Utilizing Human Patient Simulation to Improve Nursing Care of the Mentally Ill Client

Individuals who suffer with mental illness are often regarded with fear and stigma. Unfortunately these views can exist among professional nurses and nursing students. Harboring these attitudes result in a lack of confidence when caring for psychiatric patients, and inferior care for the mentally ill client. These sentiments also result in a less favorable view of psychiatric care, and leads both nurses and nursing students to choose alternative career paths. The educational opportunities provided to pre-licensure nurses must endeavor to remove the fear and stigma that many students have concerning the care of psychiatric patients. Human patient simulation (HPS) is a method of recreating a patient care setting in a safe learning environment, and offers the opportunity to provide training that is very specific to the needs of the learner. Through HPS, attitudes concerning the psychiatric patient, and the care of this individual, can be improved. This project involved the creation of three separate simulations to provide experience in caring for mentally ill patients. The objectives for this Doctor of Nursing Practice (DNP) project included the following: 1) Create, pilot and assess three human patient simulation experiences to be used in training undergraduate pre-licensure nurses, and which utilize evidence-based practice guidelines for the care of clients experiencing psychosis, depression and anxiety. 2) Disseminate the findings of this DNP project to nursing educators. Research indicates that effective training and experience can help to modify the negative views pre-licensure nurses have towards patients who are mentally ill (Arvaniti, et al., 2009; Emrich, Thompson, & Moore, 2003). HPS has been shown to improve nursing skills (Fiedler, Breitenstein, & Delaney, 2012), critical thinking (Lehr & Kaplan, 2013), and communication skills (Orr, Kellehear, Armari, Pearson, & Holmes, 2013). Most importantly, research indicates that the skills and knowledge learned in simulation are utilized when working with patients (DeBourgh & Prion, 2011). Despite the benefits of HPS, this training method is underutilized in mental health education (Hayden, 2010). IRB exemption was obtained from both the University of Utah and Brigham Young University - Idaho (BYU-Idaho). Implementation of the DNP project included: 1) Development of three psychiatric simulations. 2) Piloting the simulations in the BYU - Idaho simulation lab with students enrolled in the Registered Nurse to Bachelor of Science in Nursing (RN to BSN) program at BYU - Idaho. 3) Completion of pre- and post-survey evaluations by the simulation participants. 4) Presentation of the simulations and survey results to faculty at BYU-Idaho, and nursing faculty in the State of Idaho including a poster presentation at the Idaho Nurse Educator Conference on April 9, 2015. Three mental health simulations addressing psychosis, depression and anxiety were piloted at BYU-Idaho with 26 RN to BSN students on January 10, 2015. Student participated in each simulation experience and completed pre- and post-survey questionnaires. A comparison of the mean scores from the pre and post survey items indicate improvements in participant knowledge of the mental health conditions, and confidence in participant ability to care for and communicate with mentally ill patients. Improvement in feelings of empathy towards mentally ill clients and openness to psychiatric nursing as a possible career path were also indicated