Problem based learning in mental health nursing: the students' experience

Problem based learning (PBL) is well established within the field of health-care education for professionals worldwide, although little has been done to explore the experiences of students undertaking a PBL course in mental health nursing. Without firm evidence of the benefits of PBL, educationalists in mental health might be reluctant to view it as an option in curricula design. This U.K. study examined the experiences of pre-registration post-graduate mental health student nurses undertaking a 2-year educational course in which all teaching and assessment followed a PBL philosophy. Focus groups were used throughout the course to elicit in-depth qualitative data that was analysed by applying a constant comparative method. The analysis of the data uncovered the following broad themes: 'moves to autonomy, 'surviving the groups' and 'the impact of PBL'. The findings show that participants had mainly positive experiences and gained a range of study and interpersonal skills central to mental health nursing. Participants described initial anxieties resulting from engagement in PBL. However, they increasingly gained confidence in this approach, exercising increasing control over the PBL process. Despite this increased autonomy, participants continued to value the input of skilled facilitators. A recurring issue centred on the potential for interpersonal conflict within the student group and its impact on their learning. It is suggested that more research is needed examining the use of PBL in mental health nursing.     

Immersion experience in undergraduate psychiatric mental health nursing

Immersion practica have been used in a variety of nursing settings to help prepare culturally competent nursing students. The psychiatric setting represents a diverse culture that traditionally has not appealed to nursing students when considering career options. This article describes the experiences of baccalaureate nursing students and hospital nursing staff following a brief immersion practicum at a psychiatric facility. Seven students were assigned to one practicum for six consecutive weekdays (45 hours), without the distraction of other classes. Both the students and staff rated the experience as positive. The students believed that their ability to form therapeutic relationships, develop clinical skills, and integrate theory into clinical practice was enhanced. While nursing faculty struggle to produce more graduates, with declining clinical sites and increased competition for these sites, the brief clinical immersion may be a reasonable alternative to a traditional rotation.     

Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BackgroundStudents and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.DesignA hermeneutic phenomenological approach.MethodData were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.FindingsThree themes emerged from the data: ‘Accessibility for learning the skill’; ‘Preparation for learning and practice’; and ‘Student-directed learning’. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.ConclusionThe findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.     

Effect of psychiatric clinical learning site on nursing students' attitudes toward mental illness and psychiatric nursing

As a component of an undergraduate nursing program evaluation, the purpose of this study was to investigate the effect of the psychiatric clinical learning site on students' attitudes toward mental illness and psychiatric nursing. A pretest-posttest quasi-experimental design was utilized. The dependent measures included an Environmental Rating Scale, an Attitude Toward Mental Illness Scale, and an Attitude Toward Psychiatric Nursing Scale. The non-probability sample of convenience included 45 students enrolled in the senior level psychiatric nursing module of a baccalaureate nursing program at a midwest, metropolitan liberal arts college. The subjects were randomly assigned to a Veterans Administration (VA) Medical Center and a private hospital. The results indicated that after controlling for students' attitudes toward mental illness and psychiatric nursing prior to the psychiatric nursing module, clinical site location did not account for any significant variance in students' attitudes after the module. However, correlation analysis of the specific components of the Environmental Rating Scale did demonstrate statistically significant associations with a decrease in authoritative, restrictive attitudes toward mental illness, and an increase in the milieu therapy and community mental health orientations to psychiatric nursing.     

Improving the undergraduate clinical placement experience in mental health nursing

Recruitment in mental health nursing is an international problem. Improving the undergraduate clinical placement experience may help to attract students into mental health nursing. In this paper, the authors describe the development and evaluation of a clinical facilitation program aimed at improving the placement experience. Students were surveyed about their attitudes to mental health nursing before and after placement. Based on the results from 254 pre-placement and 248 post-placement surveys there was a large significant increase in students' interest in mental health nursing following clinical placement. Data collected from focus groups also indicated that facilitators, students, and clinical nurses all viewed the program positively.     

The impact of volunteering in mental health settings on nursing students' attitudes

Nursing faculties are working to improve students’ attitudes towards mental illness and people with severe mental illness, given the repercussions a lack of knowledge and negative attitudes may have on the quality of care. Complementing undergraduate programmes with volunteering activities affords students the opportunity to interact with people with a severe mental illness, and allow them to develop positive attitudes and overcome prejudice. Aim: to explore and deepen in nursing students attitudes prior to and following volunteering on an Acute Mental Health Inpatient Unit. By means of mixed methods approach, students were assessed at two time points by questionnaires including “Community Attitudes to Mental Illness” and “Semantic Differential”, and by testimonies gathered from interviews. Positives changes in attitudes were identified and monitored over time capturing a destigmatizing tendency. The participation in educational strategies such as volunteering in Acute Mental Health Inpatient Unit, complementary to undergraduate programmes and clinical placements in mental health, allows nursing students to develop more diversified and positive attitudes towards mental illness and people with severe mental illness. The impact of an interventional education strategy is not as powerful in nursing students as it might be in students of other non-healthcare oriented university degrees due to their baseline attitudes.     

