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Effects of simulation training on student confidence in de-escalation skills

02 January 2023
Volume 15 · Issue 1



There is increasing demand for access to mental health support services both for ongoing care and at time of crisis. Preparation of undergraduate students for encounters with those with ongoing mental health care and/or at a time of psychological distress/crisis remains sporadic and difficult to encompass. Simulation gives students opportunities to develop technical and non-technical skills through the recreation of an experience that is as close to reality as possible.


An exploratory evaluation of teaching practice of student self-perceptions of self-awareness and self-regulation in encountering clinical situations with persons in high states of arousal and potential conflict was conducted. To evaluate the exercise and its value, students were asked to self-evaluate their confidence and knowledge both prior to and subsequent to the teaching exercise.


There was a positive shift in self-awareness and self-regulation post training. Confidence in being able to de-escalate a situation was reported as the key outcome to take from the session, along with techniques on how to de-escalate a scenario.


While it is not possible at this stage to definitively measure the impact of the teaching on practice or draw firm conclusions for education providers, the evaluation exercise does evidence individual impact and enjoyment. The teaching approach may prepare the future workforce with the skills and knowledge needed to provide high-quality care.

Approximately 450 million people worldwide are affected by mental, neurological, or behavioural problems at any time (World Health Organization, 2015). In addition, the prevalence of crises, with acute psychological and behavioural manifestations, is increasing.

Given the continued transition between inpatient and community-based mental healthcare and the ongoing shortage in service provision, the NHS highlights that an increase in the urgent and emergency nature of mental health referrals is impacting emergency services, who inevitably pick up some of the shortfall (Xanthopoulou et al, 2022.

Many of the people requiring emergency or crisis mental health intervention may have physical health needs, which places them in a vulnerable position due to a continued lack of parity between physical and mental healthcare (Care Quality Commission (CQC), 2020) It is vital that care is needs-led and that first responders are trained and aware of the impact of physical and mental health comorbidities so that they treat with dignity and respect while also upholding human rights (Launders et al, 2022).

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