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Simulation and Students’ Involvement in Mobile Clinics

The Curriculum Gap

The identified needs gap in the curriculum was students’ lack of understanding of mental health outreach and crisis intervention. The literature confirms this gap since it was identified that students are often not prepared to provide mental health care to patients with alcohol withdrawal symptoms or suicidal ideation (Gates & Brown, 2017; Mirick, McCauley, Bridge, & Berkowitz, 2016). One of the possible causes for this gap is the impossibility to teach students to provide high-quality health care without adequate exposure to mental healthcare situations (Kunst, Mitchell, & Johnston, 2016). To address this gap, such teaching techniques as simulation and students’ involvement in mobile clinics may be implemented.

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Summary of the Findings

The reviewed literature identified that simulation is a promising teaching technique for educating mental health nursing students. The earliest among the selected articles on this topic, conducted by McGarry, Cashin, and Fowler (2012), showed that by 2012, high fidelity human patient simulation had been used in nursing undergraduate teaching, but its effectiveness had not been much explored by scholars. A more recent literature review performed by Brown (2015) demonstrated that research in this field increased and found that various types of simulations were effective in increasing nursing students’ skills. Simulations also decreased students’ anxiety and fear of working with mentally ill patients (Brown, 2015). These findings are consistent with the results of studies conducted by Kunst et al. (2016), Webster (2014), and Gates and Brown (2017). This evidence suggests that simulation can be used to introduce the proposed change.

One study, in particular, assessed the effectiveness of simulation for teaching nursing students to provide care to patients with severe alcohol withdrawal symptoms. It was the study by Gates and Brown (2017), who identified a gap in students’ knowledge and confidence in managing alcohol withdrawal and showed that simulation could close this gap. The studies by Carretta, Burgess, and Welner (2015), Mirick et al. (2016), and Ranahan (2013) were devoted to suicidal individuals in nursing practice. The main point is that psychiatric nurses often encounter suicidal individuals and are frequently not quite prepared to help them. Luque and Castan᷉eda (2013) observed the benefits of mobile clinics and argues that employing nursing students would be helpful for both patients and students. Kiliç and Şimşek (2018) observed the importance of nurses in crisis intervention and listed competencies necessary to provide care to patients who survived a crisis. The reviewed literature helped gain an insight into the essential content and potential teaching strategies for the proposed curriculum change.

