First Advisor

Cullen, Patricia L.


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

175 pages


Executive Summary


In the United States (US), mental health disorders affect millions of adults and children each year Anxiety and Depression Association of America. (2016). A significant challenge facing nursing faculty, and students, is the shortage of psychiatric and mental health clinical placement sites. Due to the limited opportunities for hands-on experience, student nurses may miss opportunities to practice critical skills and gain knowledge in a supervised learning environment. This can result in increased anxiety and decreased efficacy when they encounter a patient with a mental illness or one that is in psychiatric crisis. Simulation allows students to practice low-frequency, high-stakes events that occur during routine and emergency health care that replicate experiences with patients with diagnosed or undiagnosed mental health conditions (Eta, Atanga, Atashill and D’Cruz, 2011; Redden, 2015). The question addressed by the project was: Can simulation using standardized patients ease anxiety and enhance self-efficacy in nursing students working with patients experiencing mental illness?


To investigate the value of providing a simulation experience, utilizing standardized patients, to assess its effect on student knowledge, anxiety, and self-confidence as they prepare to enter their first community mental health clinical experience and work with patient experiencing emotional/mental illness. Current simulation frameworks and methodologies were used to assist community mental health students in recognizing signs of patient deterioration during psychiatric crisis or mental illness and developing vital skills transferable to other clinical practice areas.


The primary goal of the project was to provide senior-level Bachelor of Science (BSN) students with skills that can be transferred into a community mental health clinical setting to decrease student anxiety and enhance self-efficacy (self-confidence) leading to stronger clinical judgements. A secondary goal was to provide evidence-based practice findings related to the benefit of simulation in mental health nursing education and to implement these findings into nursing education practice. This study provides the potential for simulated learning in mental health education to become an evidence-based practice model for BSN nursing programs.


The project evaluated participant demographics, knowledge, self-efficacy (self-confidence), and anxiety about working with patients with mental illness through pre- and post-tests, satisfaction and confidence surveys and evaluation of reflective comments.


This was a quasi-experimental study with random assignment to intervention and comparison groups. Twenty senior-level traditionally enrolled in a pre-licensure baccalaureate nursing students, during Fall 2015, were randomly assigned to one of two groups – one receiving standard education delivery and simulation experience (intervention group), and the other receiving standard education delivery only (comparison group). Using a pre-test/post-test design, the impact of simulation on knowledge and student-reported confidence and anxiety surveys was compared to that of the group who did not receive simulated experience. A Mental Health Knowledge Test (MHKT), Spearman’s Rank-Order Correlation, the Pearson correlation coefficient, and paired t-tests were methods used to collect and analyze data. Data was analyzed using IBM SPSS PC+ software version 23.

Outcomes and Results

All six objectives were met for this project. Objective two identified that there was no statistically significant (p=/>0.05) difference in student knowledge between pre-and -post-simulation intervention, as knowledge scores remained relatively unchanged for both groups. Objective three found that there was statistical significance (p=/

Date of Award

Spring 2017

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

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