The Development of a PTSD Standardized Patient Encounter

Publication ID Published Volume
10265 November 4, 2015 11

Abstract

This standardized patient (SP) post-traumatic stress disorder (PTSD) case answers the call to collaborate with healthcare professions to better prepare new graduate nurses to enter multidisciplinary professional practice. Similarly, the Liaison Committee on Medical Education’s new accreditation standards recommend that medical education must prepare medical students to learn to collaborate with other healthcare professions. Further, collaboration can be with healthcare professions or healthcare students. Last, veterans’ health is a national healthcare concern and a priority for nursing.

This resource provides MedEdPORTAL with an SP case specifically about PTSD, which includes a flashback in response to stimuli during the encounter, thus allowing students the opportunity to recognize an impending PTSD attack and offer ways to interrupt an impending attack. This resource adds to MedEdPORTAL’s database of interprofessional teaching/learning strategies. This PTSD SP case is evidence based and has been piloted and tested.

A simulated hospital suite was modified to mimic an inpatient clinic room. The encounter was digitally recorded for review in debrief. Each SP simulation was allowed to run a maximum of 20 minutes with an announcement of “Five minutes are remaining” to cue the students to close the encounter. Faculty or students could end the scenario before the full 20 minutes if the learning objectives were successfully achieved. At the end of the scenario, the SP had a maximum of 15 minutes to come out of character, review the guidelines for debrief, and collect his relevant thoughts for feedback comments. Once this was completed, the SP joined the nursing students and faculty in debrief and engaged in guided reflection on the encounter by giving positive and meaningful feedback to the students. At the end of the debrief session, nursing students completed a web-based evaluation of the SP encounter. Results were overwhelmingly positive, with the majority of students (n = 40) agreeing or strongly agreeing the SP encounter was an effective learning experience.

Effectiveness of the work and the link to our educational objectives: 

  • Learning Objective 1: Forty undergraduate nursing students were able to perform a simulated assessment of a patient with PTSD. This SP encounter effectively replaced clinical time in a mental health facility. 
  • Learning Objective 2: Students' comments indicate the interaction with the SP rewarded caring relationship strategies and helped them to develop a therapeutic relationship with the patient and to demonstrate empathy for a patient with PTSD. 
  • The SP’s PTSD characteristics escalate and/or de-escalate based on establishment of a caring relationship by the student. This dynamic interaction is more effective than a lecture or reading, as illustrated by the learner and SP comments. 

Citation

Doolen J, Guizado de Nathan G, Johnson M, Perna C, Giddings M. The development of a PTSD standardized patient encounter. MedEdPORTAL Publications. 2015;11:10265. http://doi.org/10.15766/mep_2374-8265.10265

Educational Objectives

By the end of this session, the student will be able to:

  1. Complete a focused psychiatric assessment of the patient with PTSD as well as a mini-mental exam inclusive of a suicide assessment.
  2. Implement strategies that demonstrate the ability to establish a caring relationship with the patient.
  3. Recognize the symptoms of PTSD.
  4. Identify risk factors that will minimize harm to the patient and implement interventions that promote patient safety.

Keywords

  • Standardized Patient, Post-Traumatic Stress Disorder, Stress Disorders, Post-Traumatic, Undergraduate Nursing Students

References

  1. Alexander L, Dearsley S. Using standardized patients in an undergraduate mental health simulation. Int J Ment Health. 2013;42(2-3):149-164. http://dx.doi.org/10.2753/IMH0020-7411420209

  2. Decker S, Fey M, Sideras S, et al. Standards of best practice: standard VI: the debriefing process. Clin Simulation Nurs. 2013;9(6)(suppl):S26-S29. http://dx.doi.org/10.1016/j.ecns.2013.04.008

  3. Ironside PM. Exploring the complexity of advocacy: balancing patient-centered care and safety. QSEN Web site. http://www.qsen.org/teachingstrategy.php?id=58. Published March 30, 2007.

  4. McNaughton N, Ravitz P, Wadell A, Hodges BD. Psychiatric education and simulation: a review of the literature. Can J Psychiatry. 2008;53(2):85-92.

  5. National League for Nursing. Simulation Evaluation Instruments. New York, NY: National League for Nursing; 2013.

  6. National League for Nursing joins forces with First Lady Michelle Obama and Dr. Jill Biden to support veterans and military families [press release]. New York, NY: National League for Nursing; April 12, 2012.

  7. The NCSBN National Simulation Study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. J Nurs Regul. 2014;5(2)(suppl):S3-S40. http://dx.doi.org/10.1016/S2155-8256(15)30062-4

  8. Robinson-Smith G, Bradley PK, Meakim C. Evaluating the use of standardized patients in undergraduate psychiatric nursing experiences. Clin Simulation Nurs. 2009;5(6):e203-e211. http://dx.doi.org/10.1016/j.ecns.2009.07.001

  9. Szpak JL, Kameg KM. Simulation decreases nursing student anxiety prior to communication with mentally ill patients. Clin Simulation Nurs. 2013;9(1):e13-e19. http://dx.doi.org/10.1016/j.ecns.2011.07.003

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ISSN 2374-8265