Challenges & Successes:
Collaborative Approach to Developing Mental Health Cases with Faculty of Nursing Petra Duncan and Pamela Rock, Standardized Patient Program, University of Alberta
• Collaboration is work. • Collaboration works. • Work for collaboration.
Background: In the fall of 2007, the Standardized Patient Program (SPP) at the University of Alberta was approached by the faculty of Nursing about the opportunity to provide third year nursing students with an introduction to the types of clients they may experience in their Community Mental Health Practicum prior to their actual placement in the community.
Method: Faculty of Nursing specialists and instructors got together with trainers from SPP to guide nursing through the presentation format. Four health areas were chosen: 1) borderline in crisis; 2) schizophrenia; 3) depression; and 4) bullying. Scripts were developed from frequent real life episodes. It was necessary for us to gain some general knowledge of this specialty field of nursing, in order to successfully train SPs. This was achieved by reviewing scripts with experts in the individual areas from the faculty of Nursing and watching DVDs on mental health nursing provided by members of the nursing program. With the help of the team, we were able to translate the scripts into language that the SPs would understand. Research into each topic uncovered the character strengths and weaknesses in each case. On recruiting the SPs it was important to identify those who were capable of playing such deep and complicated roles and also to check their personal background information given on the original application form to make sure there were no personal conflicts or issues identified. Training consisted of thoroughly discussing the script, watching a DVD regarding mental health patients and then dry running the scenario in various ways with nursing instructors. The trainer would ask how the SP felt about the role and the conditions they were put under. The SPs were asked to describe their characters and help create the background information that would help the script come alive.
Objective: This was our first opportunity to provide standardized patients (SPs) to the nursing program and viewed this initial project as critical to the success of future collaborations. Due to the emphasis on developing a collaborative relationship with the faculty of Nursing, significant effort was placed on the development of shared understandings of the needs of the instructors, students, SPs and trainers.
• Understanding the role nursing plays in mental health • Development of complex mental health SP roles • Traditional script templates don't work • SP selection, preparation and training • Developing and training SPs to understand mental health • Translating clinical mental health conditions into easily understood language • Collaboratively updating and revising scripts on a regular basis • Interview time longer than in other programs
• Great working relationship with nursing instructors • Gratitude shown by nursing students post-encounter • Demand to run additional labs for 4th year nursing students to capitalize on the experience • Ability to work with nursing throughout the development of the cases • Opened new opportunities to work with other nursing instructors • Students practice in a safe environment and SPs assist with feedback • SPs (not mannequins) make situations real • Use of "time outs" adds to education value
Key Findings: • Students feel better prepared and more confident when moving out into the work place • Enhanced in depth understanding of medical conditions • Students better understand the interview process, how to communicate and give empathy when required • Collaborative approach provided a good quality, realistic and educational program
So, what is so different about this training? It is not the technique that is the question, but the whole preparation, in-depth planning and degree of understanding.
What's Next: • Expand the Program to include other mental health scenario's • Increase the amount of time for the interview and make the course into a 2-day workshop • Evolve into an interprofessional educational experience, by introducing other health sciences students
Revisions were a direct result of collaboration between SPP and nursing. Feedback from instructors, SPs and students helped in the revision process. Each script was reviewed lineby-line to ensure complete understanding. When it came time to expand the program, the 4 original SPs were involved in training the new recruits to the nursing scenarios. The original SPs needed to be able to explain the mental process behind the actions.
Acknowledgments: How Lee, Faculty of Nursing, University of Alberta Marnie MacKay, Faculty of Nursing, University of Alberta Bill Leddy, Faculty of Nursing, University of Alberta
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