High School Educator Training by Simulation to Address Emotional and Behavioral Concerns in School Settings: A Randomized Study.

The purpose of this study is to examine the impact of an online virtual human role-play simulation in teaching high school educators and staff to identify, talk to, and if necessary, refer students in psychological distress to support services. High school educators (N = 31,144) from 43 US states and 5 American territories completed a baseline survey and then randomly assigned to a wait-list control or treatment group. Participants in the treatment group completed the training simulation which included active learning strategies to teach evidenced-based communication strategies such as motivational interviewing to build skills and shift attitudes. Immediately after the training, treatment group participants completed a post-survey and then a 3-month follow-up survey. Baseline and post-surveys included the validated gatekeeper behavior scale measures which assess attitudinal constructs that predict helping behaviors. Self-reported helping behaviors were collected at baseline from both groups and at the 3-month follow-up for the treatment group. The treatment group participants' post and follow-up data were compared to the control group's baseline measures. The treatment group post-training scores were significantly higher (p < .001) than the control group's baseline scores for all gatekeeper behavior scale attitudinal constructs of preparedness, likelihood, and self-efficacy to engage in helping behaviors. A teacher subsample reported significant increases (p < .001) in the number of students referred to mental health support services when compared to baseline measures of the control group. Role-play simulations hold promise in teaching educators to become the "eyes and ears" of student mental health by empowering them to identify students in psychological distress, engage them in effective conversations about their concerns, and if necessary, make a referral to behavioral health support services. Future studies need to implement measures that document students entering counseling as a result of self-reported referrals and examine the impact of the training on the overall mental health culture within schools. Such studies could lead to simulations being widely adopted to support public health initiatives that address student mental health and wellness.

Enhancing Educator Engagement in School Mental Health Care Through Digital Simulation Professional Development.

BACKGROUND: Despite the critical role of educators as gatekeepers for school mental health services, they receive limited training to support student mental health. We report findings from a trial of an online mental health role-play simulation for elementary school teachers on changes in attitudes and self-reported helping behaviors for students experiencing psychological distress. METHODS: We randomly assigned 18,896 elementary school teachers to wait-list control or intervention conditions in which they received the 45- to 90-minute online role-play simulation. We administered a version of the validated Gatekeeper Behavior Scale at baseline and postintervention, which measures attitudinal dimensions shown to predict teacher helping behavior change. Self-reported helping behaviors were collected at baseline and 3-month follow-up. Outcomes were compared between the intervention follow-up and control group baseline measures. RESULTS: The intervention group posttraining scores were significantly higher (p < .001) than the control group for all the preparedness, likelihood, and self-efficacy Gatekeeper Behavior subscales. All 5 helping behaviors were significantly higher among the intervention group at follow-up compared to the control group at baseline. CONCLUSIONS: We found that a brief online role-play simulation was an effective strategy for improving teacher attitudes and behaviors needed to perform a positive mental health gatekeeper role in schools.

Using Virtual Patient Simulations to Prepare Primary Health Care Professionals to Conduct Substance Use and Mental Health Screening and Brief Intervention.

BACKGROUND: Primary health care professionals are in an excellent position to identify, screen, and conduct brief interventions for patients with mental health and substance use disorders. However, discomfort in initiating conversations about behavioral health, time concerns, lack of knowledge about screening tools, and treatment resources are barriers. OBJECTIVE: This study examines the impact of an online simulation where users practice role-playing with emotionally responsive virtual patients to learn motivational interviewing strategies to better manage screening, brief interventions, and referral conversations. DESIGN: Baseline data were collected from 227 participants who were then randomly assigned into the treatment or wait-list control groups. Treatment group participants then completed the simulation, postsimulation survey, and 3-month follow-up survey. RESULTS: Results showed significant increases in knowledge/skill to identify and engage in collaborative decision making with patients. CONCLUSIONS: Results strongly suggest that role-play simulation experiences can be an effective means of teaching screening and brief intervention.