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Simulation helps bring awareness to Veteran suicide prevention

By Debra A. Bartoshevich, MSN, RN
Simulation Center Director
Audie L. Murphy VA Hospital

SAN ANTONIO -- The VA South Texas Veterans Health Care System (STVHCS) at the Audie L. Murphy VA Hospital in recognition of Veteran’s Suicide Awareness month in September conducted multiple simulations on suicide prevention throughout the facility. It was the first time that the Audie L. Murphy VA Hospital Simulation Center (ALMSC) worked with trained standardized patients. ALMSC worked collaboratively with the University of Texas Health Science Center at San Antonio (UTHSCSA) School of Medicine to acquire standardized patients to participate in the simulations.

The simulation included implementing the Operation S.A.V.E. (Signs of suicidal behavior, Ask questions, Validate the person’s experience and Encourage treatment) intervention sequence, which can be found in the VA Talent Management System (TMS). Separately in TMS is the Suicide Risk Management Training for clinicians. Both TMS modules were used as pre-briefing tools for the simulation.

Larry Stokes, STVHCS, suicide prevention coordinator, facilitated and led the debriefing sessions. He said, “using the standardized patient really helped reinforce learning and made the simulation believable.”

The simulation training helped VA staff gain more knowledge and awareness when helping a Veteran who expresses thoughts of suicide. Using a standardized patient not only increases realism, but is a convincing vehicle with which to train VA staff to ask the right questions when intervening.

Having access to standardized patients that are professionally trained has been very helpful to the program. UTHSCSA School of Medicine follows the Association of Standardized Patient Educators (ASPE) standards of best practice for role portrayal and feedback, which has helped engage learners and brought realism to the scenario.  

The agreement with UTHSCSA School of Medicine Standardized Patient Program to provide these trainers efficiently conserves time and money for ALMSC. Training standardized patients is a time intensive and a specialized practice that requires trained educators and funding to create a robust program. Under the direction of Diane Ferguson, RN, BSN, the standardized patient program recruits and trains qualified individuals for acting roles. They had previously been training UTHSCSA medical residents to be competent and compassionate physicians. Suzanne Brandt, BA, the Standardized Patient Educator at UTHSCSA School of Medicine, specifically trained standardized patients for the suicide prevention simulation scenario. Brandt worked with each standardized patient ensuring the training meets the learning objectives and followed best practices.

In fact, while preparing for the simulation, it was discovered that one of the standardized patients was a Veteran, David Casillas. Casillas has been working with the UTHSCSA standardized patient program since 2009. Casillas’ training and service experience made the simulations even more realistic. It’s no surprise then that many learners commented that Casillas’ portrayal of the distressed Veteran was right on target. Casillas said, “It is an honor and privilege to be part of these simulations for our Veterans.”

The overwhelming response by STVHCS learners after the experience? “We need more training with standardized patients like this!”