Abstract:

Introduction:
Although the number of suicides in Finland has decreased relatively steadily since 1990, the suicide mortality rate, especially among young people, is still high compared to European standards. Suicidality often goes unrecognized in health care, because the issue is not discussed due to lack of competence. Good education is essential to prevent suicide deaths: suicide prevention work would become more systematic than it is now, if it was clearly reflected in health education curricula and more attention was paid to teaching methodologies. This paper presents a simulation teaching methodology as collaborative and problem-based learning in university of applied sciences education when teaching nursing students how to help people with suicidal thoughts.

Methodology:
The innovation was implemented at Laurea University of Applied Sciences in the City of Vantaa, Finland. Simulation as a teaching methodology in this study unit was developed in 2019-2022. A total of approximately 200 Finnish-speaking and 40 English-speaking the third-year nursing students participated in the simulation teaching every year. The goals of the simulation were, that the students were able to
1) encounter a patient who has attempted suicide,
2) evaluate and make decisions about the patient's mental health status and refer to appropriate follow-up care,
3) take into account the relatives of a patient and
4) act more confidently in challenging interaction situations.

The simulation teaching began with a lecture on how to assess the risk of self-harm and suicide and how to encounter suicidal person. The goals of the simulation and the simulation case were presented to the students. The students chose a role for themselves in the simulation and some of the students were assigned the role of an observer. After preparation for the simulation, the students acted out an encounter with a patient who had attempted suicide. Observers watched the simulation in another room via video link. Observers evaluated how the interview and assessment of a patient who attempted suicide took place and how the implementation of interaction (verbal and non-verbal communication) and dialogue succeeded in the situation between the staff and the patient. Each student got the opportunity to share their experiences and observations in the feedback session after the simulation, e.g. what went well, what could have been done differently and what was learned.

Results:
Feedback was asked related to study unit’s goals. According to the students' feedback, after the simulation teaching, they dare to talk more about suicidal thoughts with patients, and they got a realistic picture of healthcare practices. Simulation teaching was a good place to safely practice a difficult subject in advance without having to worry about actual consequences. It made the theoretical material more realistic and understandable.

Conclusions:
Simulation teaching has characteristics that have the potential to support skills needed when helping suicidal people. A planned feedback session is an important part of a simulation teaching that enriches learning and contributes to the consistency of the simulation-based experiences for students and teachers.

Keywords:

Simulation, Problem-Based Learning, Nursing education, University of Applied Sciences.