title: Using simulation to improve the capability of undergraduate nursing students in mental health care.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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: elicia.kunst@scu.edu.au.
authors.forename: Elicia L
authors.initials: EL
authors.lastname: Kunst
authors.affiliation: Menzies Health Institute Queensland, Griffith University Gold Coast Campus, QLD 4222, Australia; Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia. Electronic address: marion.mitchell@griffith.edu.au.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: 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: a.johnston@griffith.edu.au.
authors.forename: Amy N B
authors.initials: AN
authors.lastname: Johnston
mesh_terms: D001315:Australia; D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate; D007722:Health Knowledge, Attitudes, Practice; D000070856:High Fidelity Simulation Training / Q000379:methods*; D006801:Humans; D007858:Learning; D011568:Psychiatric Nursing; D013338:Students, Nursing
keywords: Mannequin; Mental health; Nurse education; Nurses; Nursing; Psychiatric nursing; Simulation; Students