Impact of BSN psychiatric nursing pre-clinical preparation using SP simulation

---

Heather Marie Walsh

Walsh Consulting Services, USA

: J Nurs Patient Care

Abstract

---

Background: Undergraduate BSN students are traditionally sent to mental health clinical internship with only lectures and a clinical site orientation. In order to decrease student anxiety and to foster awareness of therapeutic communication techniques, a dynamic Simulation- Psychiatric-Patient Rounds Day was prepared for students to practice interacting with psychiatric patients in a safe, controlled environment. Expressive details and behavior were important so Standardized Patients (SP) were used over manikins. Purpose: 1) To give pre-licensure nursing students the opportunity to interact as a nursing care team to manage the care of five most common challenging psychiatric disorders 2) To practice therapeutic communication techniques. 3) To decrease student anxiety and help prepare the student prior to Psychiatric clinical internship. Methods: N=50 Fourth year BSN students, ages 22-26, 94% females. The five patients were played by clinical faculty standardized patient actors. The workshop consisted of a Pre Simulation assignment, Simulation Activity, and Post Simulation Activity or group Debriefing (which occurred immediately after the Simulation by the faculty to give feedback and open discussion. On a strict schedule, of “switch every thirty minutes,” twenty-five students at a time (5 groups of 5, divided by clinical groups as much as possible), rotated through five rooms of patient scenarios for a workshop of three hours. As an “Admission ticket“students were required to hand in their completed pre-reading post quiz. As student groups progressed through the five rooms, they also rotated through the five nursing team roles, until all five scenarios or patient rooms are visited, and all roles have been performed. The student roles were: primary nurse, secondary, new graduate, student, and nurse assistant. Students were encouraged to act as a team and were given a list of therapeutic communication techniques as a reference to use to manage the situation. Five psychiatric Nursing faculty or clinical instructors were recruited to play one of five prepared Scenarios: 1) Anxiety/Panic attack, 2) Bipolar, 3) Schizophrenic, 4) Dementia, and 5) Anorexia Nervosa. The faculty would be the SP patient for the first 15 minutes providing a challenging interaction, STOP and then become the Faculty Debriefer for the remaining 15 minutes. Therapeutic Communication techniques would be identified. At the end, students completed a “Post-SIM Knowledge Quiz,” to assess learning, and also for activity Evaluation, Results: Post-SIM Quiz results were improved over the Pre-SIM Quizzes (same quiz). Students rated it high as “a valuable learning experience” and inspired “critical thinking” and “team collaboration.” Discussion/Conclusions: Students were overwhelmingly thankful for this learning opportunity and reported feeling much more relaxed and prepared to start Mental Health clinical rotation.

Biography

---

Heather Marie Walsh completed her Masters in Science, in Nursing Education at the University of Hartford, Connecticut, and specializes in Adult Medical Surgical Critical Care, Leadership, Psychiatry, Geriatrics, Transcultural Nursing, and Simulation Learning. She has forty years of diverse Nursing experience, from ICU to Infection Control, Wound Care, Psychiatry Personality Disorders, and Transcultural and Transgenerational Education. She is the CEO of Walsh Consulting Services, Los Angeles, California. She is a published writer, and also a reviewer and writer of Medical Surgical textbooks.

E-mail: HWalsh5@gmail.com