Effect of Clinical Simulation on Suicide Care Competency and Suicide Stigma Levels of Psychiatric Nursing Students
The Effect of Clinical Simulation on Mental Health and Psychiatric Nursing Students' Suicide Care Competency and Suicide Stigma Levels
This study aims to examine the effect of a suicide scenario-based clinical simulation on nursing students' suicide care competency and suicide stigma levels. The study uses a single-group pre-test/post-test (quasi-experimental) design. Nursing students enrolled in a Mental Health and Psychiatric Nursing course at a foundation university in Istanbul, Türkiye, who have not previously participated in a similar simulation, are invited to take part.
Before the simulation, participants complete a set of questionnaires assessing their suicide care competency and attitudes toward suicide stigma. They then take part in a structured simulation session involving a standardized patient portraying a person with suicidal history and risk. The session includes a prebriefing phase, a 15-minute clinical encounter, and a 60-minute debriefing session guided by the PEARLS model. Immediately afterward, participants complete the same questionnaires again.
The purpose of the study is to determine whether simulation-based training improves nursing students' competency in caring for individuals at suicide risk and reduces stigmatizing attitudes toward suicide, and to contribute evidence on the use of simulation in psychiatric nursing education.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Szczegółowy opis
Design: This study was conducted using a single-group pre-test/post-test quasi-experimental design to evaluate the effect of a suicide scenario-based clinical simulation on nursing students' suicide care competency and suicide stigma levels.
Hypotheses:
H1: Post-test mean suicide care competency scores of nursing students who participate in the simulation will be higher than their pre-test mean scores.
H2: Post-test mean suicide stigma scores of nursing students who participate in the simulation will be lower than their pre-test mean scores.
Population and Sample: The study population consists of 3rd-year students enrolled in the Mental Health and Diseases Nursing course (English Program) at the Faculty of Health Sciences, Istanbul Medipol University, during the 2026-2027 fall semester (N=110). The sample consists of students who had not previously participated in a similar suicide scenario-based simulation and who agreed to participate voluntarily.
Data Collection Tools: A Personal Information Form (9 items; developed by the researchers, covering age, gender, marital status, prior experience with suicidal individuals, self-reported care competency, personal and family history related to suicidal ideation or attempt), the Suicide Care Competence Scale (SCCS; 18 items, 5 subscales; Sun et al., 2014; Turkish validity and reliability by Erfidan & Büyükbayram Arslan, 2026; Cronbach α=0.85), and the Stigma of Suicide Scale (SOSS; 55 items, 3 subscales: Stigmatization, Isolation/Depression, Glorification/Normalization; Batterham, Calear & Christensen, 2013; Turkish validity and reliability by Öztürk, Akın & Durna, 2017; Cronbach α=0.90) were used.
Simulation Intervention: The intervention consisted of three sequential phases - prebriefing, clinical simulation, and debriefing - with identical learning objectives, environment, scenario, and procedures maintained across all participants to preserve intervention fidelity.
Prebriefing Phase: Conducted immediately before the simulation by the principal researcher, introducing the learning objectives, scenario, participant roles, expected timeline, debriefing process, and data collection instruments, and establishing a psychologically safe learning environment. Pre-test questionnaires (Personal Information Form, SCCS, SOSS) were completed at the end of this phase.
Clinical Simulation Phase: Each group of students engaged in an approximately 15-minute encounter with a standardized patient portraying a person with suicidal history and risk, communication difficulties, and nursing care needs. The scenario was set in a clinical inpatient context. Students practiced therapeutic communication and suicide risk assessment within a safe, realistic environment.
Debriefing Phase: A 60-minute structured session guided by the PEARLS (Promoting Excellence and Reflective Learning in Simulation) blended debriefing model, encompassing reaction, analysis, and summary phases. Post-test questionnaires (SCCS, SOSS) were completed immediately after the debriefing. Total session duration was approximately 2 hours.
Data Analysis Plan: Data are analyzed using SPSS 22.0. Descriptive statistics (mean, standard deviation, median, frequency, percentage) are used for quantitative and qualitative variables respectively. The paired-samples t-test is used to compare pre-test and post-test measurements. Pearson correlation analysis is used to assess relationships between variables. Statistical significance is evaluated at the 95% confidence level (p<0.05).
