Instructing Nursing Students on Early Identification and Screening for Postpartum Depression Using Simulation Training

Abstract

Early identification of depressive symptoms associated with postpartum depression (PPD) is key to its treatment. Nurses’ lack of skills and knowledge were identified in the literature as barriers to screening for postpartum depression. In this study the researcher explored the use of simulation to instruct undergraduate nursing students on the screening and care for PPD. A quasi-experimental design study was conducted in the Fall 2017 and Winter 2018, with a convenience sample of senior undergraduate nursing student at Queen’s University (n=19). Knowledge, attitudes, perceived communication skills and confidence were measured pre- and post-simulation training using a 26-items and 12 statements Perinatal Depression Monitor tool. A strong knowledge base and positive attitudes toward PPD were found prior to and after simulation. Nearly 78% of participants strongly agreed with the statement that “Nurses should assess early and often for PPD”. The participants’ mean scores of perceived communication skills and confidence levels increased in the posttest (communication skills, pretest M: 3.68, posttest M: 4.15; confidence, pretest M: 2.73, posttest M: 3.57). As the simulation in this study was the first experience for most of the participants to practise a scenario involving PPD, it was found that this simulation aligns with the Knows How level in Miller’s (1990) Pyramid of Clinical Competence. The lack of knowledge regarding the use of the Edinburg Postnatal Depression Scale screening tool and community PPD referral resources for mothers at risk for PPD were evident among the study participants. This discrepancy suggests a gap between the Shows How and Knows How levels in the pyramid. It is recommended that undergraduate students be taught with scenarios involving screening for PPD in their nursing curriculum (3rd year) to better prepare them to reach the Shows How level in the simulation laboratory. This will ideally increase the students’ competence and preparedness to screen for PPD and provide nursing care for patients with PPD in their practice.