Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis

Clinical Neuroscience Education in Psychiatry Residency Training: Where Do We Go from Here?

ABSTRACT

The growing body of clinical neuroscience knowledge is transforming the psychiatry field. Today's psychiatrists must have strong command of clinical neuroscience and its applications to clinical practice. Over the past few decades, increased emphasis has been placed on clinical neuroscience education for psychiatrists and psychiatric trainees; residency training serves as a primary avenue for such educational intervention. These efforts, however, have been met with varying beliefs, attitudes, and responses. In this perspective, we examine the existing literature on clinical neuroscience education in North American psychiatry residency training programs as reported by department chairs, program directors, practicing psychiatrists, and trainees. We note key challenges, including perceived lack of clinical relevance in teaching, insufficient integration of clinical neuroscience education into residency training, and a shortage of specialized faculty educators. We summarize existing efforts to address these challenges, then propose future directions that may further advance clinical neuroscience education in psychiatric residency training. Such propositions include further developing longitudinal and integrated curricula, tailoring teaching for diverse learner and institutional needs, incorporating effective teaching methods, and continually collaborating across parties of interest.

Virtual patient simulation in an interactive educational module on intimate partner violence: nursing students' experiences-a mixed-methods study

Background

Multiple studies have shown that healthcare professionals often feel uncertain about when to inquire about intimate partner violence (IPV), the appropriate methods for doing so, and how to respond to the answers. Virtual patient (VP) cases are an interactive educational tool that can be effective for learning and training clinical reasoning skills. However, there is a lack of research on the use of VP in psychiatry education. This study aimed to investigate nursing students' experiences of using a VP as part of an educational module, integrated into their foundational training on IPV during their nursing education.

Methods

The study employed a mixed-methods approach, incorporating both quantitative and qualitative data. Participants (N = 62) completed an interactive educational module on IPV, in three consecutive parts: (a) a web-based education on IPV, (b) training with a VP, and (c) a seminar for follow-up discussions.

Results

The VP platform was considered user-friendly and easy to navigate, although some participants found the instructions challenging. Participants perceived the VP as beneficial for learning about IPV and for practicing interactive patient dialogues. They appreciated the rich set of questions and the feedback provided, both by the experts in the field of IVP and by the VP itself. However, some participants noted that interacting with a VP on a screen was less emotional compared to real human interactions.

Conclusion

The interactive educational module, integrated into the regular nursing program, was positively received by the students. Overall, the VP was considered beneficial for learning about IPV, easy to navigate, and provided a valuable opportunity for practice.

Standardized patient simulation in nursing education: A bibliometric analysis and visualization from 2002 to 2024

AIM

This study employed a bibliometric analysis to examine the existing literature on the use of standardised patient simulation in nursing education.

BACKGROUND

SP simulation offers students the opportunity to directly interact with a range of nursing interventions and practices. It demonstrates that SP simulation can be used as an active learning methodology in nursing education.

DESIGN

Bibliometric and content analysis.

METHODS

The data set was obtained from the Web of Science database. The sample comprised 310 publications that fulfilled the a priori defined inclusion criteria. The data were subjected to both descriptive content analysis and bibliometric analysis. A bibliometric analysis was conducted using VOSviewer, a software program designed for the mapping and visualisation of bibliometric data.

RESULTS

A total of 198 publications were published in 2002-2024. The publications had 3042 citations. Nurse Education Today has the highest number of publications and citations. In terms of authors, Elcin was the author with the highest number of citations (n = 186). In accordance with the findings of the trend topic analysis, the keywords 'simulation', 'nursing education', 'standardised patient' and 'nursing students' emerged in the field.

CONCLUSION

The number of studies examining the efficacy of using standard patient simulators in nursing education has seen a notable increase in recent years. The findings of this study may offer researchers and nursing faculties new insights into the value of incorporating standardised patient simulation into nursing education, as well as potential applications of such an approach.

Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study

BACKGROUND

In recent years, the use of digital technology in the education of health care professionals has surged, partly driven by the COVID-19 pandemic. However, there is still a need for focused research to establish evidence of its effectiveness.

OBJECTIVE

This study aimed to define the gaps in the evidence for the efficacy of digital education and to identify priority areas where future research has the potential to contribute to our understanding and use of digital education.

METHODS

We used a 2-stage approach to identify research priorities. First, an umbrella review of the recent literature (published between 2020 and 2023) was performed to identify and build on existing work. Second, expert consensus on the priority research questions was obtained using a modified Delphi method.

RESULTS

A total of 8857 potentially relevant papers were identified. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, we included 217 papers for full review. All papers were either systematic reviews or meta-analyses. A total of 151 research recommendations were extracted from the 217 papers. These were analyzed, recategorized, and consolidated to create a final list of 63 questions. From these, a modified Delphi process with 42 experts was used to produce the top-five rated research priorities: (1) How do we measure the learning transfer from digital education into the clinical setting? (2) How can we optimize the use of artificial intelligence, machine learning, and deep learning to facilitate education and training? (3) What are the methodological requirements for high-quality rigorous studies assessing the outcomes of digital health education? (4) How does the design of digital education interventions (eg, format and modality) in health professionals' education and training curriculum affect learning outcomes? and (5) How should learning outcomes in the field of health professions' digital education be defined and standardized?

CONCLUSIONS

This review provides a prioritized list of research gaps in digital education in health care, which will be of use to researchers, educators, education providers, and funding agencies. Additional proposals are discussed regarding the next steps needed to advance this agenda, aiming to promote meaningful and practical research on the use of digital technologies and drive excellence in health care education.