Equipping nurses with psychiatric mental health nursing skills for the 21st century

In the fast changing environment of 21st century, life can be difficult to manage and personal relationships and interaction more complicated. They cause life stress. Hardiness of personality is therefore more important than before. Nurses are members of society. If nurses are under stress for long periods of time without efficient coping methods, they will become unconsciously fatigued and that will affect not only their occupational life but also their nursing competencies, their own making it difficult help patients and their families to relieve stress and improve their quality of life. Through literature review, this paper will explore how to help nurses to adopt elements of psychiatric mental health nursing and strengthen their physical and mental health in order to improve their personal health and professional skills.     

The importance of clinical experience for mental health nursing - part 1: undergraduate nursing students' attitudes, preparedness and satisfaction

Government inquiries and workforce data continue to draw attention to the current and impending crisis in mental health nursing. While undergraduate nursing education has been found at least partially responsible for the negative attitudes nursing students tend to hold towards mental health nursing, clinical experience has been identified as a potential strategy in enhancing more positive attitudes. However, research to date has not focused on the impact of clinical experience on specific factors such as attitudes to mental health nursing to people experiencing mental illness and perceived preparedness for the mental health field. This quasi-experimental study measured changes in students' attitudes to the three factors, including satisfaction with clinical experience following a placement in mental health nursing. A questionnaire was administered to undergraduate nursing students on the first and last day of a mental health clinical placement. This, the first of a two-part paper, compares student responses over the two-time periods and describes satisfaction with the clinical experience. The findings suggest that clinical experience in mental health nursing experience can positively influence attitudes, preparedness for practice, and the popularity of mental health nursing. Satisfaction with clinical experience was also high.     

Impact of theory and clinical placement on undergraduate students' mental health nursing knowledge, skills, and attitudes

Mental health issues are common and contemporary nursing students need to be well prepared to meet the mental health care needs of Australians. This study explored the influence of the mental health component of a Bachelor of Nursing course on second-year undergraduate nursing students' self-reported knowledge, skills, and attitudes in relation to mental health nursing. The study used a quasiexperimental research design involving questionnaires and individual interviews to determine nursing students' self-reported knowledge, skills, attitudes. Questionnaires were administered prior to undertaking the mental health theory, repeated prior to undertaking a clinical placement in either a community or inpatient mental health setting, and again after the clinical placement. The findings of the study indicated that a positive clinical placement had the greatest influence on nursing students' self-reported knowledge, skills, and attitudes and interest in nursing people experiencing mental health problems; however, the quantity of theoretical education also emerged as an influencing variable.     

Using standardized patients in enhancing undergraduate students' learning experience in mental health nursing

BackgroundConducting mental status examination and suicide risk assessment is an important skill required of nurses when they are in the clinical setting. With nursing students often expressing the anxiety and lack of confidence in doing so, the use of standardized patients provide an excellent opportunity to practice and become proficient with this skill in a simulated environment.ObjectivesTo explore the learning experience of undergraduate nursing students using standardized patients while practising their mental status examination and suicide risk assessment skills in mental health nursing module.DesignA pre- and post-test, single group quasi experimental design was used in this study. A standard didactic tutorial session and a standardized patient session was conducted to evaluate the learning experience of undergraduate nursing students learning mental status examination and suicide risk assessment. Outcome measures for this study include Student Satisfaction and Self-Confidence in learning scale.Qualitative comments in the form of open-ended questions were also collected in this study.SettingsA University offering nursing program from undergraduate to postgraduate level.ParticipantsA convenience sample of Year 2 undergraduate nursing students undertaking the mental health nursing module was included in this study.ResultsThe use of standardized patient session had significantly increased students' satisfaction and confidence level before they are posted to a mental health setting for their clinical attachment. There was a significant difference on students' self-confidence level for those who have taken care of a patient with mental illness after adjusting for pre-test on score in learning. Qualitative feedback obtained from students showed a positive outlook towards the use of standardized patient as an effective tool in augmenting didactic learning into practical skills.ConclusionsUsing standardized patient in mental health nursing education enhanced the integration of didactic content into clinical setting allowing students to practice their assessment skills learned in classroom and transfer it to the clinical area. The benefits of using standardized patient include allowing students to practice their communication skills and improving their confidence level in conducting mental status examination and suicide risk assessment by reducing anxiety as compared with traditional classroom and textbook-based pedagogy.     

