitudes towards persons with a mental health condition, and mental health simulation may be a possible solution to this.

Method

This study comprises a thematic analysis of semistructured focus groups, exploring undergraduate Bachelor of Nursing students' experiences resulting from a simulation with a simulated patient.

Results

Participants overwhelmingly noted the educational benefits of simulation for understanding mental health concepts, closing the practice-theory gap and reducing placement anxiety. Also of note was benefits of vicarious learning in simulation and the realistic representation of mental health conditions.

Conclusions

This study has demonstrated that simulation with a simulated patient is beneficial in reducing mental health placement anxiety and confronting stigmatising attitudes. Importantly, mental health simulation has also demonstrated educational benefits beyond vicarious learning, to include provision of theoretical concepts, with practical application.

Section snippets

Background

Individuals experiencing a mental health condition have long been subjected to stigmatising behaviours and discrimination from others (Arboleda-Flórez & Stuart, 2012). Extensive research has indicated the serious negative impacts these behaviours have towards people experiencing a mental health condition, including employment discrimination (Corrigan, Powell, 2012, Rüsch, 2012), social rejection (Mårtensson, Jacobsson, & Engström, 2014), homelessness (Cleary, Deacon, Jackson, Andrew, & Chan,

Aim

The aim of this study was to explore the attitudes of undergraduate Bachelor of Nursing (UGBN) students following a mental health simulation. The authors also explored any educational benefits of simulation and sought to identify if simulation resulted in any behavioural changes. The research question is as follows:

  • What are the impacts of simulation-based education on undergraduate nursing students' attitudes towards the mentally ill?

Methods

This study comprises the final of three independent studies in a mixed-methods sequential explanatory design exploring UGBN students' behaviours and perceptions towards the mentally ill and the impacts of simulation on attitudes. The simulation intervention (study two) was the impetus of the focus groups and comprised a two-hour simulation with a simulated patient (SP) trained at presenting with schizophrenia. The SP presented as delusional and paranoid and was provided with a peer-reviewed

Participant Selection

Participants were recruited from a group of UGBN students from an Australian University who had previously participated in a mental health simulation (undertaken prior to this study) that was made available to a cohort of 327 students. Of these, 34 students voluntary participated in the intervention (mental health simulation), and all participants were invited to join the focus groups. In total, 13 students (2 males, 11 females) consented to participate in the semistructured focus groups. Two

Analysis

The qualitative approach to this study was thematic analysis of semistructured focus groups. Impetus for using this qualitative method was its flexibility as a research paradigm and its use in the identification and recording of themes within a set of data (Braun & Clarke, 2006). Thematic analysis is the exploration and recording of themes within a set of data (Braun & Clarke, 2006) that is presented in a narrative context (Guest, MacQueen, & Namey, 2012). As noted by Guest et al. (2012),

Theme 1: Bridging Theory-to-Practice Gap With Simulation

Participants readily identified (n = 9) mental health simulation as an important educational experience that assisted them in consolidating skills and information they had learned during their mental health theoretical and practical units. They noted that simulation was beneficial in determining aspects of learning that were deficient, and this provided a prompt to apply themselves to further, independent study:

It (simulation) can highlight where you to need to possibly go back and do some more

Discussion

This study has provided useful information regarding the attitudes of students undertaking mental health nursing towards persons experiencing a mental health condition. This research has demonstrated in accordance with other such literature that simulation has been identified as beneficial in skill acquisition (Ackermann, 2009, Coolen et al., 2012). Negative perceptions towards those experiencing a mental illness has been cited as one of the more serious issues in attracting graduate nurses to

Conclusion

Simulation is a contemporary educational modality that can offer much to mental health nursing and those students studying such units. History tells us that we need to address negative attitudes towards people experiencing a mental health challenge or they will continue to be discriminated and suffer adversity. This study has demonstrated that simulation has been beneficial in reducing anxiety, confronting stigmatising attitudes and challenging perceptions of the mentally ill.

Acknowledgment

The authors would like to thank participants from Australian Catholic University for their involvement in this research.

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      Citation Excerpt :

      While this study was an analysis of a single nursing program with a limited sample size, it was notable that levels of stigma in the group that had the mental health simulations not only declined but declined more than students who completed a theoretical course without a simulated component. Congruent with Alexander and colleagues (2018), this is notable as it suggests that mental health simulations not only provide content (or improve) on professional practice skills, but they also have the potential to reduce mental illness stigma. This is an important finding as we consider whether simulations provide the full value of professional practice experience or if something is lost in working with standardized patients.

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    Funding sources: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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