Standardized Patient Simulation Research Articles

Effects of Standardized Patient Simulation and Mobile Applications on Nursing Students' Clinical Competence, Self-Efficacy, and Cultural Competence: A Quasi-Experimental Study.

Simulation-based education has emerged as an effective approach in nursing education worldwide. We aimed to evaluate the effectiveness of a surgical nursing education program based on a simulation using standardized patients and mobile applications among nursing students. A mixed-methods design with a quasi-experimental longitudinal approach and focus group interviews was employed. The data were collected from 130 third-year nursing students at three different time points who were equally divided into experimental and control groups. This study measured the level of clinical surgical nursing competence, self-efficacy in clinical performance, cultural competence, and satisfaction with simulation experience. Four focus group interviews were conducted using open-ended questions to explore the participants' perspectives on the course's efficacy and satisfaction. There were statistically significant differences in clinical surgical nursing competence (F = 8.68, p < 0.001), self-efficacy in clinical performance (F = 13.56, p < 0.001), and cultural competence (F = 10.35, p < 0.001) across time between the intervention and control groups. Student satisfaction with the simulation-based training was high, particularly regarding debriefing and reflection, with an overall mean satisfaction level of 4.25 (0.40). Students' perspectives regarding integrated hybrid training are categorized into three themes: educational achievement, dynamic learning experiences, and satisfaction and suggestion. Simulation-based learning provides a dynamic and immersive educational experience that enables undergraduate nursing students to develop and refine essential clinical skills while also fostering confidence and cultural competence.

How to HEEAL: A Patient and Peer-Centric Simulation Curriculum for Medical Error Disclosure.

Medical errors are an unfortunate certainty with emotional and psychological consequences for patients and health care providers. No standardized medical curriculum on how to disclose medical errors to patients or peers exists. The novel HEEAL (honesty/empathy/education/apology-awareness/lessen chance for future errors) curriculum addresses this gap in medical education through a multimodality workshop. This 6-hour, two-part curriculum incorporated didactic and standardized patient (SP) simulation education with rapid cycle deliberate practice (RCDP). The morning focused on provider-patient error disclosure; the afternoon applied the same principles to provider-provider (peer) discussion. Summative simulations with SPs evaluated learners' skill baseline and improvement. Formative simulations run by expert simulation educators used RCDP to provide real-time feedback and opportunities for adjustment. Medical knowledge was measured through pre- and postintervention multiple-choice questions. Learners' confidence and attitude towards medical errors disclosure were surveyed pre- and postintervention with assistance of the Barriers to Error Disclosure Assessment tool, revised with the addition of several questions related to provider-provider disclosure. Fourteen medical students participated in this pilot curriculum. Statistical significance was demonstrated in medical knowledge (p = .01), peer-disclosure skills (p = .001), and confidence in medical error disclosure (p < .001). Although there was improvement in patient-disclosure skills, this did not reach statistical significance (p = .05). This curriculum addresses the need for designated training in medical error disclosure. Learners gained knowledge, skills, and confidence in medical error disclosure. We recommend this curriculum for medical students preparing for transition to residency.

Hyperventilation During Manual Ventilation Can Be Reduced Using a Novel Ventilator but Not With Education Interventions.

