Learning Outcomes Identify strategies to introduce standardized - - PDF document

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 1

Standardized Patient Simulations for Essential Psychiatric Nursing Skills

Laura Rodgers, PhD, PMHNP-BC Barbara J Limandri, PhD, PMHNP, BC

Learning Outcomes

• Identify strategies to introduce standardized

patient simulations in baccalaureate psychiatric nursing clinical.

• Describe the process of conducting the

standardized patient simulation and debriefing.

• Describe the benefits and challenges of using

standardized patient simulations for essential psychiatric nursing skills in baccalaureate approach to teaching psychiatric nursing.

Disclosures

Neither of the speakers have any financial conflicts of interests related to this content

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 2

Identified Challenges

• Psychiatric-mental health nursing content

ever growing but curricular space is retracting

• Demands on clinical placements
• Limitations of clinical sites
• Reductions in amount of time in clinical

sites

Identified Needs

• What is essential for every baccalaureate

nurse to know to be a nurse today and in the near future?

• What are essential skills that every

baccalaureate nurse needs to demonstrate today and in the near future?

• How do we provide that in a standardized

way given curricular resources?

Knowledge

• Scope and standards of psychiatric-mental

health nursing

• Basics of mental disorders
• Life span approach
• Chronic care and acute care
• Neuroscience of mental disorders and

treatments

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 3

Attitudes

• Compassion as an antidote to stigma
• Commitment to the Recovery Model
• Community based care
• Every nurse is a psychiatric nurse

Skills

• Therapeutic communication
• Mindfulness
• Critical thinking
• De-escalation
• Validation

Essential Skills

• Assessment and management of the

acutely suicidal person

• Communication with the person who is

hallucinating

• Communication and management of the

person who is in a manic state

• Addressing medication self-management

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 4

Simulation

• Low, medium and high fidelity
• Good ole role plays
• Talking manikins
• Simulation lab

Standardized Patients

• Traditionally used for physical assessment

skills

• Specialized actors
• Interviewing and auditioning
• Training
• Briefing and debriefing

Developing Scenarios

• NLN Center for Innovation in Simulation

and Technology

– Simulation Innovation Resource Center – Training in developing simulation

• Script writing
• Expectations and preparations for

students

• Simulation environment

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 5

Scenarios

• David with bipolar disorder in a manic

episode, presenting in the ED

• Frank with schizophrenia hallucinating and
• ff meds, presenting in day treatment
• Helen with severe depression and suicidal,

presenting in PCP’s office

David Frank

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 6

Helen Debriefing

• Students complete brief reflection
• Meet as a group to view all the videos
• How to critique colleague performances
• Review together with SP attending as

available

• Received critique by SP

Outcomes

• Most students became engaged with the

reality of the simulation

• All expressed incredible learning
• Clinical faculty expressed leap in students’

therapeutic communication awareness

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 7

Faculty Critique

• Need to prepare students for experience
• SPs drifted toward greater authenticity and

responsiveness to students

• Debriefing required more time than could

be allotted

• Need to modify rubric to be more general
• Recognition of therapeutic communication

skill deficits

What We Learned

• Students found this to be an incredible

learning experience

• Debriefing was lengthy and detailed, and

students wanted the critique

• Continue to refine the process including

technology and scenario design

• Having the SPs offer their critique

provided another layer of learning

What We Learned

• Reducing the time for each scenario to

press students to get to the point

• Provide clear directions of what was

expected of students

• Moving the experience to different times in

the term provided different kinds of learning

APNA 29th Annual Conference Session 3014.1: October 30, 2015 Limandri 8

References

• Becker, K.L., Rose, L.E., Berg, J.B., Park, H., Shatzer, J.H.

(2006). The teaching effectiveness of standardized patients. Journal of Nursing Education, 45: 103-110.

• Buccheri, R.K.; Trygstad, L.N.; Buffum, M.D.; Lyttle, K.; Dowling,
• G. (2010). Comprehensive evidence-based program teaching self-

management of auditory hallucinations on-inpatient psychiatric

• units. Issues in Mental Health Nursing 31,223-231.
• Cooper, J., Martin, T., Walker, J. Fisher, W., Helms, P. (2010).

Integrating standardized patients and clinical simulations in a mental health nursing course. Clinical Simulations in Nursing, 6, e. 110.

• Guise, V, Chambers, M., Valimaki, M. (2012). What can virtual

patient simulation offer mental health nursing education? Journal

• f Psychiatric and Mental Health Nursing, 19, 410–418.

References

• Jeffries, P., & Rogers, K. (2007). Theoretical framework for

simulation design. In P. Jeffries (Ed.), Simulation in Nursing Education (pp. 21-33). New York: National League for Nursing.

• Lasater, K. (2007). High fidelity simulation and the

development of clinical judgment: Student experiences. Journal of Nursing Education, 46(6), 269-276.

• Video: YouTube Video:

http://www.youtube.com/watch?v=dkB2CGL769o