Patient health outcomes in psychiatric mental health nursing

This integrative literature review examined evidence concerning the relationship between psychiatric mental health nursing interventions and patient-focused outcomes. Empirical studies, published between 1997 and 2007, were identified and gathered by searching relevant databases and specific data sources. Although 156 articles were critically appraised, only 25 of them met the inclusion criteria. Findings from this review showed that the most frequently used outcome instruments assessed psychiatric symptom severity. Most of the instruments targeted two symptom categories: altered thoughts/perceptions and altered mood. Other outcome instruments were categorized in the following domains: self-care, functioning, quality of life and satisfaction. The most important finding of this review is the lack of consistently strong evidence to support decisions concerning which outcome instrument or combination of instruments to recommend for routine use in practice. Based on this review, additional research to conceptualize, measure and examine the feasibility of outcome instruments sensitive to psychiatric mental health nursing interventions is recommended.     

Nursing students' preconceptions of the community health clinical experience: implications for nursing education

It is essential that nurse educators identify and attempt to understand students' preconceptions related to upcoming clinical experiences to develop strategies that are effective in preparing the students for entry into new and unique settings. This qualitative study described nursing students' preconceptions as they entered the community health clinical rotation. Six major themes emerged: feeling insecure and unprepared for the community health clinical experience; contemplating risks to personal and client safety in the community; anticipating a change of pace; sensing a loss of control; envisioning isolation; and interpreting the value of community health nursing. Findings from this study provide nurse educators and preceptors with insight into understanding students' needs as they enter the community setting. Facilitating a positive transition for students supports efforts to improve the image of and create favorable attitudes toward community health nursing practice.     

The role of a mental health consumer in the education of postgraduate psychiatric nursing students: the students' evaluation

Recent Australian Government policy reflects the integral nature of active consumer participation to the planning and delivery of mental health services. The effectiveness of consumer participation in improving mental health services has received some attention in the literature. Commonwealth Government funding enabled the development of a partnership between the Centre for Psychiatric Nursing Research and Practice and the Melbourne Consumer Consultants' Group. The successful application enabled the employment of a mental health consumer as an academic staff member of the Centre for Psychiatric Nursing Research and Practice. One important aspect of this role involved the mental health consumer teaching a consumer perspective to postgraduate psychiatric nursing students. The primary aim was to increase the students' awareness of and sensitivity to greater consumer participation within the mental health arena. This paper presents the results of an evaluation of the consumer academic role in teaching within the Postgraduate Diploma in Advanced Clinical Nursing (Psychiatric Nursing). An evaluation form was distributed to students (n = 21) on completion of the semester. The findings suggest the experience was considered beneficial to students and was impacting significantly on their current practice. This project supports the value of consumer participation in the education of mental health professionals.     

培养中专护生沟通能力的体会

沟通能力是临床护士全面获得病人信息不可缺少的技能。培养护生的沟通能力是素质教育的重要组成部分。在临床带教中,通过培养护生热爱护理专业;定期举行沟通知识与技巧讲座;加强护生的临床沟通训练;培养护生良好的情绪;争取病人合作等方法,提高了护生的沟通能力。     

A mental health nursing clinical experience with hospice patients

The author describes a clinical experience with hospice patients developed for an 8-week mental health nursing course. The experience focused on the promotion of mental health in the patient and the therapeutic use of self with students. Students were assigned a hospice patient each of whom they visited once a week. Students kept a journal and met for a weekly support group meeting with their instructor. The experience was evaluated positively by students who thought it improved their use of therapeutic communication, empathy, and gained insight into death and dying.     

The impact of mental health nursing education on undergraduate nursing students' attitudes to consumer participation

Consumer participation in all aspects of mental health service delivery, including the education of mental health professionals, is now a policy expectation in Australia. Whether education programs introducing nurses to mental health nursing lead to more favourable attitudes towards consumer participation is yet to be examined in pre-registration nursing programs in Australia. The current evaluation examined changes in scores for the Consumer Participation Survey for undergraduate nursing students (n = 68) in an Australian University. Data were analysed, using repeated measures t-test, to compare the pre- and post-test scores. There was a significant improvement in views on consumers participating as staff members. There were no statistically significant changes in attitudes towards consumer capacity and consumer involvement in care processes. Consumer participation in mental health care is now clearly articulated in Australian Government policy. For this to be successfully implemented a more comprehensive understanding of the ability of education to influence attitudes is required.