Traumatic brain injury (TBI) is the leading cause of combat casualties in modern war with an estimated 20% of casualties experiencing head injury. Since the release of the Brain Trauma Foundation's Guidelines for the Management of Severe Traumatic Brain Injury in 1995, recommendations for management of TBI have included the avoidance of routine hyperventilation. However, both published and anecdotal data suggest that many patients with TBI are inappropriately ventilated during transport, thereby increasing the risk of morbidity and mortality from secondary brain injury. Enlisted Air Force personnel with prior emergency medical technician training completing a 3-week trauma course were evaluated on their ability to provide manual ventilation. Participants provided manual ventilation using either an in-situ endotracheal tube (ETT) or standard face mask on a standardized simulated patient manikin with TBI on the first and last days of the course. Manual ventilation was provided via a standard manual ventilator and a novel manual ventilator designed to limit tidal volume (VT) and respiratory rate (RR). Participants were given didactic and hands-on training on the third day of the course. Half of the participants were given simulator feedback during the hands-on training. All students provided 2 minutes of manual ventilation with each respirator. Data were collected on the breath-to-breath RR, VT, and peak airway pressures generated by the participant for each trial and were averaged for each trial. A minute ventilation (MV) was then derived from the calculated RR and VT. One hundred fifty-six personnel in the trauma course were evaluated in this study. Significant differences were found in the participant's performance with manual ventilation with the novel compared to the traditional ventilator. Before training, MV with the novel ventilator was less than with the traditional ventilator by 2.1 ± 0.4 L/min (P = .0003) and 1.6 ± 0.5 L/min (P = .0489) via ETT and face mask, respectively. This effect persisted after training with a difference between the devices of 1.8 ± 0.4 L/min (P = .0069) via ETT. Both traditional education interventions (didactics with hands-on training) and simulator-based feedback did not make a significant difference in participant's performance in delivering MV. The use of a novel ventilator that limits RR and VT may be useful in preventing hyperventilation in TBI patients. Didactic education and simulator-based feedback training may not have significant impact on improving ventilation practices in prehospital providers.

Improving Adolescent Psychosocial Assessment through Standardized Patient Simulation: An Interdisciplinary Quality Improvement Initiative.

Adolescent suicide and mental illness have increased at alarming rates. Healthcare professionals report a lack of skill and confidence in obtaining adolescent histories and managing confidential care due to limited training in residency. Nursing professional development practitioners face challenges of adequately preparing interdisciplinary healthcare providers to assess, identify, and intervene at all points of contact with adolescents. To increase the confidence in clinical communication skills and clinical competency, and to increase the number of social work referrals related to modifiable risk factors for adolescent patients, a Texas pediatric tertiary care center utilized standardized patient (SP) methodology to supplement traditional clinical experiences with communication-focused education based on the Home, Education, Eating, Activities, Drugs, Sexuality, Suicidality, and Safety (HEEADSSS) interviewing. This quality improvement (QI) pilot demonstrated the benefits of utilizing standardized patient methodology in communication-focused education based on the HEEADSSS interviewing. Following the SP simulations, confidence in clinical communication skills increased by 13%, clinical competency in performing comprehensive psychosocial interviews increased by 11%, use of HEEADSSS increased by 64%, and social work referrals increased by 89%. This interdisciplinary SP interviewing simulation pilot was beneficial in improving the 36 physician and nursing residents' ability to conduct psychosocial assessments for risk factors of suicidality among adolescents.

(121) Utilizing ChatGPT for Urology Trainee Simulation of Peyronie’s Disease Counseling

