Comparing virtual, standardized patient and hybrid psychiatric simulation in undergraduate nursing: Impact on clinical judgment, communication and attitudes toward mental illness.

BACKGROUND

Limited clinical exposure and persistent stigma can hinder the development of clinical judgment, therapeutic communication, and positive attitudes toward mental illness among undergraduate nursing students. Although simulation-based education shows promise, comparative evidence on virtual simulation, standardized patient (SP) simulation, and hybrid simulation in psychiatric nursing remains limited.

OBJECTIVE

To compare the effects of virtual simulation, SP simulation, and hybrid simulation on undergraduate nursing students' clinical judgment, therapeutic communication, self-reported communication competence, and attitudes toward mental illness.

METHODS

A randomized three-group pretest-posttest quasi-experimental study was conducted with 240 undergraduate nursing students allocated to virtual simulation, SP simulation, or hybrid simulation. Psychometrically evaluated instruments were used to assess clinical judgment, therapeutic communication, self-reported communication competence, and attitudes toward mental illness.

RESULTS

All three simulation modalities improved clinical judgment, therapeutic communication, self-reported communication competence, and attitudes toward mental illness. The hybrid simulation group achieved the highest post-intervention scores across all outcomes, followed by the SP simulation group and then the virtual simulation group. These differences remained significant after adjustment for baseline scores, academic level, and sex.

CONCLUSIONS

Virtual, SP, and hybrid psychiatric simulations were all effective in improving clinical judgment, therapeutic communication, self-reported communication competence, and attitudes toward mental illness. Within this study context, hybrid simulation appeared to provide the greatest educational benefit and may be a useful approach for strengthening undergraduate psychiatric nursing education, particularly when clinical placement opportunities are limited.