Pharmacists' mental health support behaviours with simulated patients: a mixed-methods pilot study

Tina X Ung; Sarira El-Den; Rebekah J Moles; Jack C Collins; Kevin Ou; Jenny Chen; Claire L O'Reilly

doi:10.1016/j.japh.2024.102263

Pharmacists' mental health support behaviours with simulated patients: a mixed-methods pilot study

J Am Pharm Assoc (2003). 2024 Oct 12:102263. doi: 10.1016/j.japh.2024.102263. Online ahead of print.

Authors

Tina X Ung¹, Sarira El-Den², Rebekah J Moles³, Jack C Collins⁴, Kevin Ou⁵, Jenny Chen⁶, Claire L O'Reilly⁷

Affiliations

¹ The University of Sydney School of Pharmacy, Sydney, NSW, Australia. Electronic address: tina.ung@sydney.edu.au.
² The University of Sydney School of Pharmacy, Sydney, NSW, Australia. Electronic address: https://twitter.com/SariraEl_Den.
³ The University of Sydney School of Pharmacy, Sydney, NSW, Australia. Electronic address: https://twitter.com/bekidoll.
⁴ The University of Sydney School of Pharmacy, Sydney, NSW, Australia. Electronic address: https://twitter.com/jackccollins.
⁵ Training Delivery & Assessment, The Pharmaceutical Society of Australia. Electronic address: https://twitter.com/kev_o_168.
⁶ The University of Sydney School of Pharmacy, Sydney, NSW, Australia.
⁷ The University of Sydney School of Pharmacy, Sydney, NSW, Australia. Electronic address: https://twitter.com/oreilly_claire.

PMID: 39401695
DOI: 10.1016/j.japh.2024.102263

Abstract

Background: Simulated mental health role-plays provide a safe and relevant learning experience for pharmacy students, improving confidence in and attitudes towards providing mental health support. Little research explores the use of mental health role-plays, enacted by trained actors, with pharmacists.

Objectives: This study aimed to pilot the adaptation of simulated patient (SP) role-plays, from the university classroom with students, to a workshop with pharmacists, and explore pharmacists' experiences.

Methods: Pharmacists attended a two-hour workshop. Trained actors enacted simulated scenarios (previously developed for pharmacy education) with pharmacist volunteers, while being observed by peers, a workshop facilitator and mental health consumer educator (MHCE). Pharmacists engaged in self-assessment immediately post-roleplay, followed by performance feedback and debrief discussions with MHCEs, workshop facilitators and peers. Pharmacists completed pre- and post-workshop surveys exploring intended mental health support behaviours, then invited to participate in an interview exploring their workshop experiences and opinions about using mental health role-plays in clinical practice (via mystery shopping). Non-parametric tests were conducted to analyse role-play and survey scores, and thematic analyses undertaken on interview transcripts.

Results: Thirty-five pharmacists attended the workshop. Fourteen role-plays were analysed. Pharmacist self-assessment scores were significantly lower than MHCE scores (p=0.028). Overall, the role-plays significantly increased pharmacists' intentions in supporting a person experiencing mental health crises such as suicide and psychosis, as well as encouraging other supports (p<0.05). Four themes emerged from interviews (n=4): realistic context for skills application and practice, benefits of observing, self-assessment and feedback, and integrating into clinical practice (via mystery shopping).

Conclusion: SP role-plays of mental health symptoms and crises, enacted by trained actors, may effectively assess and enhance pharmacists' intended mental health support behaviours. It is recommended that the SP method is adapted into clinical practice, via repeated mystery shopping visits with immediate performance feedback, to shape pharmacists' mental health support behaviours.

Keywords: continuing; education; feedback; mental health; patient simulation; pharmacists; pharmacy; self-assessment.