Simulation training programme to improve the integrated response of teams in mental health crisis care

Abstract

BackgroundThis report presents the findings of a simulation programme to improve the integrated response of teams working in mental health crisis (MHC) care. The programme consisted of the delivery of five interprofessional training courses that aimed to improve the core skills of teams working in MHC care.MethodsQuestionnaires were conducted pre-training and post-training, measuring participants’ human factors using the Human Factors SKills for Healthcare Instrument, as well as self-reported learning experience using free text questions.ResultsThe results found a significant change in human factors scores across all courses. Additionally, thematic analysis of the free text questions showed that participants identified improvements in communication, teamwork and clinical knowledge across all courses, with improvements in other skills in specific courses.ConclusionOverall, the findings suggest a positive impact of the simulation programme across a range of personal and clinical skills, developing further the case for including simulation training in routine mental healthcare education programmes. Future research should consider the long-term impact of interprofessional simulation training in MHC teams to gain further insight into the efficacy of this training modality.

Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta‐analysis

“…However, recent pedagogical developments should help to overcome these difficulties, such as infant manikins with a SP playing the mother (Kameg et al, 2013). Furthermore, recent developments in interprofessional simulation can reflect a deeper complexity of the teamwork required to support difficult clinical situations (Ortega Vega et al, 2020).…”

Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education

“…Expected to complete within 3 months. 3 cohorts—Cohort 1 (English speaking), Cohort 2 (Spanish speaking), Cohort 3 (in Uruguay) Retention and Education Nursing Workforce USA (high income) Public facilities Retrospective pre-test/post-test design No No Knowledge Eight pre–post within-module exams Education 22 Ortega et al 2021 [ 61 ] Not stated Improve knowledge and skill acquisition Program to improve the integrated response of mental health crisis teams through simulated patient training Inservice training/education program Maudsley Simulation Program of 5 interprofessional simulation courses (11 sessions) focusing on core skills to improve mental health crisis situations. Simulation scenarios with trained actors of 10–15 min with 30–40 min debrief Safety and Education Mental Health, Nursing, Allied Health, Social and Medical Workforce UK (high income) All clinical facilities Mixed methods—pre-test/post-test design No No Measure of social and cognitive abilities in demanding situations The Human Factors Skills for Healthcare Instrument (HuFSHI) Education 23 Parmar et al 2022 [ 62 ] The Foundational Caregiver-Centered Care Education program Improve knowledge and skill acquisition Person-centred competency-based education program for the care workforce working with family caregivers Inservice training/education program University of Alberta ethics 1 h free competency education to identify, assess, support and partner with family caregivers.…”

“…Knowledge = midpoint to post fellowship (mean difference = 4.23%, t = 5.59, p < 0.0001) 1. Knowledge = Repeated-measures analysis of the percent of correct answers on the knowledge score yielded significant improvement across the entire year (mean difference = 11.8%, t = 15.76, p < 0.0001) Significant Diff 21 Ortega et al 2018 [ 60 ] Cohort 1 = 58 Cohort 2 = 111 Cohort 3 = 120 TOTAL = 289 (Majority): Cohort 1 = 72% 41–55 years Cohort 2 = 56% 41–55 years Cohort 3 = 50.8% 26–40 years Cohort 1 = M = 3 F = 55 Cohort 2 = M = 13 F = 98 Cohort 3 = M = 9 F = 111 TOTAL = M = 25 F = 264 Learner performance pre-test/100%: Cohort 1 = (average) 65% Cohort 2 = 57.5% Cohort 3 = 53.4% Cohort 1 = 48 Cohort 2 = 83 Cohort 3 = 89 TOTAL = 220 Not specific due to drop outs Not specific due to drop outs Learner performance post-test: Cohort 1 = 87% Cohort 2 = 89.3% Cohort 3 = 78.4% Mean total performance on modules: Cohort 1 = 95.4% Cohort 2 = 90.3% Cohort 3 = 89.6% 90% mean score on final exam NOTE: pre- and post-test data, therefore, were not individually matched; statistical significance could not be calculated Non-significant Diff 22 Ortega et al 2021 [ 61 ] n-85 Not stated Not stated Only HuFSHI change scores provided (see difference between groups results) n = 85 Not stated Not stated Only HuFSHI change scores provided (see difference between groups results) Assessment and Mental State course:—t(7) = − 6.587, p < 0.000; Decision Making course: t(10) = − 4.411, p < 0.000; Place of Safety course: t(18) = − 4.932, p < 0.000; Crisis Resolution and Home Treatment Teams course: t(16) = − 4.737, p < 0.000 Significant Diff 23 Parmar et al 2022 [ 62 ] n = 161 Average 37 years M = 59 F = 101 Knowledge and confidence = out of a score of 50 mean score 38.90 n = 161 Average 37 years M =...…”

“…Of the 24 education investigations, 18 were conducted in high income countries, [ 40 , 43 – 46 , 50 – 52 , 55 – 57 , 59 – 61 , 64 , 66 , 67 ] and six were conducted in low-to-low–middle income countries, [ 41 , 42 , 48 , 49 , 58 , 65 ]. Of the four studies that did not demonstrate significant findings, three were based on the USA (high income country) and aimed to improve cancer knowledge, [ 57 ] nursing leadership, [ 60 ], and care workforce needs during COVID-19 [ 66 ].…”

Simulation Training in Psychiatry for Medical Education: A Review

“…Further, SBE can expose health workers to unusual or uncommon scenarios that they may have had limited opportunity to engage with individually or within teams. This is particularly true for more inexperienced staff, and for emergency or out-of-hours situations, such as managing a mental health crisis (60).…”