Collaboration, Innovative Use of Technology Help Psych NP Students Hone Suicide Prevention Skills

As any behavioral health provider can attest, suicide is a major public health concern in the United States. Suicide rates in this country have climbed by more than a third over the past two decades, and death by suicide stands as the second-leading cause of death of young people ages 10-34.

A new collaboration between the University of Rochester School of Nursing and the Department of Psychiatry takes aim at that rising tide with an innovative approach to educating students in suicide prevention.

In virtual simulation settings with standardized patients, UR Psychiatric Mental Health Nurse Practitioner (PMHNP) students can build on their competencies specific to suicide assessment and prevention and augment skills they use in clinical settings with patients.

Susan Blaakman, PhD, RN, PMHNP-BC, FNAP, director of the PMHNP program, along with Joanne Bartlett, MS, RN, PMHNP-BC, instructor of clinical nursing, Julia Mitchell, PMHNP-BC, instructor of clinical nursing, and Kate Tredwell, DNP, RN, PMHNP-BC, assistant professor of clinical nursing, worked with Wendi Cross, PhD, professor of psychiatry to offer standardized patient experiences in which students and trained clinical actors would participate in scenarios that have been well tested and modified for PMHNP competencies in a telehealth format. “COVID-19 has shown us that educating students in a telehealth model makes sense,” said Blaakman. “The likelihood

UR School of Nursing Psychiatric Mental Health Nurse Practitioner students, such as Erica Boccia (top left) and Princewill Fonta (bottom left) honed their clinical competencies and bolstered their suicide assessment skills by conducting telehealth visits with standardized patients. The collaboration with the UR Department of Psychiatry allows PMHNP students to use simulation and technology to improve their ability to engage with patients experiencing psychosocial issues and stressors.

HRSA Grant to Help Infuse Trauma-Informed Care into NP Curriculum

The University of Rochester School of Nursing will receive nearly $1 million from the Health Resources and Services Administration (HRSA) to expand the behavioral health workforce serving at-risk children and adolescents.

Depression, anxiety, and suicidality in youth are a growing concern in New York and across the nation and are linked to traumatic experiences. The grant, Project ENACT: Educating NPs to Address Childhood Trauma, will prepare UR School of Nursing Psychiatric Mental Health Nurse Practitioner (PMHNP) students to better serve children and adolescents through the addition of a trauma-informed care (TIC) curriculum.

Part of this curriculum innovation is the ongoing interprofessional collaboration between the University of Rochester Medical Center’s Department of Psychiatry as well as expert, nationally recognized, community partners, including the Mt. Hope Family Center and the TRANSFORM Research Center.

Through these partnerships, Susan Blaakman, PhD, RN, PMHNP-BC, FNAP, the principal investigator and director of the PMHNP program, and her team will develop TIC didactic, simulation, and immersion learning experiences, and launch an online curriculum toolkit by the end of the project. The TIC curriculum toolkit will be shared as a resource with the support of the TRANSFORM Center to enhance the care of vulnerable youth while disseminating findings from this work to national audiences.

The project faculty will establish at least four new practicum sites to offer new opportunities for PMHNP students to employ TIC with children and adolescents and to participate in interprofessional teams that will support a smooth transition to practice upon graduation. The grant will also fund standardized patient experiences in URMC’s Department of Psychiatry Laboratory of Behavioral Health Skills to practice TIC skills.

Building on previous work with the Skills Lab, trained actors will engage PMHNP students in telehealth simulations addressing the greatest risks for patients, including suicidality and trauma. Through realistic, yet low-stakes, scenarios, students receive feedback from the patient actors and their faculty, and perform self-assessments to develop essential competencies for clinical care. “I’m so grateful that HRSA is supporting our commitment to incorporate more trauma-informed care into our curriculum and real-life learning opportunities for our students, ” said Blaakman. “Now, more than ever, we need a behavioral health workforce prepared to meet the complex needs of the vulnerable populations we serve. With our community partners, and this funding, we will have a real impact on how PMHNPs deliver care regionally and beyond.”

of them working in telehealth modalities is even higher now, so it is beneficial to have them practice essential skills in that method, as well.”

Over several months, the PMHNP students participated in formative assessments with standardized patients of different ages and genders experiencing various psychosocial issues and stressors. While students learn how to conduct a mental status evaluation in their didactic coursework, the simulation allows them to receive feedback from a “patient” in a low-risk setting before future high-risk interactions with actual patients.

Prior to each recorded telehealth visit, students received the standardized patient’s history and reason for the visit as if they were in a clinical setting. The students asked questions about the patient's underlying illnesses, family history, current risk, and how to mitigate them with safety planning and prevention resources like the National Suicide Prevention Lifeline at 1-800-273-TALK.

After each session, the standardized patient provided feedback on the student’s engagement and interview skills. Additionally, faculty members evaluated the students on their competencies, attitudes, and satisfaction. The students also completed surveys to gauge their confidence in their skillset. “These types of practice opportunities and immediate feedback are important to the reduction of harm for our patients,” said PMHNP student Erica Boccia. “Being able to have a no-risk trial with prompt constructive feedback may be the thing that saves a life later.” “I have never had the opportunity for patients assessing and giving me feedback regarding my performance,” added another PMHNP student, Princewill Fonta. “The standardized patient experience was a good tool to help assess my rapport with patients, my skills, my engagement during the assessment process, and if I`m asking the questions correctly.”

With the success of the project, UR School of Nursing faculty members were eager to pursue ongoing collaboration and interprofessional learning opportunities through the Skills Lab. In June, Blaakman received the news that the school will receive nearly $1 million in support over four years from the Health Resources and Services Administration (see sidebar story). “It’s important work. We know that patients have complex stressors; we know that we need to reach them where they are, and we need to work together to be effective. This is just one piece of becoming more prepared and responsive,” said Blaakman. “My dream is that telehealth will allow other professions to join efforts. I think there are opportunities to grow interprofessional education, and practice, using this model.”