Before this simulation day, I was somewhat nervous due to the fact that we had yet to have had experience in working with mental health patients in person due to our virtual simulation for this course. From my experience in undergrad with simulations with live actors, I knew very well that any plan made ahead of time with questions or a flow that you had envisioned was not going to go the way that you planned. This can be due to natural flow of conversation and the patient providing information at their own rate. One aspect that I was excited for was the fact that we were in groups as a part of an ACT team working with the mental health clients. This allowed us to bounce ideas off of each other and jump into the conversation when we had ideas and then let others voice their ideas. I wish that my group and I had more time to prepare together as a group for each of the clients rather than the short break in between patients.
Each patient brought unique challenges that I didn’t anticipate. Our first client was Carla who was experiencing a manic episode as part of her Bipolar disorder. This was particularly challenging for me because her outward energy was overwhelming for me and made me apprehensive to join in the conversation. When I did, she made comments to me about my appearance and how she liked my hair and others that made me uncomfortable and as a provider I wasn’t entirely sure on how to continue the conversation other than ignoring it. I wasn’t sure if I should acknowledge the comments or continue with asking questions. The second client of Paul made me feel more confident in the skills and tactics that I have learned through this course and felt as if I asked appropriate questions regarding his auditory hallucinations. The last client of Marnie and Borderline Personality Disorder was a unique case because she had a guard up very high and even made comments to us about how we were just asking questions off of a checklist. This was very apparent in our group as we had a very long awkward pause towards the end because we ran out of questions to ask her and personally, I avoided eye contact in that moment because I didn’t have anything to add to the conversation. This was a very good lesson to learn not to treat them like filling out a worksheet, they are a person with many dimensions, and we are there to get to know them in the moment and treat them like we would like to be treated as providers.
From this simulation, I learned that these interactions should be more of a fluid conversation rather than going down a checklist. This will come with time and practice and I think this was a great first practice. I learned that I need to have more experiences with mental health patients to gain more confidence in interacting with them because I am still apprehensive with knowing what the right things to say. I am grateful for this simulation day and for the great work of the standardized patient actors.
