Highlights
- •A standardized patient was perceived as more authentic than peer role play.
- •Experiencing simulated verbal aggression fostered reflection and empathy.
- •Simulated aggression allowed students to develop their communication skills.
Abstract
Background
Nurses are increasingly at risk of experiencing physical or verbal violence, during
their career. The aim of this study was to explore undergraduate student nurses’ responses
to patient aggression in a simulated patient care scenario and to facilitate development
of de-escalation management skills.
Methods
Using role-play methodology, 28 third-year nursing students took part in a simulated
aggressive patient scenario. Data were drawn from recorded participant debriefing
sessions immediately following simulation immersion.
Results
Students reported a high level of stress and a variety of emotive responses. They
identified new insights into strategies that could be used to defuse volatile situations
in their future practice and highlighted that the use of a standardized patient enhanced
the authenticity of the experience.
Conclusions
Facing verbal aggression is confronting for nursing students. Practicing and reflecting
on de-escalation management strategies, in an authentic simulated safe environment,
provided students with an opportunity to gain new insights into their role as nurses
while developing effective strategies to draw on in clinical practice.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical Simulation In NursingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Examining nursing students' stress in an end-of-life care simulation.Clinical Simulation in Nursing. 2018; 14: 21-28https://doi.org/10.1016/j.ecns.2017.10.006
- Healthcare providers' neurobiological response to workplace violence perpetrated by consumers: Informing directions for staff well-being.Applied Nursing Research. 2018; 43: 42-48https://doi.org/10.1016/j.apnr.2018.06.019
- Using thematic analysis in psychology.Qualitative Research in Psychology. 2006; 3: 77-101https://doi.org/10.1191/1478088706qp063oa
- Do we feel the same empathy for loved and hated peers?.PLoS ONE. 2015; 10e0125871https://doi.org/10.1371/journal.pone.0125871
- Nursing students and intimate partner violence education: Improving and integrating knowledge into health care curricula.Journal of Professional Nursing. 2013; 29: 233-239https://doi.org/10.1016/j.profnurs.2012.05.011
- Nurse and midwifery education and intimate partner violence: a scoping review.Journal of Clinical Nursing. 2017; 26: 2100-2125https://doi.org/10.1111/jocn.13376
- Implicit bias in healthcare professionals: A systematic review.BMC Medical Ethics. 2017; 18: 19https://doi.org/10.1186/s12910-017-0179-8
- Emotionally intelligent strategies students use to manage challenging interactions with patients and families: A qualitative inquiry.Nurse Education in Practice. 2020; 43102743https://doi.org/10.1016/j.nepr.2020.102743
- The contribution of individual psychological resilience in determining the professional quality of life of Australian nurses.Frontiers in Psychology. 2015; 6: 1613https://doi.org/10.3389/fpsyg.2015.01613
- Prevalence and characteristics of aggression and violence experienced by Western Australian nursing students during clinical practice.Contemporary Nurse. 2014; 49: 113-121https://doi.org/10.5172/conu.2014.49.113
- Aggression and violence in healthcare and its impact on nursing students: A narrative review of the literature.Nurse Education Today. 2018; 62: 158-163https://doi.org/10.1016/j.nedt.2017.12.019
- Healthcare simulation standards of best practicetm simulation design.Clinical Simulation in Nursing. 2021; 58: 14-21https://doi.org/10.1016/j.ecns.2021.08.009
- The impact of stress on paramedic performance during simulated critical events.Prehospital and Disaster Medicine. 2012; 27: 369-374https://doi.org/10.1017/S1049023x12001021
McGregor, C., Bonnis, B., Stanfield, B., & Stanfield, M. (2017). Integrating big data analytics, virtual reality, and ARAIG to support resilience assessment and development in tactical training. IEEE 5th International Conference on Serious Games and Applications for Health (SeGAH), Perth, WA. Retrieved from https://ieeexplore.ieee.org/document/7939256
- Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital.Advances in Simulation. 2020; 5: 21https://doi.org/10.1186/s41077-020-00139-9
- Simulated patient methodology: Theory, evidence and practice.John Wiley & Sons Inc, 2015
- Causes of student anxiety during simulation: What the literature says.Clinical Simulation in Nursing. 2013; 9: e507-e512https://doi.org/10.1016/j.ecns.2013.03.003
- Intervention training using peer role-play and standardised patients in psychodynamic psychotherapy trainees.Counselling and Psychotherapy Research. 2019; 19: 508-522https://doi.org/10.1002/capr.12232
- Violence on the job: The experiences of nurses and midwives with violence from patients and their friends and relatives.Healthcare (Basel). 2020; 8: 522https://doi.org/10.3390/healthcare8040522
- Cultivating empathy: Inspiring health professionals to communicate more effectively.Bentham Science Publishers, 2014
Sydney Clinical Skills and Simulation Centre. (2016). Open, reflect, close: Debriefing script. In. Sydney, NSW: Sydney Clinical Skills and Simulation Centre.
- Women's experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis.BMJ Open. 2020; 10e041339https://doi.org/10.1136/bmjopen-2020-041339
Article info
Publication history
Published online: March 01, 2023
Identification
Copyright
© 2023 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
