Effects of a Mental-Health Clinical Simulation Experience Using Standardized Patients and Two Debriefing Styles on Prelicensure Nursing Students' Knowledge, Anxiety, and Therapeutic Communication and Psychiatric Assessment Skills
Date of Graduation
Doctor of Education (Ed.D.)
School of Education
Learning and Instruction
The purpose of this quasi-experimental pretest-posttest study was to compare the effects of two debriefing styles (insimulation and postsimulation) on (a) students’ knowledge of psychiatric assessment and therapeutic communication, (b) students’ performance of a psychiatric assessment using therapeutic communication, (c) students’ perceived anxiety related to a clinical rotation in psychiatric mental-health, and (d) students’ perceptions of the efficacy of the insimulation debriefing. The participants (n = 67) were senior, prelicensure nursing students enrolled in a baccalaureate degree program. Students were assigned randomly to either the treatment or the compression group and participated in a series of simulated interviews using student volunteers as standardized patients.
The simulation strategy was a formative experience designed to introduce students to psychiatric assessment while concurrently providing a forum to practice therapeutic communication. The simulations replicated common patient diagnoses that students would encounter during their psychiatric clinical rotation.
The results of this simulation learning experience suggest that both methods of debriefing are effective for the acquisition of knowledge. Both groups showed a statistically significant gains in knowledge on the posttest; however, there were no statistically significant differences between the groups. The results of the paired-sample t test for the Psychiatric Assessment Rubric showed both groups had statistically significant differences from pretest to posttest with effect sizes ranging from 1.45 to 3.30; however, there were no statistically significant difference between groups. Additionally, both groups reported an overall decrease in anxiety for both groups with no important variations in the qualitative data between groups.
The treatment group was higher, on average, for therapeutic and nontherapeutic communication. Differences in means between the insimulation and the postsimulation group for therapeutic (M =1.39, 0.83) and nontherapeutic communication (M = -1.95, - 0.79) were statistically and practically significant from pre- to posttest with effect sizes of 0.98 and -1.50. Suggesting that insimulation debriefing was an effective tool for teaching therapeutic communication.
Results from the postsimulation survey indicated that the treatment group (insimulation) rated the effectiveness of the debriefing higher than their peers in the postsimulation group. Postsimulation qualitative data from the treatment group revealed several themes. The students in the insimulation group reported that being able to stop, rethink, and redo helped reinforce concepts and decrease anxiety. Several students stated that they would prefer to have a combination of insimulation and postsimulation debriefing.
Even though nursing literature has documented the effectiveness of simulation and suggested that debriefing is an essential component of the simulation learning experience, this research addressed a gap in the nursing literature. The large gains in communication skill observed in the treatment group clearly suggest a need for further investigation of debriefing methods.
Gaylle, Debrayh, "Effects of a Mental-Health Clinical Simulation Experience Using Standardized Patients and Two Debriefing Styles on Prelicensure Nursing Students' Knowledge, Anxiety, and Therapeutic Communication and Psychiatric Assessment Skills" (2015). Doctoral Dissertations. 288.