Abstract Introduction Peyronie’s disease is a medical issue with significant psychological overtones. However, trainee exposure to initial counseling and management can be limited and therefore understanding both the disease state and its psychological effects can be difficult to master. Institutions have incorporated simulation-based education to augment resident skills and knowledge in topics such as transgender health and SICU patient management. The gold standard of assessing trainees in simulated clinical interaction has been objective structured clinical examinations (OSCE). However, novel AI-based technologies like ChatGPT offer a promising alternative for resident education and assessment. ChatGPT, developed by OpenAI, utilizes natural language processing technology to provide human-like responses to open-ended questions posed by users. Preliminary reports have already described its use in training emergency medicine residents in delivering bad news. Objective To simulate a realistic clinical scenario utilizing ChatGPT to improve resident and student confidence in Peyronie’s disease evaluation and treatment, and to assess ChatGPT’s ability to deliver actionable feedback to trainees on both knowledge base and patient interaction compared to evaluation by a sexual medicine specialist. Methods ChatGPT Plus was utilized to roleplay the patient in an initial consultation for Peyronie’s disease. A detailed input was composed to establish the rules of the simulation (Figure 1). ChatGPT was prompted to conduct a final assessment of trainee performance with standardized scales in accuracy, comprehensiveness, and empathy (A, C, E). ChatGPT was prompted to use the 2015 AUA Peyronie’s Disease Diagnosis and Treatment Guidelines when formulating its assessment and feedback. Three trainees with different experience levels performed the simulation. At completion, a fellowship-trained sexual medicine specialist separately graded each trainee’s performance using the same scale. Cohen’s kappa was calculated to assess inter-rater reliability. Results Three urology trainees performed the simulation: a 3rd year medical student, a PGY2 resident, and a PGY4 resident. Trainee performance scores are shown in Table 1. Mean ChatGPT ratings were 8.7, 8.0, and 9.0 (A, C, E), while andrologists ratings were 7.0, 4.7, and 6.3 (A, C, E). Progressive improvement was demonstrated as trainee experience increased. ChatGPT generally rated trainees at higher competency levels than andrologists. Cohen’s kappa was calculated to be -0.125, -0.125, and 0.0 (A, C, E), indicating an overall low level of agreement between ChatGPT and andrologists assessment of trainees. Conclusions Our findings demonstrate that ChatGPT has potential to be a successful tool for urology resident and medical student education on Peyronie’s disease counseling. However, there was disagreement in trainee ratings between ChatGPT and the sexual medicine specialist. ChatGPT provided trainees constructive, actionable feedback referencing current guidelines (Figure 2). When given defined parameters for a clinical scenario, ChatGPT can be effective in designing a realistic standardized patient simulation. However, ChatGPT has not appeared to master the competency and accuracy of that expected from a sexual medicine specialist. Tweaking the initial input can allow for testing competency in various alternative clinical vignettes. Further collection of real-world data is needed to better assess ChatGPT’s rating of the learner’s performance, ideally in conjunction with national/international guidelines. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow, Posterity Health, Coloplast, Hims, Genentech.

Implementation of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education.

Background: Communication and interpersonal skills are essential medical components of oncology patient care. Patients and families rely on physicians for treatment, expertise, guidance, hope, meaning, and compassion throughout a life-threatening illness. A provider's inability to empathize with patients is linked to physician-related fatigue and burnout. Because oncology training programs focus on teaching evidence-based medicine and clinical acumen, little time may be dedicated to professional development and acquisition of interactive skills. Traditional communication courses typically include two components: formal, knowledge-based learning skills, which are gained from didactic lectures, and role-playing, which usually occurs in small groups. We report the implementation of a novel longitudinal communication curriculum for trainees in Oncology. Materials and Methods: At a single-center institution, an innovative communication curriculum titled "REFLECT" (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) was implemented for radiation oncology residents and medical oncology fellows to improve and refine physician/patient interactions. All oncology specialty residents and fellows were eligible to participate in this communication curriculum. The curriculum emphasized a reflective process to guide trainees through challenging scenarios. Results: Since October 2018, this comprehensive course consisted of quarterly (four hour) workshops comprising assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. The curriculum provided longitudinal communication training integrated with the learners' daily physician/patient encounters rather than occasional isolated experiences. Fifteen workshops have been completed. Each focused on navigating challenging situations with patients, loved ones, or colleagues. Conclusions: Future directions of the curriculum will entail improving the communication skills of oncology trainees and gathering communication improvement data to assess the program's success formally.

Beyond multiple choice: Clinical simulation as a rigorous and inclusive method for assessing genetic counseling competencies.

Educational use of clinical simulation is a way for students to immerse themselves within a realistic yet safe and structured environment as they practice clinical skills. It is widely used in healthcare training and evaluation, and there are best practices for design, implementation, debriefing, and assessment. An increasing number of genetic counseling graduate programs use simulation in various ways, ranging from role-plays to working with professional simulated/standardized patient (SP) actors. At this time, there is very little consistency across programs, research on the approaches, and standards by which simulation is incorporated into training. Simulation is an understudied but promising approach for genetic counselor (GC) education and assessment. After graduation, GCs demonstrate their competence as entry-level providers through American Board of Genetic Counseling (ABGC) multiple-choice examination (MCE), along with their participatory clinical encounters from graduate training. Data from genetic counseling and other professions highlight the limitations and biases of MCEs, suggesting they not only fail to accurately capture competency, but also that they disadvantage underrepresented individuals from entering the field. In addition, MCEs are limited as a tool for assessing nuanced counseling and communication skills, as compared to more quantitative scientific knowledge. We propose that innovative, evidence-based approaches such as simulation have the potential to not only enhance learning, but also to allow GCs to better demonstrate competency during training and in relation to the board examination. Collaborative approaches, research, and funding are needed to further explore the viability of routinely incorporating simulation into GC training and assessment.