Typ studiów
Typ studiów
Zapisy (Rzeczywisty)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Lokalizacje studiów
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Istanbul, Turcja (Türkiye), 34810
- Istanbul Medipol University, Faculty of Health Sciences, Department of Nursing
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
- Enrolled in the Mental Health and Diseases Nursing course (3rd year, English Program, Istanbul Medipol University)
- Willing to voluntarily participate and provide written informed consent
- No prior participation in a similar simulation-based training on approaching patients with suicidal ideation or risk
Exclusion Criteria:
- Refusal to participate in the study
- Absence during the simulation implementation session
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Inny
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Eksperymentalny: Experimental Group
There is one group. All participants received a suicide scenario-based clinical simulation before their psychiatric clinical placement. The intervention consisted of three sequential phases - prebriefing, clinical simulation, and debriefing - with identical learning objectives, environment, scenario, and procedures maintained across all participants to preserve intervention fidelity. |
A structured simulation-based intervention consisting of three phases: (1) Prebriefing: introduction of learning objectives, scenario, and roles; completion of pre-test questionnaires (Personal Information Form, Suicide Care Competence Scale, Stigma of Suicide Scale). (2) Clinical Simulation: a 15-minute standardized patient encounter in which nursing students practice therapeutic communication and suicide risk assessment with a patient portraying suicidal history and risk. (3) Debriefing: a 60-minute structured reflective session guided by the PEARLS model, followed by immediate post-test administration. Total duration approximately 2 hours. |
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in Suicide Care Competency
Ramy czasowe: Baseline (pre-simulation) and immediately after debriefing (approximately 2 hours after baseline)
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Measured by the Suicide Care Competence Scale (SCCS; 18 items, 5 subscales). Scores range from 18 to 90; higher scores indicate greater suicide care competency. Turkish validity and reliability established by Erfidan and Büyükbayram Arslan (2026); Cronbach alpha=0.85. |
Baseline (pre-simulation) and immediately after debriefing (approximately 2 hours after baseline)
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Change in Suicide Stigma Levels
Ramy czasowe: Baseline (pre-simulation) and immediately after debriefing (approximately 2 hours after baseline)
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Measured by the Stigma of Suicide Scale (SOSS; 55 items, 3 subscales: Stigmatization, Isolation/Depression, Glorification/Normalization). 5-point Likert scale. Turkish validity and reliability established by Öztürk, Akın and Durna (2017); Cronbach alpha=0.90. |
Baseline (pre-simulation) and immediately after debriefing (approximately 2 hours after baseline)
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
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Self-Perceived Care Competency for Suicidal Patients
Ramy czasowe: Baseline only
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Single-item visual analog scale (0-10) from the Personal Information Form assessing students' self-perceived competency in caring for patients admitted due to suicidal attempt. |
Baseline only
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Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Merve Geylani, phD, Medipol University
Publikacje i pomocne linki
Publikacje ogólne
- Sun FK, Chiang CY, Chen WJ, Wang RH, Huang HM, Lin HY. Development and psychometric testing of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan. Arch Psychiatr Nurs. 2014;28(4):284-9. doi:10.1016/j.apnu.2014.05.001 Erfidan SC, Büyükbayram Arslan A. Turkish Validity and Reliability Study of the Suicide Caring Competence Scale: A Methodological Study. Archives of Health Science and Research. 2026;13:1-9. doi:10.5152/ArcHealthSciRes.2026.25168 Batterham PJ, Calear AL, Christensen H. The Stigma of Suicide Scale: Psychometric properties and correlates of the stigma of suicide. Crisis. 2013;34(1):13-21. doi:10.1027/0227-5910/a000156 Öztürk A, Akın S, Durna Z. Testing the Psychometric Properties of the Turkish Version of the Stigma of Suicide Scale (SOSS) with a Sample of University Students. Journal of Psychiatric Nursing. 2017;8(2):102-109. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106-115. PMID:25710312 Goh YS, Selvarajan S, Chng ML, Tan CS, Yobas P. Using standardized patients in enhancing undergraduate students' learning experience in mental health nursing. Nurse Educ Today. 2016;45:167-172. PMID:27526302 Del Pozo-Herce P, Ruiz-Lozano RE, Tejada-Garrido CI, Morán-Rodríguez M, Alonso-Sangregorio M, Olmos-Jiménez R. Mental Health Nursing Student's Perception of Clinical Simulation about Patients at Risk of Suicide. Nurs Rep. 2024;14(1). doi:10.3390/nursrep14010049 PMID:38535721 Campbell C, Lugger M. Innovative Approaches to Mental Health Education: Standardized Patients and Tag Team Simulation. Issues Ment Health Nurs. 2025. doi:10.1080/01612840.2025.2474109 PMID:40068187 Shubel L, et al. Standardized Patients to Deliver or Evaluate Suicide Prevention Trainings for Health Professionals: A Scoping Review. Am J Pharm Educ. 2025. doi:10.1016/j.ajpe.2025.101497 PMID:40882819 Bruce E, Shaughne
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Rozpoczęcie studiów
Zakończenie podstawowe (Rzeczywisty)
Zakończenie podstawowe
Ukończenie studiów (Rzeczywisty)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- E-10840098-50.04-6898
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Individual participant data will not be shared, as the study involves student participants whose confidentiality is protected under the ethics committee approval. Aggregate findings will be reported in peer-reviewed publications.
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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