Background/context The Duty Senior Nurse (DSN) role in South London and Maudsley NHS Foundation Trust (SLaM) has hitherto been an under-supported and somewhat nebulous one. Anecdotally many DSN’s have craved more clarity and a forum to reflect with peers.
Existing training for this group is primarily didactic in nature with little accommodation of reflective practice or experiential learning indicated as key to optimal learning.1 Our team’s recent work has indicated potential for simulation in a mental health setting, a novel application of the modality.
A DSN course was developed to allow learners to explore their own and colleagues’ practice, to recognise the impact of related non-technical skills, to identify personal and practical alternative behaviours and areas for improvement in providing safe, therapeutic services.
Methodology/description The three-day course was delivered on three occasions. It consisted of thirteen scenarios, each followed by a debrief. Iterative design was implemented whereby feedback from each course contributed to the next. Participants (n = 34) were senior nurses who responded as Leader to emergency calls in inpatient settings.
Scenarios included: managing agitation, relatives/carers, seclusion, staff conflict, medical deteriorations, section 136, infection control and business continuity. Each was followed by a structured debrief.
Results/outcomes Feedback was very positive. Over 97% of participants agreed the program was useful and relevant to them, with 100% stating that they would recommend the course to a colleague. Most respondents identified specific lessons learned and changes they could apply to their own practice.
In addition, a pre/post measure of confidence, knowledge and attitudes regarding the DSN role showed significant increases in most dimensions.
Potential impact Further research will be conducted on the course as it is implemented on a larger scale, but initial results indicate potential for simulation to be a valuable tool to aid the development of psychiatric nurses in mental health settings.
Rudolph J, Simon R, Raemer D, Eppich W. Debriefing as formative assessment: Closing performance gaps in medical education. Acad Emerg Med 2008;15(11):1010–1016
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