767. Impact of Standardized Patient Simulation on Pharmacy Students' Confidence and Perceptions in Community-Acquired Bacterial Meningitis Management

Abstract Background Limited data describes the use of standardized patient simulation (SPS) for infectious disease (ID) education, particularly among pharmacy students. We sought to assess the impact of SPS on pharmacy students’ knowledge and confidence of community-acquired bacterial meningitis (CABM), and to evaluate students’ perceptions of SPS. Methods This single-center, cross-sectional, voluntary, anonymous survey was conducted among second-year Doctor of Pharmacy students (n=69). CABM education was initially delivered via didactic, large classroom instruction, which occurred 1.5 weeks prior to the SPS. The pre-SPS survey asked students to assess their confidence in CABM. The confidence questions focused on pathophysiology, microbiology, clinical presentation, diagnosis, and empiric/targeted management. The SPS included two group graded sections: a rounding experience focused on patient assessment, clinical presentation, and empiric management (Figure 1) followed by a microbiology lab simulation, targeted management, and duration/monitoring. A post-SPS survey was distributed, which included the same pre-survey questions and questions related to perceptions of SPS. All survey confidence and perception questions were evaluated using a Likert scale from strongly disagree (1) to strongly agree (5). Descriptive statistics and Student’s t-test were used. Standardized Patient Simulation Rounding Experience Student group engaged in the standardized patient simulation rounding experience (all individuals pictured gave permission for the use of this picture). Results Sixty-three students fully completed the pre- and post-SPS surveys (91.3% response rate), and pre-post responses were matched. Overall mean (+SD) confidence in CABM management was significantly higher following SPS (4.3+0.5 vs. 3.5+0.7; p&amp;lt; 0.001). A statistically significant mean increase was also observed for each individual confidence item following SPS. Mean (+SD) perceptions following SPS for feeling more comfortable with patient interaction skills, preferring SPS compared to written case-based instruction, and having interest in more ID SPS were 4.2+0.8, 4.2+0.9, and 4.3+0.9, respectively. Conclusion SPS was associated with increased confidence in CABM management among pharmacy students. Students appeared to have a positive impression of SPS and are interested in future ID SPS. SPS appears to be an effective educational modality for CABM and should be assessed among other student clinicians for ID. Disclosures Wesley D. Kufel, Pharm.D., BCPS, BCIDP, AAHIVP, Merck &amp; Co.: Grant/Research Support

Methods of Teaching Transgender Health in Undergraduate Nursing Programs: A Narrative Review.

Transgender populations experience disproportionately higher rates of mental and physical health issues such as suicidality and heart disease than their cisgender counterparts. Education of health professions students and providers is recognized as an effective method in mitigating transgender health disparities. This narrative review investigated the methods in which transgender health is taught in undergraduate nursing programs. Suggestions for optimizing transgender health education are presented. This review critically appraised and synthesized 28 articles that met these inclusion criteria: articles in English describing teaching strategies used in transgender health education with samples that include undergraduate nursing students. Didactic lecture is the most widely used method, followed by role-play simulation, use of film and video, guest presentation, and high-fidelity and standardized patient simulation. Lectures remain the dominant method of delivering transgender health content. Improvements in students' knowledge and attitude related to transgender care were noted posteducation.

Standardized Patient Simulation in Healthcare Education

Standardized Patient Simulation in Healthcare Education

Feasibility and reliability of the pandemic-adapted online-onsite hybrid graduation OSCE in Japan.

