Research Article| Volume 77, P23-29, April 2023

Learning to Manage De-escalation Through Simulation: An Exploratory Study

Published:March 01, 2023DOI:


      • 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.



      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.


      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.


      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.


      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.


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