Nursing Students' Perceptions and Use of Generative Artificial Intelligence in Nursing Education

Background/Objectives: Artificial intelligence (AI) is transforming nursing, with generative AI (GenAI) tools such as ChatGPT offering opportunities to enhance education through personalized learning pathways. This study aimed to explore nursing students' use of generative artificial intelligence (GenAI) and their perceptions of its use in nursing education, including its advantages, disadvantages, and perceived support needs. Methods: This study employed an online survey. The participants were 99 undergraduate nursing students in New York City. Data was collected online through self-report measures using semi-structured, open-ended questions. The data was analyzed using content analysis. Results: Most participants (92%) used GenAI tools to access accurate information, clarify nursing concepts, and support clinical tasks such as diagnoses and health assessments, as well as schoolwork, grammar checks, and health promotion. They valued GenAI as a quick, accessible resource that simplified complex information and supported learning through definitions, practice questions, and writing improvements. However, the participants noted drawbacks, such as subscription costs, over-reliance, information overload, and accuracy issues, leading to trust concerns. The participants suggested financial support, early guidance, and instructional modules to better integrate AI into nursing education. Conclusions: The results indicate that GenAI positively impacts nursing education and highlight the need for guidelines on critical evaluation. To integrate GenAI effectively, educators should consider introductory sessions, support programs, and a GenAI-friendly environment, promoting responsible AI use and preparing students for its application in nursing education.

Faculty-Led Action Research on Simulation-Based Learning: Enhancing Mental Health Nursing Competency in Undergraduate Education at a Public University in Oman

Nursing programs provide holistic education in caring for people with various health conditions, including mental health conditions. This study aimed to explore the experience of faculty regarding planning and implementing mental health simulation as a method for enhancing the mental health nursing competency training of undergraduate students. The researchers have adopted an action research design under the qualitative paradigm to find answers to the research questions. A purposive sample of nine participants, including mental health nursing faculty and simulation unit staff working in a public university in Oman were included in the study. Ethical clearance was obtained from the institutional ethics committee. Data were collected through in-depth individual interviews with the faculty. Thematic analysis was done synchronously with the steps of action research through the process of coding, categorising and organising the data into meaningful themes. Member checking was done to ensure the transparency and correctness of the themes and subthemes. Seven themes were derived from thematic analysis of the transcripts, such as 'Need for creating innovative mental health nursing learning experiences for students', 'Perceived readiness for simulation', 'Experience in developing mental health simulation', 'Arrangement of resources', 'The zeal for implementing simulation', 'Challenges in the simulation experience', and 'Gaining momentum and confidence'. A conceptual framework for simulation in mental health nursing was developed by the authors based on the findings and by referring to existing models. Faculty can effectively plan and implement simulation experiences for their students. Simulation-based training can become an effective means to make the students more confident and competent in mental health nursing. Implementation of simulation-based teaching will enhance the quality of nursing education and, thereby, the standard of mental health care in clinical settings.

Comparative Effectiveness of Mental Health Simulation Techniques in Nursing Education: A Systematic Review and Meta-Analysis

Simulation-based training in mental health is increasingly recognised as an effective tool within nursing education. This systematic review and meta-analysis aimed to evaluate the effectiveness of various simulation modalities, including standardised participants (SPs), role-plays, virtual reality (VR), mannequins and voice simulations, in improving educational outcomes for nursing students. A comprehensive literature search was conducted to identify studies evaluating the impact of mental health simulation on nursing education. Data from 62 studies were extracted and analysed. The primary outcomes included knowledge, confidence, self-efficacy, competence and anxiety. Meta-analyses assessed both pretest/posttest changes and comparisons between simulation and control groups. Pretest/posttest analyses revealed significant improvements across multiple modalities: SPs enhanced knowledge (SMD = 1.26), confidence (SMD = 1.20), self-efficacy (SMD = 0.94), attitude (SMD = 0.22), competence (SMD = 2.30) and anxiety reduction (SMD = -0.88). Role-plays demonstrated gains in knowledge (SMD = 0.87), confidence (SMD = 1.24), self-efficacy (SMD = 0.74), attitude (SMD = 0.53), competence (SMD = 0.82) and reduced anxiety (SMD = -0.73). VR improved knowledge (SMD = 0.86), self-efficacy (SMD = 0.75) and competence (SMD = 0.69). Mannequins showed no significant changes in knowledge or competence. Voice simulations improved knowledge (SMD = 0.96). Comparisons with control groups indicated that SPs significantly increased knowledge (SMD = 1.31), competence (SMD = 1.51) and reduced anxiety (SMD = -2.01). Role-plays enhanced knowledge (SMD = 1.03) compared with inactive controls; VR increased knowledge (SMD = 0.86) compared with controls. Mannequins showed no significant differences, and voice simulations lacked sufficient data for comprehensive analysis. This meta-analysis underscores the value of simulation-based training in mental health nursing education, with SPs proving particularly effective in enhancing clinical preparedness. Role-plays, VR and voice simulations offer supplementary benefits but may require integration with more interactive methods for optimal impact. Future research should prioritise high-quality randomised controlled trials, standardised simulation protocols and long-term follow-up to clarify the sustained effects of simulation training on clinical practice.

Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review

BACKGROUND

Equality, diversity and inclusion initiatives seek to embed the concept of inclusive pedagogy to promote inclusive educational environments. However, no evidence synthesis exists which examines whether and how the concept of inclusive pedagogy is addressed in online simulation-based learning in the undergraduate nursing education literature.

AIMS

To map the evidence regarding the adoption of inclusive pedagogy in online simulation-based learning in undergraduate nursing education.

DESIGN

A scoping review.

METHODS

Data were extracted, synthesized and presented in narrative and table format.

DATA SOURCES

A systematic search of five databases and five sources of grey literature was conducted to search literature published between 1st January 2010 to 1st June 2022.

RESULTS

Thirty-eight papers published between 2011 and 2022 were included. The results are presented under three identified themes: (1) Learner diversity; (2) Theoretical frameworks promoting equality, diversity and inclusion in online simulation and (3) Online simulation feedback.

CONCLUSION

Inclusive pedagogy has not been considered or embedded in its entirety in online simulation in undergraduate nursing education literature.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Utilizing an inclusive pedagogy framework may prove advantageous in generating inclusive teaching approaches to support all students.

IMPACT

This review will interest educators and managers that wish to incorporate equality, diversity and inclusion initiatives in nursing education.

REPORTING METHOD

This scoping review has adhered to the EQUATOR guidelines: the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Partnering with Persons Living with Bipolar Disorder to Develop an Authentic Virtual Simulation

Nursing students, faculty, and community partners report a gap in the preparation of nurses to work collaboratively with persons living with mental health conditions in a variety of healthcare settings. Engaging the expertise from lived experience within undergraduate nursing education promotes a holistic approach to care that aligns with clients' real-world needs. This paper describes the steps we followed to create a virtual simulation in partnership with persons living with mental health conditions. In 4 months, a team with diverse expertise worked together to develop an open-access virtual simulation module. The process resulted in a quality product that was worth the time invested. Of importance to our team, this development project resulted in a meaningful and authentic person-centred simulation. This virtual simulation is a tool to provide scalable and meaningful experiential learning in a safe environment for students and nurses.

Using Virtual Reality in Mental Health Nursing to Improve Behavioral Health Equity

Nursing students often experience anxiety, stress, and fear during a clinical rotation in a mental health setting due to stressors and biases toward the setting as well as lack experience in caring for patients with mental health conditions. One in four people worldwide suffers from a mental disorder; therefore, it is critical that nurses feel confident interacting with these patients to provide equitable care. Undergraduate training is a critical period for changing students' attitudes toward this population. This study's goal was twofold. First, we offered students' exposure to common behaviors and symptoms displayed by a patient with mental illness through an engaging and immersive virtual reality simulation experience before taking care of patients in a clinical setting. Second, we aimed to determine if a virtual reality simulation will change students' attitude and stigma, favorably, toward patients with mental health conditions. We used a mixed-method comparative analysis to collect information and identify themes on undergraduate students' attitudes and stigma toward patients with mental health conditions. Our findings demonstrate that virtual reality simulations enhance awareness and sensitivity to the situations of others (empathy) while improving their communication skills. The use of virtual reality in a baccalaureate curriculum deepens the understanding of health equity in behavioral health for nursing students.

Harnessing Innovative Technologies to Train Nurses in Suicide Safety Planning With Hospital Patients: Formative Acceptability Evaluation of an eLearning Continuing Education Training

BACKGROUND

Suicide is the 12th leading cause of death in the United States. Health care provider training is a top research priority identified by the National Action Alliance for Suicide Prevention; however, evidence-based approaches that target skill building are resource intensive and difficult to implement. Novel computer technologies harnessing artificial intelligence are now available, which hold promise for increasing the feasibility of providing trainees opportunities across a range of continuing education contexts to engage in skills practice with constructive feedback on performance.

OBJECTIVE

This pilot study aims to evaluate the feasibility and acceptability of an eLearning training in suicide safety planning among nurses serving patients admitted to a US level 1 trauma center for acute or intensive care. The training included a didactic portion with demonstration, practice of microcounseling skills with a web-based virtual patient (Client Bot Emily), role-play with a patient actor, and automated coding and feedback on general counseling skills based on the role-play via a web-based platform (Lyssn Advisor). Secondarily, we examined learning outcomes of knowledge, confidence, and skills in suicide safety planning descriptively.

METHODS

Acute and intensive care nurses were recruited between November 1, 2021, and May 31, 2022, to participate in a formative evaluation using pretraining, posttraining, and 6-month follow-up surveys, as well as observation of the nurses' performance in delivering suicide safety planning via standardized patient role-plays over 6 months and rated using the Safety Plan Intervention Rating Scale. Nurses completed the System Usability Scale after interacting with Client Bot Emily and reviewing general counseling scores based on their role-play via Lyssn Advisor.

RESULTS

A total of 18 nurses participated in the study; the majority identified as female (n=17, 94%) and White (n=13, 72%). Of the 17 nurses who started the training, 82% (n=14) completed it. On average, the System Usability Scale score for Client Bot Emily was 70.3 (SD 19.7) and for Lyssn Advisor was 65.4 (SD 16.3). On average, nurses endorsed a good bit of knowledge (mean 3.1, SD 0.5) and confidence (mean 2.9, SD 0.5) after the training. After completing the training, none of the nurses scored above the expert-derived cutoff for proficiency on the Safety Plan Intervention Rating Scale (≥14); however, on average, nurses were above the cutoffs for general counseling skills per Lyssn Advisor (empathy: mean 4.1, SD 0.6; collaboration: mean 3.6, SD 0.7).