Objective structured clinical examination (OSCE) is widely used to assess medical students' clinical skills. Virtual OSCEs were used in place of in-person OSCEs during the COVID-19 pandemic; however, their reliability is yet to be robustly analyzed. By applying generalizability (G) theory, this study aimed to evaluate the reliability of a hybrid OSCE, which admixed in-person and online methods, and gain insights into improving OSCEs' reliability. During the 2020-2021 hybrid OSCEs, one examinee, one rater, and a vinyl mannequin for physical examination participated onsite, and a standardized simulated patient (SP) for medical interviewing and another rater joined online in one virtual breakout room on an audiovisual conferencing system. G-coefficients and 95% confidence intervals of the borderline score, namely border zone (BZ), under the standard 6-station, 2-rater, and 6-item setting were calculated. G-coefficients of in-person (2017-2019) and hybrid OSCEs (2020-2021) under the standard setting were estimated to be 0.624, 0.770, 0.782, 0.759, and 0.823, respectively. The BZ scores were estimated to be 2.43-3.57, 2.55-3.45, 2.59-3.41, 2.59-3.41, and 2.51-3.49, respectively, in the score range from 1 to 6. Although hybrid OSCEs showed reliability comparable to in-person OSCEs, they need further improvement as a very high-stakes examination. In addition to increasing clinical vignettes, having more proficient online/on-demand raters and/or online SPs for medical interviews could improve the reliability of OSCEs. Reliability can also be ensured through supplementary examination and by increasing the number of online raters for a small number of students within the BZs.

Acceptability of an online communication training intervention for genetic counseling students.

Technology provides opportunities to enhance communication skills training for genetic counseling graduate students. We assessed the acceptability of an online communication training program. Graduate student volunteers completed five online training modules on basic communication skills with opportunities to practice the skills within three simulated/standardized patient (SP) sessions. Participants completed online questionnaires reporting on acceptability, perceived usefulness, and realism of the modules and SP sessions. They also reported on the ease of transferring skills from the modules to clinical practice. Out of the 60 students who completed the baseline session, 35 (58%) completed all five training modules. Out of these 35 students, most found the modules to be useful (94%) and agreed that they were relevant to clinical practice (97%). At least 88% of participants found the genetic counselors, patient, and case scenarios to be realistic. Twenty-eight students had participated in clinical rotations since completing the intervention. Of these, 17 (61%) reported that it was at least slightly easy to use the skills in actual clinical cases. Most students also reported being able to transfer the skills they had learned into clinical practice. While the training was well-received, the relatively low completion rate of 58% raises concern that the intervention may need formal integration into the program curriculum to succeed due to the time and effort demands on students.

An Exploration of Diversity, Equity, Inclusion, and Antiracism in Standardized Patient Simulations

A trending topic in pharmacy education is the importance of educating and exposing student pharmacists to topics of diversity, equity, inclusion, and antiracism (DEIA). Incorporation of diverse patient populations is one emerging learning opportunity for students in the DEIA space. This commentary presents the findings of seven pharmacy programs reporting similarities and differences in standardized patient (SP) recruitment and training, and their use in DEIA simulation learning activities. Common barriers of DEIA-centric SP activities in pharmacy programs were also identified and included recruitment of diverse SPs, lack of faculty knowledge for implementation of DEIA-focused simulations, and emotional protection of SPs involved. While no best practices or standardized processes exist, the authors provide suggestions for addressing barriers, and make a call to action for further research to determine best practices related to recruitment, training, and utilization of diverse SPs in simulation activities in pharmacy education.