Literature Review Summary Table

First Author
(Pub Year)
Title Purpose Context Findings Relevance Strength of Evidence
McGarry et al. (2012) Child and adolescent psychiatric nursing and the
‘plastic man’
To explore how Lewin’s change theory can be useful for adopting the use of high fidelity human patient simulation (HFHPS) in psychiatric nursing HFHPS is a promising teaching strategy for psychiatric nursing. Applying Lewin’s change theory could decrease anxiety related to the introduction of HFHPS, and guide its adoption. Lewin’s change theory can facilitate the adoption of the proposed change. VII
Brown (2015) Simulation in undergraduate mental health nursing education To review the literature on the use of simulation techniques in psychiatric nursing education Simulation becomes widely popular for teaching psychiatric nurses to provide high-quality care. Simulation increased students’ critical thinking, therapeutic communication, and risk assessment and decreased their fear of working with real patients. Simulation may be an effective technique to be used for the adoption of the proposed change. VII
Kunst et al. (2016) Manikin simulation in mental health nursing education To investigate how high-fidelity manikin simulation influences nursing students’ knowledge and confidence in providing mental health care It is difficult to develop an ability to provide high-quality mental health care without adequate exposure to mental health care situations. Simulation increases students’ satisfaction with learning, confidence, and self-efficacy in managing mental health care situations. Simulation is an effective teaching strategy that can be used for educating psychiatric nursing students. I
Webster (2014) Using standardized patients to teach therapeutic communication in psychiatric nursing To explore the efficacy of the standardized patient experience (SPE) as a teaching strategy The research into the effectiveness of the SPE for improving nursing therapeutic communication skills is limited. After the SPE intervention, nursing students showed improvement in therapeutic communication skills. Provides an effective method of improving therapeutic communication skills in nursing students. III
Carretta et al. (2015) Gaps in crisis mental health To determine the difference in toxicology findings on autopsy between suicide cases and homicide-suicide cases Mental health care does not distinguish between suicide cases and homicide-suicide cases. Homicide-suicide perpetrators had twice as many stimulants in their bodies than people who committed suicide. Those who suicided had higher levels of alcohol or drugs in blood than homicide-suicide perpetrators. Determines the predictors of suicide and homicide-suicide. This could be included into the proposed course’s content. IV
Mirick et al. (2016) Continuing education on suicide assessment and crisis intervention To determine whether a 1-day workshop can improve mental healthcare professionals’ knowledge of assessment and crisis intervention with patients having suicidal thoughts Mental healthcare professionals often encounter suicidal individuals in their practice. Although most healthcare professionals encountered suicidal individuals in their work in the past 3 months, they did not possess high levels of knowledge or confidence in how to deal with them. A 1-day workshop increased their knowledge and confidence. Suicidal individuals are frequent in mental healthcare; therefore, nurses should be taught how to help them. III
Ranahan (2013) Pathways for preparation: Locating suicide education in preparing professionals for encounters with suicidal adolescents To identify how mental healthcare professionals working with youth can be educated in suicide prevention intervention Suicide is a prevalent reason for young people’s deaths. The topic of suicide is insufficiently covered in university programs. Integration of suicide prevention content into the curriculum may increase healthcare professionals’ readiness for suicide-prevention practice. Confirms the identified needs gap in nursing education. VII
Gates et al. (2017) Preparing nursing and social work students to care for patients in acute alcohol withdrawal To prepare nurses and social workers to care for patients with severe alcohol withdrawal symptoms Nursing and social work students are often not prepared to care for such patients. IPE addictions simulations improve nursing and social work students’ knowledge of alcohol withdrawal management and allow them to understand the role of interprofessional colleagues in this procedure. Identifies the gap in the curriculum related to dealing with alcohol withdrawal and suggests an educational intervention. III
Luque et al. (2013) Delivery of mobile clinic services to migrant and seasonal farmworkers To assess the efficacy of mobile clinics and summarize effective partnership models to facilitate mobile outreach Migrants and seasonal farmworkers are a vulnerable population with barriers to healthcare. Mobile clinics have the potential of improving the health outcomes of vulnerable populations. Mobile clinics provide training opportunities for students. Proves the feasibility of establishing mobile clinics and suggests that students should be employed in such clinics. I
Kiliç et al. (2018) Psychological first aid and nursing To describe the concept of psychological first aid Nurses are key actors in helping people to cope with the psychological consequences of a crisis. Psychological first aid involves ensuring contact and engagement, safety, stabilization, information gathering, and connection with social supports and collaborative services. Outlines key competencies necessary for crisis interventions. VII

References

Brown, A. M. (2015). Simulation in undergraduate mental health nursing education: A literature review. Clinical Simulation in Nursing, 11(10), 445-449.

Carretta, C. M., Burgess, A. W., & Welner, M. (2015). Gaps in crisis mental health: Suicide and homicide-suicide. Archives of Psychiatric Nursing, 29(5), 339-345.

Gates, S. A., & Brown, J. R. (2017). Preparing nursing and social work students to care for patients in acute alcohol withdrawal. Journal of Addictions Nursing, 28(3), 143-147.

Kiliç, N., & Şimşek, N. (2018). Psychological first aid and nursing. Journal of Psychiatric Nursing, 9(3), 212-218.

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Kunst, E. L., Mitchell, M., & Johnston, A. N. B. (2016). Manikin simulation in mental health nursing education: An integrative review. Clinical Simulation in Nursing, 12(11), 484-495.

Luque, J. S., & Castan᷉eda, H. (2013). Delivery of mobile clinic services to migrant and seasonal farmworkers: A review of practice models for community-academic partnerships. Journal of Community Health, 38, 397-407.

McGarry, D., Cashin, A., & Fowler, C. (2012). Child and adolescent psychiatric nursing and the ‘plastic man’: Reflections on the implementation of change drawing insights from Lewin’s theory of planned change. Contemporary Nurse, 41(2), 263-270.

Mirick, R., McCauley, J., Bridge, J., & Berkowitz, L. (2016). Continuing education on suicide assessment and crisis intervention: What can we learn about the needs of mental health professionals in community practice? Community Mental Health Journal, 52, 501-510.

Ranahan, P. (2013). Pathways for preparation: Locating suicide education in preparing professionals for encounters with suicidal adolescents. Child & Youth Services, 34(4), 387-401.

Webster, D. (2014). Using standardized patients to teach therapeutic communication in psychiatric nursing. Clinical Simulation in Nursing, 10(2), e81-e86.

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