CONCLUSIONS

Findings suggest the completion of the training activities and use of novel technologies within this context are feasible. Technologic modifications may enhance the training acceptability and utility, such as increasing the virtual patient conversational abilities and adding automated coding capability for specific suicide safety planning skills.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/33695.

The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers: A Double-Blind, Randomized, Controlled Single-Center Study

This study aimed to investigate the effect of simulation-based training on hand hygiene knowledge and practices among palliative caregivers. The study was conducted with 60 caregivers in a palliative care clinic between December 2022 and September 2023. The participants were divided into two groups by simple randomization. The intervention and control groups received the same hand hygiene theoretical education and demonstration. The intervention group also received additional simulation-based hand hygiene practices recommended by the World Health Organization. A pretest-posttest design was used to assess hand hygiene knowledge and practices. Data were collected with personal information, hand hygiene knowledge, and hand hygiene practice forms. Analysis of covariance was performed to compare posttest scores between the groups. Simulation-based hand hygiene training programs offer an effective and feasible strategy to improve the hand hygiene knowledge and practices of caregivers. It should be integrated into clinical areas to increase palliative caregivers' hand hygiene knowledge and practices. Evidence-based practices can be improved by increasing randomized controlled studies on the effectiveness of simulation-based hand hygiene training for caregivers. Trial Registration: The study was registered at ClinicalTrials.gov with registration number NCT05848596.

Training approaches for the dissemination of clinical guidelines for NSSI: a quasi-experimental trial

BACKGROUND

Non-suicidal self-injury (NSSI) is of high clinical relevance due to its high prevalence and negative long-term implications. In 2016, the German consensus-based clinical guidelines for diagnostic, assessment and treatment of NSSI in childhood and adolescence were published. However, research indicates that clinical guidelines are often poorly implemented in clinical practice. One crucial part of this process is the training of healthcare professionals to transfer knowledge and capacities to bring guideline recommendations into clinical practice.

METHODS

The effect of three different dissemination strategies (printed educational material, e-learning, and blended-learning) on the NSSI guidelines´ recommendations was examined among 671 physicians and psychotherapists via an online-survey. The quasi-experimental study included three measurement points (before the training, after the training, 3-month follow-up) and mixed effects models were used to test for changes in knowledge, competences and attitudes toward NSSI and treatment. Moreover, the transfer of gained competences to practical work and user satisfaction were reviewed.

RESULTS

With all three training formats, the intended changes of the outcome variables could be observed. Hereby, the printed educational material condition showed the lowest improvement in the scores for the 'negative attitudes toward NSSI and those who self-injure'. The training effect remained stable throughout the follow-up measurement. The highest application rate of acquired intervention techniques in clinical practice was reported for the blended-learning condition. For all three training strategies, user satisfaction was high and evaluation of training quality was positive, with printed educational material receiving the lowest and blended-learning the highest evaluations.

CONCLUSIONS

In summary, all three training formats were perceived to be of high quality and seem to be suited to cover the needs of a heterogeneous group of physicians and psychotherapists. The choice of training method could be driven by considering which training goals are desired to be achieved and by the benefit-cost ratio allowing for tailored training approaches.

Exploring Undergraduate Nursing Students' Preferences in Psychiatric Nursing Simulation Modalities

BACKGROUND

The use of high-fidelity simulators (manikins) and standardized patients (SPs) in simulation has been incorporated into many nursing schools throughout the nation to augment the clinical rotation experience. There is little to no data available on comparing undergraduate students' preferences between SPs and manikins in psychiatric nursing.

METHODS

A quantitative descriptive exploratory design was used to evaluate pre-licensure nursing students' preferences in both traditional 4-year Bachelor of Science in Nursing (BSN) and accelerated BSN programs (ABSN).

RESULTS

Overall, students preferred having an SP over a manikin to learn how to properly perform a nursing assessment on a psychiatric patient.

CONCLUSIONS

Standardized patients offer a more realistic experience when assessing various domains of the mental status examination and when practicing therapeutic communication techniques in psychiatric nursing. The growth of SP training programs should be fostered. Well-trained SPs are an asset to simulation, especially in psychiatric nursing.

Effects of Immersive Technology-Based Education for Undergraduate Nursing Students: Systematic Review and Meta-Analysis Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Approach

BACKGROUND

The adoption of immersive technology in simulation-based nursing education has grown significantly, offering a solution to resource limitations and enabling safe access to clinical environments. Despite its advantages, there are still diverse reports regarding the effectiveness of immersive technology. It is crucial to verify the effectiveness of immersive technology in nursing education to inform future educational programs.

OBJECTIVE

This systematic review aimed to identify the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods.

METHODS

A literature search was performed using 4 databases: PubMed, CINAHL, Embase, and Web of Science; the latest search was completed on January 19, 2023. The inclusion criteria were as follows: participants were undergraduate nursing students; studies were published in Korean or English; designs included randomized controlled trials (RCTs) or nonrandomized studies; and interventions involved virtual reality (VR), augmented reality (AR), mixed reality, or extended reality. Quality assessment was conducted using Cochrane Risk-of-Bias Tool version 2 for RCTs and the Risk-of-Bias Assessment Tool for Nonrandomized Studies. The main outcomes of the included studies were classified according to the New World Kirkpatrick Model (NWKM), ranging from level 1 (reaction) to level 4 (results). Meta-analysis was conducted using RevMan 5.4 software, and subgroup analysis was conducted due to heterogeneity of the results of the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was adopted for assessing certainty and synthesizing results of the relevant literature.