School children brief training to save foreign body airway obstruction

Foreign body airway obstruction (FBAO) is a relatively common emergency and a potential cause of sudden death both in children and older people; bystander immediate action will determine the victim’s outcome. Although many school children’s basic life support (BLS) training programs have been implemented in recent years, references to specific training on FBAO are lacking. Therefore, the aim was to assess FBAO-solving knowledge acquisition in 10–13-year-old school children. A quasi-experimental non-controlled simulation study was carried out on 564 ten-to-thirteen-year-old children from 5 schools in Galicia (Spain). Participants received a 60-min training led by their physical education teachers (5 min theory, 15 min demonstration by the teacher, and 30 min hands-on training) on how to help to solve an FBAO event. After the training session, the school children’s skills were assessed in a standardized adult’s progressive FBAO simulation scenario. The assessment was carried out by proficient researchers utilizing a comprehensive checklist specifically designed to address the variables involved in resolving a FBAO event according with current international guidelines. The assessment of school children’s acquired knowledge during the simulated mild FBAO revealed that 62.2% of participants successfully identified the event and promptly encouraged the simulated patient to cough actively. When the obstruction progressed, its severity was recognized by 86.2% and back blows were administered, followed by abdominal thrusts by 90.4%. When the simulated victim became unconscious, 77.1% of children identified the situation and immediately called the emergency medical service and 81.1% initiated chest compressions. No significant differences in performance were detected according to participants’ age.  Conclusion: A brief focused training contributes to prepare 10–13-year-old school children to perform the recommended FBAO steps in a standardized simulated patient. We consider that FBAO should be included in BLS training programs for school children.What is Known:• Kids Save Lives strategy states that school children should learn basic life support (BLS) skills because of their potential role as first responders.• This BLS training does not include content for resolving a foreign body airway obstruction (FBAO).What is New:• Following a 60-min theoretical-practical training led by physical education teachers, 10–13-year-old school children are able to solve a simulated FBAO situation.• The inclusion of FBAO content in BLS training in schools should be considered.

Web-based standardized patient simulation for taking anamnesis: an approach in nursing education during the pandemic

BackgroundTo address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students’ anamnesis taking skills and their views about its application.MethodWe conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video.ResultsThe total scores of students’ anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p < 0.05).ConclusionWeb-based standardized patient practice is an alternative for clinical practice facilitating the gaining of competencies in making holistic nursing diagnoses under conditions that limit face-to-face interactions, such as pandemics.

The effect of standardized patient simulation method on getting nursing students to gain care providing skill for the individual diagnosed with dementia: a randomized controlled trial

ABSTRACT This study was aimed at investigating the effect of standardized patient simulation training on getting nursing students to gain care providing skill for the individual diagnosed with dementia. The study is a randomized controlled trial. Training was provided to the experimental group (n = 36) through patient simulation method, while the control group (n = 35) was trained through standard curriculum. As a result of simulation training, it was determined that the experimental group students’ communication skills, ability to evaluate cognitive capacity, and ability to identify nursing diagnoses and interventions suitable for the individual diagnosed with dementia were higher compared to those of the control group students (p < .05). It was concluded that simulation training was effective in getting nursing students to gain care providing skill for the individual diagnosed with dementia

“But I'm a Good Driver!”: A Standardized Patient Simulation to Teach Nurse Practitioner Students to Screen Older Adult Drivers

BackgroundChanges of aging put older adult drivers at risk of motor vehicle crashes, injury, and death. Nurse Practitioners (NP) can make clinical decisions regarding counseling at-risk drivers about transitioning away from driving. However, NP students typically receive little deliberate instruction in this content. MethodsStandardized Patients portrayed at-risk older adult drivers during a 25-minute simulated office visit. Four hundred eight-one NP students participated (in-person, n = 234; telehealth, n = 247). Students conducted brief driving histories, performed one cognitive and one physical screening measure, discussed results using best-practice communication skills, recommended appropriate referrals, and documented findings. Self-debriefing worksheets, faculty observation, debriefing discussion, and the Simulation Effectiveness Tool-Modified (SET-M) were examined. ResultsWritten debriefing and faculty-facilitated debriefing demonstrated desire to know more about reporting/referral and expressed the value of practicing difficult conversations related to driving transition. SET-M scores revealed all subscale means above 2, indicating positive perceptions of the experience. ConclusionsThis simulation provided clinical decision-making opportunities to discuss driving transition with at-risk older adult drivers using best-practice communication skills and resulted in positive perceptions reflecting beneficial learning.

The Effect of Simulation Training on Enhancing Nursing Students' Perceptions to Incorporate Patients' Families Into Treatment Plans: A Randomized Experimental Study.

