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Nurse Educ Today. 2017 Mar;50:29-35. doi: 10.1016/j.nedt.2016.12.012. Epub 2016 Dec 18.

Using simulation to improve the capability of undergraduate nursing students in mental health care.

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Southern Cross University, Gold Coast Campus, Southern Cross Drive, Bilinga, QLD 4225, Australia; Menzies Health Institute Queensland, Griffith University Gold Coast Campus, QLD 4222, Australia. Electronic address:
Menzies Health Institute Queensland, Griffith University Gold Coast Campus, QLD 4222, Australia; Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia. Electronic address:
Menzies Health Institute Queensland, Griffith University Gold Coast Campus, QLD 4222, Australia; Department of Emergency Medicine, Gold Coast University Hospital, D Block, LG096 1 Hospital Blvd, Southport, QLD 4215, Australia. Electronic address:



Mental health care is an increasing component of acute patient care and yet mental health care education can be limited in undergraduate nursing programs. The aim of this study was to establish if simulation learning can be an effective method of improving undergraduate nurses' capability in mental health care in an acute care environment.


Undergraduate nursing students at an Australian university were exposed to several high-fidelity high-technology simulation activities that incorporated elements of acute emergency nursing practice and acute mental health intervention, scaffolded by theories of learning. This approach provided a safe environment for students to experience clinical practice, and develop their skills for dealing with complex clinical challenges.


Using a mixed method approach, the primary domains of interest in this study were student confidence, knowledge and ability. These were self-reported and assessed before and after the simulation activities (intervention) using a pre-validated survey, to gauge the self-rated capacity of students to initiate and complete effective care episodes. Focus group interviews were subsequently held with students who attended placement in the emergency department to explore the impact of the intervention on student performance in this clinical setting.


Students who participated in the simulation activity identified and reported significantly increased confidence, knowledge and ability in mental health care post-intervention. They identified key features of the intervention included the impact of its realism on the quality of learning. There is some evidence to suggest that the intervention had an impact on the performance and reflection of students in the clinical setting.


This study provides evidence to support the use of simulation to enhance student nurses' clinical capabilities in providing mental health care in acute care environments. Nursing curriculum development should be based on best-evidence to ensure that future nursing graduates have the skills and capability to provide high-quality, holistic care.


Mannequin; Mental health; Nurse education; Nurses; Nursing; Psychiatric nursing; Simulation; Students

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