RESULTS

A total of 23 studies were included, with participant numbers ranging from 33 to 289. Of these, 19 (82.6%) studies adopted VR to simulate various nursing scenarios, including disaster training, resuscitation, health assessments, and home health care; 4 (17.4%) studies used AR technologies; and 15 (65.2%) studies involved virtual patients in their scenarios. Based on the NWKM, the main outcome variables were classified as level 1 (usability and satisfaction), level 2 (knowledge, motivation, confidence, performance, attitude, and self-efficacy), and level 3 (clinical reasoning); level 4 outcomes were not found in the selected studies. Results of the subgroup analysis showed that immersive technology-based nursing education is more effective than traditional education in knowledge attainment (standard mean difference [SMD]=0.59, 95% CI 0.28-0.90, P<.001, I2=49%). Additionally, there were significant difference differences between the experimental and control group in confidence (SMD=0.70, 95% CI 0.05-1.35, P=.03, I2=82%) and self-efficacy (SMD=0.86, 95% CI 0.42-1.30, P<.001, I2=63%).

CONCLUSIONS

These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies be conducted to evaluate the effects of immersive technology-based nursing education on NWKM level 4.

Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study

AIM

To evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice.

METHOD

A pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient).

RESULTS

The Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The "Home Visits" assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it.

CONCLUSION

The ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

The effectiveness of virtual reality technology in student nurse education: A systematic review and meta-analysis

AIM

The purpose of this study was to analyze the effectiveness of virtual reality technology in nursing education.

BACKGROUND

Virtual reality technology is regarded as one of the advanced and significant instructional tools in contemporary education. However, its effectiveness in nursing education remains a subject of debate, and there is currently limited comprehensive research discussing the impact of varying degrees of virtual technology on the educational effectiveness of nursing students.

DESIGN

Systematic review and meta-analysis.

METHODS

The present systematic review and meta-analysis were applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The PubMed, Embase, CINAHL, ProQuest, Cochrane Library, Web of Science, and Scopus were searched for relevant articles in the English language. The methodologies of the studies evaluated were assessed using Cochrane Risk of Bias2 (ROB 2) tool and Joanna Briggs Institute (JBI) assessment tool. We took the learning satisfaction, knowledge, and skill performance of nursing students as the primary outcomes, and nursing students' self-efficacy, learning motivation, cognitive load, clinical reasoning, and communication ability were assessment as secondary outcomes. The meta-analysis was performed using R 4.3.2 software according to PRISMA guidelines. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95 % confidence intervals (CIs) were used as effective indicators.

RESULTS

Twenty-six studies were reviewed, which involved 1815 nursing students. The results showed that virtual reality teaching, especially immersive virtual reality, was effective in improving nursing students' learning satisfaction (SMD: 0.82, 95%CI: 0.53-1.11, P < 0.001), knowledge (SMD: 0.56, 95%CI: 0.34-0.77, P < 0.001), skill performance (SMD: 1.13, 95 % CI: 0.68-1.57, P < 0.001), and self-efficacy (SMD: 0.64, 95%CI: 0.21,1.07, P < 0.001) compared to traditional teaching methods. However, the effects of virtual reality technology on nursing students' motivation, cognitive load, clinical reasoning, and communication ability were not significant and require further research.

CONCLUSIONS

The results of this study show that virtual reality technology has a positive impact on nursing students. Nonetheless, it is crucial not to underestimate the effectiveness of traditional education methods, and future research could analyze the impact of different populations on nursing education while improving virtual reality technology, to more comprehensively explore how to improve the quality of nursing education. Moreover, it is imperative to emphasize the integration of virtual education interventions with real-world experiences promptly. This integration is essential for bridging the gap between the virtual learning environment and real-life scenarios effectively.

REGISTRATION NUMBER

CRD42023420497 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails).

Evaluation of the Effectiveness of Standardized Patient Simulation as a Teaching Method in Psychiatric and Mental Health Nursing

Background: The use of standardized patient simulation in psychiatric nursing education addresses the unique challenges presented by mental healthcare settings. Students' attitudes toward clinical simulation remain predominantly favorable, with many expressing enthusiasm for the opportunities it provides in terms of embracing challenges, enhancing realism, and promoting critical thinking through problem solving, decision-making, and adaptability. Methods: This quantitative study used a cross-sectional, descriptive, correlation design to investigate the effectiveness of standardized patient simulation as a teaching method in the Psychiatric and Mental Health nursing course in a university setting. A total of 84 nursing students were recruited for the convenience sample. Data were collected using a three-part questionnaire survey which included the following: a demographic data sheet, the Student Satisfaction and Self-confidence in Learning Scale, and a narrative open-ended question asking the participants to write the advantages and disadvantages of their simulation experience. Data were analyzed using the statistical software JMP pro17. Results: The total satisfaction with learning subscale score ranged between 5 and 25 with a mean score of 19.36 ± 6.32. The total self-confidence subscale score ranged between 8 and 40 with a mean score of 30.87 ± 9.1. Pearson's correlation coefficient r revealed a statistically significant positive relationship between the participants' satisfaction with the learning experience and their self-confidence (t = 0.923, p < 0.0001). Approximately 91.7% of the students recommended using simulation. The results confirmed the students' recommendations of simulation use in teaching psychiatric and mental health courses; furthermore, the results showed a statistically significant positive correlation with the total SSLS (p = 0.01) and satisfaction with learning subscale (0.003). Participants reported that authentic, practical, comfortable, and safe learning environments contributed to an enriched learning experience. Additionally, factors such as timesaving, access to information, cost-effectiveness, standardized teaching, varied exposure, skill development, and immediate feedback also enhanced the learning experience through patient simulation in psychiatric and mental health nursing. Conclusion: Simulations can contribute efficiently and positively to psychiatric and mental health nursing education in a manner that optimizes the learning experience while ensuring the consistency of student learning in a safe learning environment.

