“Mental health simulation is an interactive, experiential type of learning that has been shown to help nurses prepare for real-life situations, particularly the kinds of challenging experiences they often face in clinical settings,” said Denise A. Soccio, DNP, RN, a McLean nursing professional development specialist. “With mental health simulation, students are much more engaged in what they learn.”
Soccio advocated for mental health simulation, or “SIM,” during a McLean Grand Rounds lecture delivered on Thursday, October 28. Part of the McLean Forum series, the presentation discussed the history of simulated training methods, presented research findings attesting to SIM’s effectiveness as a learning approach, and offered a real-time demonstration of how SIM can provide effective nursing education.
What Is SIM?
According to Soccio, SIM is “a technique, device, or activity that aims to authentically recreate, imitate, or amplify characteristics, processes, and experiences of the real world for the purposes of teaching, acquiring, and assessing skills and attitudes.”
The aviation, space, and nuclear industries, along with the military, have long used simulators for training, Soccio reported. In the 1960s, medical schools adapted simulation training techniques, which led to the creation of the human patient simulator. The anesthesia simulation environment was developed in the 1980s. In recent years, simulation has been increasingly studied—and adopted—by the mental health field.
Soccio stated that studies conducted over the past 10 years—including her own work at Regis College—show that practitioners can learn communication skills, improve psychiatric assessments, gain experience in de-escalation, and more through mental health SIM.
These studies, she said, show that students “learn better through active experience and interaction versus passive listening.” She explained that the experiential learning offered by SIM is relatable to real-life clinical scenarios and can lead to increased knowledge retention.
Soccio cited one report suggesting that high-quality simulation can be used as a replacement for up to 50% of traditional clinical hours for pre-licensure nursing curricula.
Soccio delivered a lecture, “The Effectiveness of Mental Health Training Simulation on Learning Outcomes,” during McLean Grand Rounds on October 28, 2021.
SIM training can come in many forms, Soccio said, but mental health SIM works particularly well with trained actors who serve as live “simulated patients.”
In these situations, various mental health scenarios are prepared in advance, and scripts are written. Students then work through various real-world evaluations and treatment scenarios with the actors.
“It’s important to make these scenarios as realistic as possible so that it suspends disbelief,” Soccio stated. “If the learner thinks it’s too fake, you are not going to get the level of engagement you need.”
These scenarios, along with many studies and surveys, clearly demonstrate the value of SIM in nursing education, Soccio asserted. “In nursing class, the focus is on theory, but things are different when you’re assigned to interact with an actual patient,” she said. “And, unfortunately, psychiatric clinical inpatient experiences are limited with restrictions on what students can do on the units.”
With SIM, students can engage in experiences that they will surely encounter on the job.
For example, Soccio stated that because of liability issues many nursing students do not always learn how to de-escalate agitated behavior. However, SIM, she said, “gives them hands-on experience with an actor in a safe environment” to address these challenging—and all too common—situations.
To demonstrate the effectiveness of the SIM approach, Soccio moderated two, live-action, real-time virtual SIM teaching scenarios on motivational interviewing during her Grand Rounds talk. In each case, a mental health practitioner engaged with a “patient”—played by an actor—and discussed a mental health issue. As the scenarios unfolded, Soccio commented on the interaction and offered advice to the clinicians.
McLean nursing professional development specialists Danielle Murkidjanian, MSN, RN, and Abigail Rice, MSN, RN, served as the clinicians in these scenarios.
More Research Needed
During her talk, Soccio reported on research studies and student evaluations that provide compelling evidence that mental health SIM is an effective training tool. However, she believes that more research is needed.
“We have thousands of studies showing that SIM provides valuable learning experiences, and it can be used to evaluate clinician competency,” she said.
“However, there is a need for future studies on transferability of SIM learned skills to actual practice. In addition, we need to know if SIM leads to improved patient mental health outcomes.”
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