使用虚拟模拟来支持心理健康教育

在患者中识别精神疾病可能是护士面临的最大挑战之一。识别潜在的精神疾病的能力可以大大改变评估和诊断过程，从而改变治疗计划。最终结果可以转化为更好的患者预后。

One in four people – approximately 450 million people worldwide – suffer from mental disorders.¹Yet, up to 50% of serious cases go untreated in high-income countries.²Misdiagnosis is common in the realm of mental health, often because symptoms can often materialize in different ways and at different times. Nurses can feel more confident in their ability to assess and diagnose a mentally-ill patient when they have an understanding of how certain mental illnesses present themselves, and the critical-thinking skills required to take an accurate patient history.

识别是提供专业的第一步per treatment. In this article, we discuss how training with a practical delivery mode, likevirtual simulation, can better prepare nursing students to recognize mental illness and can promote a more favorable attitude by care givers toward patients with a mental illness. The result can be better patient-centered care.

In the United States, approximately 56 million American adults suffer from mental illness.³Suicide is the tenth leading cause of death, and four of the ten leading causes of disability are mental disorders (major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder).^4,5Some experts have even begun to label the growing concern over mental illness as a “mental health crisis”.

Nurses are the largest group of professionals providing mental health care, whether it’s in primary or specialist health services. Because of nurses’ direct relationships with patients, it is critical that they feel confident in their ability to detect mental illness and treat patients accordingly. Nursing educators advocate for an early and immersive mental health education at both the pre-licensure and graduate levels.⁷

Despite resounding agreement among nurse educators about the importance of mental health education, there is often a question of justhowto impart the right skills to learners. Some facilities have introduced standardized patients, or actors who play the part of a patient suffering from a mental illness. Though this can be extremely useful in teaching how to take the patient’s history, educators commonly state that the inability of standardized patients to display physiological changes is a shortcoming. Other facilities have implemented the use of high-fidelity simulators in their nursing programs, which can demonstrate physiological changes throughout the care pathway and serve as a means to augment learner’s existing knowledge.

Virtual simulation, a method of engaging students via eLearning, has increased in popularity because it can help to introduce mental health education in an interactive and realistic way.In fact, 65% of nursing programs are currently using virtual simulation.⁸通过使用虚拟仿真,学习者can fine-tune their assessment skills and improve their ability to recognize mental illness, both through the observable physiological changes and the patient interview.

受精神疾病影响的人通常避免由于围绕精神障碍的公众污名而寻求帮助。从文化上讲，我们仍然没有超越社会避免患有精神疾病的人的进步。⁹The general public has made strides toward helping patients of mental illness, but there are still underlying stigmas that can negatively affect relationships. And, nurse-patient relationships are no exception.

研究表明stigmatizing attitudes are also found among healthcare staff and they are reflective of negative public opinion.¹⁰这引起了人们对心理健康患者接受的护理质量的关注。假设和偏见的观点可能会对患者的护理产生负面影响。

Factors contributing to these negative perceptions are:¹¹

• Lack of knowledge
• Less professional experience
• No familiarity (i.e. no friends or relatives with mental illness)

相反，增加的心理健康教育和更多的精神疾病经验会影响医疗保健提供者的积极方向。护士教育者的任务是提供一种心理健康教育，以促进患有精神疾病的患者的包容性，同理心和尊重。

“护理计划可以做准备护士以护理精神疾病患者的最重要的事情是告诉他们，心理健康问题在人群中普遍存在，患有精神疾病的人应得到与任何人相同的照顾，同情和尊重其他患者”，南加州大学科斯塔梅萨大学的RN玛丽·威克曼（Mary Wickman）说。¹²In addition, educators should be debunking myths – especially in regard to violence among the mentally ill. Only 3-5% of violent acts can be attributed to individuals living with a serious mental illness.¹³

Preparation for nursing students is awareness.通过将学习者暴露于与精神疾病相关的常见行为和症状，他们对精神病患者“看起来”或“行为”的看法将逐渐从污名转变为现实。

Simulation benefits learners in this regard because it provides an opportunity to introduce less common events that may not be seen in a traditional clinical placement.¹⁴具体来说，虚拟仿真被证明是培训护士的一致和有效方法。研究表明up to 60% better consistency of learning can be achieved through technology-based training.¹⁵Each scenario requires learners to gather the patient history and practice patient-centered care. The learning experience promotes the development of critical-thinking and decision-making skills, while also giving learners a “real life” experience with mental illness.

Simulation in mental health nursing can help to develop empathetic care practices and increase a student’s understanding of mental illness.¹⁶Both of these developments can contribute to higher recognition, a reduced chance of misdiagnosis, and better quality of care.

通过虚拟模拟，使学习者可以按照自己的步调移动，因此好处是多种多样的。一项研究发现，当护理人员自主参与互动视频学习时，与仅接受讲座的人相比，他们对培训的遵守和满意度更高。¹⁷而且，另一项研究发现，虚拟患者有助于向护理学生讲授临床决策技巧。¹⁸在虚拟模拟过程中，与错误的诊断和治疗没有相关的风险，这为学生提供了freedom to make mistakes before they treat their first real patient.

虚拟仿真还可以帮助找到和填补教科书阅读和讲座中留下的知识空白。在心理健康护理实践中，提高了学生在治疗沟通，批判性思维，解决问题，决策和风险评估方面的技能，模拟提供了学生所需的接触。¹⁹

Equipped with the skills to recognize and empathetically treat patients, your nurses will feel competent and confident in their ability to address mental illness.