'It's not everybody's snapshot. It's just an insight into that world': A qualitative study of multiple perspectives towards understanding the mental health experience and addressing stigma in healthcare students through virtual reality

Objective

The resurgence of virtual reality (VR) technologies has led to their increased use in contemporary healthcare education. One promising application is simulating the experiences of individuals with mental health conditions (MHCs) to reduce stigma among future healthcare professionals. This study set out to explore what those impacted by, or involved in, the education of healthcare students think about using VR in this way.

Methods

One individual interview and five focus groups were conducted with healthcare students (n = 7), healthcare educators (n = 6), and lived experience experts (n = 5). Before sharing their perspectives, participants familiarised themselves with VR equipment and immersive materials simulating MHCs. The constant comparative method and thematic analysis were used to analyse the data.

Results

Participants recognised the acceptability and utility of VR for addressing mental health stigma in healthcare students, emphasising the immersive nature of this technology. However, some participants raised concerns about the limited insight VR could provide into the experiences of patients with the same MHCs and its potential emotional impact on users. Participants recommended the incorporation of interactive, realistic environments with a person-centred focus into future VR-based stigma reduction interventions while stressing the importance of providing healthcare students with opportunities for reflection and support.

Conclusions

Healthcare students, healthcare educators, and lived experience experts highlighted both advantages and barriers associated with using VR to understand the experience of patients with MHCs. Furthermore, the recommendations put forward can inform the design, content, and delivery of VR-based stigma reduction interventions in healthcare education.

Breaking the Stigma in Mental Health Nursing through High-Fidelity Simulation Training

The social stigma toward individuals with mental health problems is habitual among nursing students, which can lead to poor quality of health care services for patients with mental illnesses. The purpose of the present study was to learn about nursing students' perceptions of providing care to patients with severe mental disorders before and after participating in a simulated student clinical case. A descriptive qualitative study was conducted through 39 interviews. The difficulties expected by the students and their perceptions about patients were explored before the simulation training. Their perceptions about the use of clinical simulation for learning about the adequate management of these patients were analyzed afterwards. Results: Before the simulation training, the students assessed the case as being complicated, expressed their lack of specific training, and felt fear and insecurity, thus reproducing the stigma towards mental health patients. After this training, they positively valued the usefulness of the clinical simulation for gaining confidence and overcoming the stigma. Discussion: The use of high-fidelity simulation offers nursing students the opportunity to approach patients with mental health conditions, overcoming their fears and normalizing mental disorders. Simulation training allows nursing students to analyze the reasoning of clinical judgment and to detect the influence of previous prejudices about mental illness in their clinical decision. This study was not registered.

Innovations in teaching during the COVID-19 pandemic: comparisons of the impacts of different teaching approaches in psychiatric nursing on undergraduate nursing students

BACKGROUND

Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.

METHODS

A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.

RESULTS

The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.

CONCLUSION

This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners' task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.

Acute and intensive care nurses' perspectives on suicide prevention with medically hospitalized patients: Exploring barriers, facilitators, interests, and training opportunities

AIMS

To explore opportunities for acute and intensive care nurses to engage in suicide prevention activities with patients hospitalized for medical, surgical or traumatic injury reasons.

DESIGN

A qualitative descriptive study.

METHODS

We conducted two studies consisting of 1-h focus groups with nurses. Study 1 occurred prior to the onset of the COVID-19 pandemic during January and February of 2020 and identified barriers and facilitators of engaging in an eLearning training in suicide safety planning and engaging patients on their units in suicide safety planning. Study 2 occurred in December of 2020 and explored nurses' perspectives on their role in suicide prevention with patients on their units and training needs related to this. The research took place at an urban level 1 trauma center and safety net hospital where nurses universally screen all admitted patients for suicide risk. We conducted a rapid analysis of the focus group transcripts using a top-down, framework-driven approach to identify barriers, facilitators, strategies around barriers, and training interests mentioned.

RESULTS

Twenty-seven registered nurses participated. Nurses indicated they serve a population in need of suicide prevention and that the nursing role is an important part of suicide care. A primary barrier was having adequate uninterrupted time for suicide prevention activities and training; however, nurses identified various strategies around barriers and offered suggestions to make training successful.

CONCLUSION

Findings suggest training in suicide prevention is important for nurses in this context and there are opportunities for nurses to engage patients in interventions beyond initial screening; however, implementation will require tailoring interventions and training to accommodate nurses' workload in the hospital context.

IMPACT

Acute and intensive care nurses play a key role in the public health approach to suicide prevention. Understanding perspectives of bedside nurses is critical for guiding development and deployment of effective brief interventions.

NO PUBLIC OR PATIENT INVOLVEMENT

This study is focused on eliciting and exploring perspectives of acute and intensive care nurses.