As clinical placement in bachelor's nursing programs becomes increasingly difficult, simulation is becoming increasingly common to enhance learning. Blended learning incorporating simulation videos provides students with the opportunity to observe and learn from exemplary practices while bridging the gap between theoretical knowledge and its practical application. This study aimed to investigate the effect of simulation training on enhancing nursing students' perception of integrating patient's families' assessments into their treatment plan. A quantitative, experimental research design was used, with a control (56) and intervention group (67) from levels 7 and 8 senior nursing students at King Saud Bin Abdulaziz University for Health Sciences, College of Nursing, Jeddah, assigned randomly to each group. The tool consists of three sections: personal information, a Van Gelderen family rubric, and a role-play survey. The validity and reliability of the tools were confirmed by the original developer. In the current study, the reported Cronbach's alpha was 95%. A total of 123 studentsparticipated in the study. Their ages ranged between 19 and 23 yearsand 23 years and above, with a mean age of 21.3 ± 1.3 among the control group and 22.2 ± 1.1 among the experimental group. There was an improvement in the mean scores in the post-training phase compared to the pre-training phase in the experimental group, with a statistically significant difference at p < 0.05. However, there were no significant differences noted between the control and experimental groups in the pre-training phase compared to the statistically significant difference noted between the two groups in the post-training phase. The findings of the study indicated that the utilization of scenario-based standardized patient-simulated exercises, guided by dedicated faculty and accompanied by reflective debriefing exercises, proved to be an effective approach for bridging the gap between theoretical knowledge and its application in clinical practice. Therefore, the study prompts curriculum revisions to incorporate family assessment into nursing practices, as well as evidence-based strategies, such as learning activities that use standardized patient or high-fidelity simulation technology to address and possibly reduce the theory-practice gap for graduates when entering clinical practice.

The Effects of Manikin-Based and Standardized-Patient Simulation on Clinical Outcomes: A Randomized Prospective Study

The Effects of Manikin-Based and Standardized-Patient Simulation on Clinical Outcomes: A Randomized Prospective Study

Impact of Standardised Patient Simulation Training on Clinical Competence, Knowledge, and Attitudes in Mental Health Nursing Education

BACKGROUND: The limited practical placement opportunities in mental health care often induce uncertainty among nursing students. To ameliorate this, simulation training, especially with standardized patients (SPs), is employed to promote clinical competence, allowing students to navigate the complexities associated with mental health nursing, including stigma and stereotypes.&#x0D; &#x0D; OBJECTIVE: This systematic literature review primarily aims to explore and synthesise the studies in simulation education research conducted related to the effects of SPs on clinical competence, knowledge and attitudes of undergraduate pre-registration mental health nursing students.&#x0D; &#x0D; METHODS: following the systematic literature review approach, a comprehensive search was conducted across five electronic databases: MEDLINE, CINAHL, Embase, PsycINFO, and Scopus. The PICO model guided the identification of search terms. The Mixed Methods Appraisal Tool (MMAT) evaluated study quality.&#x0D; &#x0D; RESULTS: Ten studies were included, all examining the impact of SP simulations on undergraduate nursing students. Of these, five evaluated confidence and anxiety levels, while two assessed competence and satisfaction. Other aspects such as motivation, preparation, knowledge, communication skills, and critical thinking were examined individually. The collective results indicate SP simulation as a potentially efficacious strategy for enhancing competencies in graduate nursing education.&#x0D; &#x0D; CONCLUSION: Across all studies, SPs in simulation methods exerted a positive influence on mental health nursing education, bolstering students&amp;#39; preparation for clinical practice by reducing anxiety and fostering confidence, competence, knowledge, and communication skills. However, limitations including insufficient supervision, small sample sizes, homogenous samples, and absence of control groups were present in all studies. Future research should address these issues to fortify evidence supporting the use of SPs in mental health nursing education.&#x0D; &#x0D; RECOMMENDATIONS: Further robust, experimental research with larger sample sizes and validated assessment tools is needed to corroborate these findings and explore the effects of SP simulations on a wider array of learning outcomes.