standardised actors have limitations to project psychiatric symptoms, where it vary from patients to patient in same diseases. Simulation will help the students to have an idea about psychiatric patients which can be done by vedio shows and other visual methods.

I am a nursing instructor in a college in central Pensylvania, USA. We use standardized patients for mental health scenarios. The issue I have witnessed is how the instructor approaches the debriefing. If they are well trained in this type of learning environment it can lead to an enriching experience for the student. There needs to be training for facilitators/instructors in this area of undergraduate education. Just because someone has a master's degree or higher does not mean they have knowledge/experience in this type of teaching.

We are seeing similar changes in mental health in Canada. Traditionally we have had students on wards as that was where treatment took place. Now that so much is happening in the community I wonder if we need to develop different practice models in order to prepare students for where and how they will practice. This means separating practice from bricks and mortar. It will also mean moving from having the clinical instructor 'on site' with a group of students. Other disciplines have been making this shift for decades. It may be time for nursing to also evolve.

This will mean placing students where practice is taking place and may not be within the formal health care system or within buildings.

I am a Prof of Nursing for a PMHNP program in the US. I use SP for graduate PMHNP students in an outpatient clinic setting and also in the classroom using scripts, training of SPs and debriefing. I like the option of being able to tape the interactions and let the student observe, reflect and be empowered to change their approaches after they view their tapes. We also use SP in the classroom so that I can stop students and have them consider their approaches with feedback from peers and faculty. We have also developed multiple scenarios that may be inpt, outpatient, ED ect. Indeed, it is essential to create scenarios where students will practice after graduation.

Hi,

I'm the Prof of Mental Health Nursing at UOW.

We use simulation here at the University of Wollongong (UOW), NSW, Australia. Like many jurisdictions we also experience challenges gaining clinical placements in specialty areas like mental health. Acute in-patient settings are OK for students to be exposed to not at all representative of most consumers lives. As such, we need to think much more broadly than in-patient settings.

We do not count simulation as clinical. We use it as part of student learning. However... we have a very innovative clinical placement experience where we take health students and 30 consumers away on a week long "recovery camp". For 5 days health students (nursing, medical, psychology, dietetics, exercise physiology, 4 mental health nurse academics (including me) and 30 people with a lived experience of mental illness spend time together at programmed therapeutic recreation camp, learning from each other. We call this "The Recovery Camp". This does count as clinical as it is a fully educational immersive programme with defined learning objectives. We won a national award for it last year. Positive all round and an innovative mental health placement.

regards

Lorna

Lorna

That is awesome! I love that idea. Did you publish it? I would like to read more about it. Australians are so creative and clever! I married one (LOL) and I got my PhD at Flinders Uni of SA and lived in Adelaide. So, I know first hand!

Victoria

Hi Victoria,

G'day from down under!

We are in the process of publishing. All good things take time as you would appreciate.

It WAS awesome. Some consumers described it as Lifechanging. They had never had a break for 20 years. It was very humbling for the health professionals who really appreciated a strengths based and truly person centred approach. A search engine might get you to some info. Try Recovery Camp and Australian College of Mental Health Nurses. We are soon to have a big feature in an Australain newspaper too.

Bet you have lots of barbies (BBQs) with that aussie hubby !

You may want to contact faculty at Minnesota State University, Mankato who have developed cutting edge simulation strategies for teaching family nursing theory and how to offer a brief therapeutic conversation to families in busy health care contexts. They also have simulation room that mirrors a family home. They are funded by a special endowment made possible by the Glen Taylor Nursing Institute for Family & Society and they will be offering a special workshop about the use of simulation in June 2014: http://www.mnsu.edu/news/read/?id=1384884119&paper=nursing_institute. Contact Dr. Sandra Eggenberger, Director of the Glen Taylor Nursing Institute for more information: http://ahn.mnsu.edu/nursing/institute/

At Kingston and St George's we use simulations with actors but as others have said, as part of clinical learning rather than a replacement of clinical placement time. These are evaluated very highly by students and we have an ongoing arts project alongside. Our simulations have also won national awards and you might want to contact Chris Hart or Harvey Wells at Kingston about these?

We have used OSCEs as part of the MH nursing programme at Huddersfield for some years. The topics are interpersonal skills and the adminsitration of medicines. These allow students to get feedback from Practitioners, Service Users and Faculty staff before they go out on practice.

I published an article late last year on the OSCE and medicines-cited here.

Cheers

Steve

Hi Natalie,

We are utilizing SPs to teach undergraduate students in psych mental health for the past four years. We focus on the use of SPs to teach therapeutic communication and assessment skills and have developed seven different diagnoses/scenarios. Our students have two SP experiences (SPEs), both count as clinical hours, in which they interact with the SP, have a debriefing, view the video-recording, and complete a written assignment. The first SPE is at the beginning of the semester and is formative. The second is at the end of the semester and is summative. We have developed out own feedback/grading rubric and will be making some adjustments this year. We have received very positive feedback from our students. Additionally, I do have a couple of publications on what we are doing with SPs. Good luck.

Debbie

Hi Natalie,

I'm the Prof of Mental Health Nursing as well as the Simulation instructor at Midland college in Midland Texas. We use simulation in mental health in our simulation lab as part of the students clinical practice. We have developed standardised scenarios and algorithms to maintain accuracy in assessment. Our students have one to scenario specific to Mental Health and we incorporate Mental health into our other scenarios as well. I feel that nurses experience mental health issues in all areas of the medical profession. They love their Sims clinical days. I am not familiar Lasaters rubric to mental health simulation. I would be interested in finding out more about this. If you could get me information on this it would be greatly appreciated.

Hi

We did a project on eSimulation for undergrads and post grads looking at mental health issues in general hospital wards, have a look here and we have a few publication related to it see my contributions

http://www.inkysmudge.com.au/eSimulation/mhl.html

Thank you Scott for that link to a fabulous teaching resource. Do we need permission to use it on our course or is this a public link?

Natalie

We are introducing  Hearing Voices that are Distressing simulation but althoough critical in challenging student perceptions and attitudes, I have not seen this as a substitute for clinical placement

I agree simulation in mental health is not a substitute for clinical that is becoming very apparent! What I think we should be looking to co-ordinate is using simulation to try and cover a range of 'common' situations nurses may come across in their career as they do not all get a similar experience in clinical. We also run a hearing voices workshop which the students find very helpful in understanding the distress and disruption voices can cause.

Hi,

Clinical simulation in mental health is not a substitute for clinical experience, but at the same time students may not be able to come across all the psychiatric conditions in hospital. So the missing conditions can be done as clinical simulation. I have noticed that students attitude towards clinical simulation is more attentive if the teachers participate as an actor along with the students while simulation is on. That can be considered while clinical simulation in mental health.