Virtual clinical simulation to teach mental health concepts: a scoping review protocol

OBJECTIVE

The objective of this review is to determine the extent of the literature on the use of virtual clinical simulation to teach health professional students about mental health.

INTRODUCTION

Graduates of health professional programs need to be prepared to provide safe and effective care for persons with a mental illness in every practice context. Clinical placements in specialty areas are difficult to obtain and cannot ensure students will have opportunities to practice specific skills. Virtual simulation is a flexible and innovative tool that can be used in pre-registration health care education to effectively develop cognitive, communication, and psychomotor skills. Given the recent focus on virtual simulation usage, the literature will be mapped to determine what evidence exists regarding virtual clinical simulation to teach mental health concepts.

INCLUSION CRITERIA

We will include reports that focus on pre-registration health professional students and use virtual simulation to teach mental health concepts. Reports that focus on health care workers, graduate students, patient viewpoints, or other uses will be excluded.

METHOD

Four databases will be searched including MEDLINE, CINAHL, PsycINFO, and Web of Science. Reports with a focus on mental health virtual clinical simulation for health professional students will be mapped. Independent reviewers will screen titles and abstracts, then review the full texts of articles. Data from studies meeting the inclusion criteria will be presented in figures and tables, and described narratively.

REVIEW REGISTRATION NUMBER

Open Science Framework https://osf.io/r8tqh.

Standardized Patients Versus Mannequins in Mental Health Simulation

BACKGROUND

Mental health nursing simulation using various modalities can be useful in increasing student confidence, satisfaction, knowledge, and communication skills. Studies comparing the benefits of mental health nursing simulation using standardized patients versus mannequins are scarce.

AIMS

The purpose of this study was to explore differences in knowledge, clinical learning, clinical reasoning, communication, confidence, and learner satisfaction when conducting mental health nursing simulation with standardized patients compared to mannequins.

METHODS

A convenience sample of 178 senior level baccalaureate nursing students enrolled in the mental health nursing course participated in this study. Of the total sample, 41.6% (n = 74) participated in high-fidelity mannequin simulation and 58.4% (n = 104) in standardized patient simulation. Measures included a knowledge assessment, Satisfaction with Simulation Experience Scale (SSE), and a simulation evaluation survey.

RESULTS

While knowledge levels increased regardless of simulation modality, clinical reasoning, clinical learning, communication, realism, and overall rating of the simulation experience were significantly higher among participants in standardized patient simulation compared to mannequins.

CONCLUSIONS

Mental health simulations can be a useful learning tool for engaging in mental health scenarios in a safe simulated learning environment. While both mannequins and standardized patient modalities are helpful in increasing mental health nursing knowledge, standardized patient simulation has a greater impact on several other aspects including clinical reasoning and communication. Future multisite studies with larger samples are needed, including a wider variety of mental health scenarios.

The Use of Mental Health Simulation in Pharmacy Practice and Education: A Systematic Review

OBJECTIVES

To explore how mental health simulation has been used in the context of pharmacy practice and education, specifically what types of simulation techniques have been used, and which mental health-related content has been simulated.

FINDINGS

A literature search retrieved 449 reports, from which 26 articles pertaining to 23 studies were eligible for inclusion. Most studies were conducted in Australia. The most common type of simulation utilized was live simulated/standardized patient, followed by pre-recorded scenarios, role-play, and auditory simulation. While many study interventions included content relating to multiple mental illnesses and included activities other than simulation, the most simulated mental health content was enacting a person living with depression (with or without suicidal thoughts), mental health communication, followed by stress-induced insomnia, then hallucinations. Key outcomes from included studies were significantly improved student outcomes such as mental health knowledge, attitudes, social distance, and empathy scores, as well as highlighting the potential to further improve the mental healthcare skills of community pharmacists.

SUMMARY

This review demonstrates a varied use of techniques to simulate mental health in pharmacy practice and education. Future research is suggested to consider other simulation methods such as virtual reality and computer simulation, and to investigate how lesser-simulated mental health content such as psychosis could be incorporated. It is also recommended that future research provides greater detail on the development of the simulated content, such as involving people with lived experience of mental illness and mental health stakeholders in the development process to improve the authenticity of simulation training.

Simulation Versus Written Fall Prevention Education in Older Hospitalized Adults: A Randomized Controlled Study

Using a randomized controlled, non-blinded, two-group design, differences in fall risk assessment, post-discharge sustainable fall risk changes, fall events and re-hospitalization were examined in 77 older adults who received a simulation (n = 36) or written (n = 41) education intervention. Between-group differences and changes in pre- versus post-fall risk assessment scores were examined using Pearson's chi-square, Wilcoxon rank sum or Fisher's exact tests (categorical variables) and two-sample t-tests (continuous variables). There were no statistically significant differences between groups in demographic characteristics. Patients who received simulation education had higher fall risk post-assessment scores than the written education group, p = .022. Change in fall risk assessment scores (post-vs.-pre; 95% confidence intervals) were higher in the simulation group compared to the written education group, 1.43 (0.37, 2.50), p = .009. At each post-discharge assessment, fall events were numerically fewer but not significantly different among simulation and education group participants. There were no statistically significant between-group differences in re-hospitalization.

