Date of Award
Fall 2023
Document Type
Dissertation - Restricted
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Kristina Thomas Dreifuerst
Abstract
Psychiatric mental health (PMH) nursing struggles for recognition among its’ nursing peers, patients, and nursing students. PMH nursing is historically rated among the least desired practice settings within the discipline, at a time when the need for mental health services is large and growing. While some students select PMH nursing as their preferred specialty, all nurses interact with and care for patients who have PMH conditions. In addition, nursing professional organizations are currently immersed in strategy to make prelicensure curriculum competency based. This change impacts the way PMH will be taught and assessed. Prelicensure students may begin their nursing education in associate, bachelor’s, or direct-entry master’s degree program. Within these programs, PMH curriculum varies widely. Some learning experiences are in the classroom only, while others report not having PMH didactic curriculum. Additionally, some programs include traditional clinical with practicum experiences with or without classroom content while others include simulation practicum experiences with or without traditional clinical and/or didactic content. All of this variety impacts the pipeline of nursing students into PMH settings. This quantitative pretest-posttest study examined the relationship between academic program and pedagogy on the students’ confidence and competence to provide care for patients with PMH conditions. Self-report of clinical confidence using the Mental Health Clinical Confidence Survey (MHNCCS) and self-report of clinical competence using the Behavioral Health Clinical Competence instrument (BHCC), were measured in 61 participant students from eight Midwestern nursing programs. The data revealed that there was no statistically significant difference in outcomes based on either pedagogy or program type however, there were differences of practical importance. Self-report of clinical confidence was shown to predict self-report of clinical competence. This study contributes to the body of knowledge influencing curricular decisions in prelicensure programs. In planning curriculum, courses and experiences, particular attention must be paid to the relationship between academic experience on student’s clinical confidence and clinical competence in providing PMH nursing care. Nursing faculty and nursing program administrators can use this evidence when making decisions regarding curriculum and course design. Practicum experience must be prioritized to prepare nursing students to provide care for patients with PMH conditions.