1. Psychiatric Students Evaluation of Learning in a Simulated Environment Siobhn Smyth and Evelyn Byrne

2. Aim To ascertain students perspective of a simulated mental health ward prior to internship using the METI Simulation Effectiveness Scale To enable students draw on prior knowledge and clinical experience while caring for patients (actors) under the supervision of experienced clinicians, lecturers and service user 3. Context The transition to practice causes great anxiety; the level of stress of newly qualified nurses experience influences their ability to function effectively in their new role The complexity of todays healthcare system requires nurses to be Critical thinkers Provide safe, timely, appropriate & effective care 4. What is Simulation? According to Ker and Bradley (2007)the narrow, popularist view of simulation is that of advanced technologies recreating the clinical experience, such as those found in virtual reality and advanced computer - controlled human patient simulators. But simulation does not focus exclusively on technical or psychomotor performance; it encompasses a broad perspective, incorporating both cognitive and affective domains. Simulation may involve a wide range of techniques and approaches applicable to learners at all levels of seniority, from novice to expert, one of the major underlying drivers being to develop safe healthcare practitioners (p. 164) 5. Benefits of Simulation A valuable approach for engaging students in their learning (Bland et al, 2010)Supports teachers --- integrate role play, questioning, reflection, & feedback to strengthen critical thought & problem solving capabilities, resulting in the construction of new knowledgeEnvironment resembles clinical practice as closely as possible (Rauren, 2004)Present students with simple/complex patient scenarios - opportunity to integrate knowledge, skills, attitude enhance critical thinking (Guhde, 2011) Supports students learning (Baxter et al. 2009), think on their feet, not in their seat (Rauen, 2001), increase students confidence (Cant & Cooper , 2010) 6. Limitations of SimulationDoes not replace learning in the real workLong term benefit of simulation unprovenSignificant costs Personnel; low student-teacher ratio Equipment, annual maintenance, consumables Physical infrastructureTime consuming Planning and preparation Developing case scenarios 7. Students Prior Exposure 1st exposure before 1stclinical placement Baseline assessment of patient during OPD review 2nd exposure 3rd year Ward simulation 3rd exposure 4th year Drug round Ward simulation 8. Simulation in Action! 9. Quantitative Evaluation 10. Qualitative Evaluation What one thing did you like or appreciate the MOST from your simulation experience today? Realness of whole situation --excellent Opportunity to practice in a safe environmentThinking on my feet Learning about my deficitsDealing with difficult situations/aggressive patient Cardiac arrest experience --wonderful Chance to experience and learn great skills Encouraged to use my current knowledge Knowing what is expected as students Receiving immediate feedback from patient and assessor --excellent, very helpful 11. Qualitative Evaluation contd.. What one thing did you like or appreciate LEAST from your simulation experience today? Anxiety provoking Stressful coping with manufactured environment being watched not knowing what to do Pressure Threatened with death Busyness --- dealing with interruptions 12. Qualitative Evaluation contd.. What can we do to improve the overall simulation experience? Provide regular and frequent simulations reduce anxiety increase confidence Create more clinical space avoid busy environment Clinical scenarios dealing with difficult/challenging experiences and situations 13. Conclusion Critical thinking was identified as a key factor: instructors questioning technique facilitated students critical thinking and enhanced decision-making skills Other facets students feeling better prepared to care for patients improvement in their assessment skills greater confidence in recognising and predicting changes in patients mental state 14. Finally Suggestions for improvement include integration of simulation throughout the program despite the stress the students experienced Challenge --- explore ways of increasing frequency of simulation in an already packed curriculum 15. Acknowledgments Students Participation in the evaluation Professor Jeanette Rossetti & Colleagues - Northern Illinois University School of Nursing tool and guidance and support 16. QuestionsReferences available from siobhan.smyth@nuigalway.ie