Nurse Educators' Pedagogical Approaches Addressing Student Nurses' Mental Health Care Competence: A Qualitative Study

Nurses' mental health care competence is vital for addressing the current mental health care crisis' demand for quality in mental health care and services. These challenges also involve educational institutions. In the mental health course of the bachelor's nursing curriculum, nurse educators face multiple tasks and challenges concerning preparing students for their clinical placement. This study aimed to explore and describe nurse educators' pedagogical approaches across three universities. The study applied a qualitative and descriptive design, and data were collected from individual qualitative interviews with 13 experienced nurse educators. A content analysis approach in lines with Graneheim and Lundman was used to analyse the data. The content analysis resulted in one theme and three categories, and each category was characterised by three subcategories. The theme intentionally preparing student nurses for mental health care competence served as an overarching theme describing the educators' overall reflections and descriptions. The three categories were: activating students for the mental health context; caring for students on a personal level; and supporting students in grasping the scope of nursing within the mental health context. These categories described the varieties and complexity of nurse educators' pedagogical approaches addressing student nurses' mental health care competence.

Evaluation of an Online Learning Concept for Nursing Students in Caring for Patients with Dementia: Results of a Questionnaire Survey

BACKGROUND

Nurses have key roles in caring for patients with dementia. To prepare them for demand-oriented nursing care, there is a need for education. An online course with a focus on healthcare needs assessment was designed.

METHODS

A quantitative study with a qualitative component using questionnaire-based interviews was implemented. The recruitment of students used the following inclusion criteria: (a) second-year students, and (b) absent from less than three lectures. Overall, n = 48 met the inclusion criteria. Twenty-eight students participated. Quantitative data were analyzed using descriptive statistics. Qualitative data were evaluated using Kuckartz's content analysis with the software MAXQDA.

RESULTS

Nursing students judged the overall course structure as very good (M 1.36, SD 0.48). The learning aims were clearly defined (M 1.61, SD 0.68) and the learning content was adequately demonstrated (M 1.68, SD 0.67). The exercise on geriatric assessment promoted the internal learning process (M 1.67, SD 1.00). The online simulation training made the lectures' contents easier to understand (M 1.86, SD 0.89). Correlations were determined, among others, between the course structure and the clear definitions of the learning aims (r^Sp 0.566, p = 0.002).

CONCLUSIONS

The study describes the feasibility of the online course. To identify the impact on patients' health and caregivers' lives, further studies are needed.

An innovation on clinical placement for occupational therapy mental health during the COVID-19: A mixed-methods feasibility study

The COVID-19 pandemic altered the health profession's education. Educational activities were shifted to online, and clinical placements were compromised in certain countries. A mixed-methods study included 17 undergraduates undergoing a mental health placement. The first 3 weeks of clinical placement applied online case-based learning in written and in video format. The last 2 weeks involved hybrid remote and physical onsite clinical placement. SPICES model utilizing various active learning activities, case studies and client attendance, facilitator engagement, discussion and feedback were implemented. A self-administered System Usability Scale (SUS), e-learning preference level, focus group discussion, and reflective writing was conducted at the end of each week and the students' final marks were compared with the past cohort who attended conventional physical clinical placement. Two-way mixed ANOVA indicates no significant interaction was found on the SUS (p = 0.062, ηp2 = 0.062) and preference scores (p = 0.285, ηp2 = 0.079) according to week and practical site. There was no significant difference in the final mark among the online and onsite placement of the current cohort (p = 0.350, d = 0.47). The current cohort reported better marks than the previous cohort who attended conventional placement (p = 0.006, d = 0.99). Qualitative findings show positive responses where online activities have minimal restriction on the learning process. This innovative approach is acceptable for substituting conventional clinical learning during this restricted situation.

Mapping the research hotspots and theme trends of simulation in nursing education: A bibliometric analysis from 2005 to 2019

BACKGROUND

Simulation-based nursing training has been used incorporated into nursing education for decades, however, there is limited information related to simulation research hotspots and theme trends over time.

OBJECTIVES

To investigate the research hotspots and theme trends of simulation in nursing education through bibliometric analysis.

METHODS

Relevant articles on simulation in nursing education published between 2005 and 2019 were retrieved from PubMed. The Bibliographic Item Co-occurrence Matrix Builder (BICOMB) was used to extract and quantitatively analyze the Medical Subject Headings (MeSH) terms and subheadings. The biclustering analysis was conducted using gCluto1.0 to identify the research hotspots. A strategic diagram was employed to reveal the development trend of the theme.

RESULTS

A total of 4102 publications were retrieved from PubMed showing an overall increasing trend. Based on the results, the United States was the most productive country (2868,55.7 %), the journal Nurse Education Today journal was the top journal concerning this field, and Cooper SJ and Holtschneider ME were authors with the highest number of publications on this topic. Quantitative and co-word biclustering analyses were used in this study. The research hotspots in recent 5 years were focused on: (1) interprofessional simulation in patient-care teams; (2) patient simulation in psychiatric nursing education; (3) virtual reality simulation (VRS) in midwifery and nursing education; (4) simulation in critical care nurses' continuing education/training, and (5) simulation in pediatric resuscitation education. The strategic diagram showed that the VRS in midwifery and nursing education might have a significant potential to become an emerging hotspot soon.

CONCLUSION

The research literature production of simulation in nursing education was increasing over the past 15 years. Through co-word biclustering analysis, five research hotspots were identified. Among them, simulation in psychiatric education and critical care continuing education had a central priority that researchers should pay further attention to, and VRS could be the major trend for future study. Furthermore, this study described the overall range of research interests and provided ideas for innovative and efficient research projects.