Educational Approaches Using Simulation for Psychiatric Risk Assessment: a Scoping Review.

OBJECTIVE: The ability to assess a patient's risk of harm to self or others is a core competency for mental health clinicians which can have significant patient outcomes. With the growth of simulation in medical education, there is an opportunity to enhance education outcomes for psychiatric risk assessment. The purpose of this study was to determine how simulation is used to build competency in risk assessment and map its educational outcomes. METHODS: The authors conducted a systematic scoping review using the Arksey and O'Malley framework. Electronic database searches were conducted by an academic librarian. Studies published before August 2022 which described simulation activities aimed at training clinicians in suicide, self-harm, and/or violence risk assessment were screened for eligibility. RESULTS: Of the 21,814 articles identified, 58 studies were selected for inclusion. The majority described simulations teaching suicide risk assessment, and there was a notable gap for building competency in violence risk assessment. Simulation utility was demonstrated across emergency, inpatient, and outpatient settings involving adult and pediatric care. The most common simulation modality was patient actors. A smaller subset implemented technological approaches, such as automated virtual patient avatars. Outcomes included high learner satisfaction, and increases in psychiatric risk assessment knowledge, competency, and performance. CONCLUSION: Simulation as an adjuvant to existing medical curricula can be used to teach risk assessment in mental health. Based on the results of our review, the authors provide recommendations for medical educators looking to design and implement simulation in mental health education.

Increasing capacity to address the physical health needs of patients in a mental health and addictions hospital.

PURPOSE: This paper describes the strategy and outcomes of a quality improvement initiative focused on building the capacity of nurses at a mental health and addictions teaching hospital to provide an improved standard of physical health care. Education was provided via a series of e-learning modules and interactive workshops. To reinforce the education and enhance practice change, improvements were made to electronic documentation templates and organizational standards. Further, the organization provided increased access to physical health equipment, a mobile application to support assessments and a reference card for lanyards. CONCLUSIONS: Nurses identified increased confidence in performing physical assessments, and documentation improved with standards and automated forced functionality in the electronic health record. Ultimately, the organization successfully implemented a multifaceted strategy to improve physical healthcare services for people with mental health and substance use concerns. PRACTICE IMPLICATIONS: Organizational investment can lead to sustainable changes in nursing confidence and increased physical health assessment completion.