Abstract:

“Simulation offers many opportunities for the development of skills, knowledge and behaviours for students and clinicians working in mental health settings […] [and can] address the challenges related to stigma, safety, and liability” (Brown, 2008). Within clinical education, there is a growing use of simulation-based learning to expand learners’ appreciation of the personal experiences of patients and families living with mental health difficulties. This approach enables the learner to develop a broad but intimate understanding of some of the conditions that affect the most basic activities of daily life. Contemporary nurse education in the UK faces the additional pressure of facilitating continuous learning despite significant disruption to clinical placement opportunities as a result of the Covid-19 Pandemic. As a result, the implementation of high fidelity, highly immersive simulation-based learning opportunities has never been more relevant (hee.nhs.uk, NMC cited,2021).

Led by mental health nursing faculty and supported by the Director of Simulation in the colleges of medicine, health, and life sciences at Swansea University, a simulation project was undertaken with 34 first-year students in response to a significant shortfall in placement availability within local health boards. The dual aim of the experiential learning sessions was to determine the value of immersive SBL following a structured approach to design. and to enhance the novice learners’ understanding of auditory hallucinations (specifically hearing voices) and their empathy towards individuals who hear voices. Secondary goals included challenging stigma associated with hearing voices and the misconception that the presence of auditory hallucinations must signify severe psychotic illness.

Method:
With the knowledge that SBE has been effective in teaching mental health auditory hallucination scenarios (Hyun & Wojnar, 2019), and using Kerns 6 Steps to curriculum design structure, the presentation will review how the simulations were designed to enhance these learners’ insight into the lived experience of their future patients, thereby amplifying their empathy.
To facilitate this, the MH faculty pre-recorded a range of benign voice options – from the disinterested to the absurd - which were delivered to the individual student wirelessly via a discrete Bluetooth earpiece. This technology maintained the level of fidelity within the group exercise and enabled the student group to undergo a variety of experiences. A pre-brief, core scenario and debrief - including a take to practice focus - were adopted as part of these simulation sessions. Faculty maintained learner psychological safety through pre-brief/guided debriefs and by ensuring an extra faculty member, was on hand to support any students experiencing distress from the session. The presentation will highlight the methods, tools and strategies undertaken to achieve the learning objectives, immersion, and fidelity within a university setting.

Results:
The presenters will discuss the results of post-event evaluations, placement outcomes and the “take to practice” discussions. The team will highlight the impact of the results, including learner statements on how the simulation would affect their behaviour in the future. The results section will also include observations from the participating faculty and their thoughts on adopting this educational modality for future MH modules.

Keywords:

Simulation, Nursing education, Mental Health, Immersive Learning.