The purpose of this study is to examine the impact of an online virtual human role-play simulation in teaching high school educators and staff to identify, talk to, and if necessary, refer students in psychological distress to support services. High school educators (N = 31,144) from 43 US states and 5 American territories completed a baseline survey and then randomly assigned to a wait-list control or treatment group. Participants in the treatment group completed the training simulation which included active learning strategies to teach evidenced-based communication strategies such as motivational interviewing to build skills and shift attitudes. Immediately after the training, treatment group participants completed a post-survey and then a 3-month follow-up survey. Baseline and post-surveys included the validated gatekeeper behavior scale measures which assess attitudinal constructs that predict helping behaviors. Self-reported helping behaviors were collected at baseline from both groups and at the 3-month follow-up for the treatment group. The treatment group participants’ post and follow-up data were compared to the control group’s baseline measures. The treatment group post-training scores were significantly higher (p < .001) than the control group’s baseline scores for all gatekeeper behavior scale attitudinal constructs of preparedness, likelihood, and self-efficacy to engage in helping behaviors. A teacher subsample reported significant increases (p < .001) in the number of students referred to mental health support services when compared to baseline measures of the control group. Role-play simulations hold promise in teaching educators to become the “eyes and ears” of student mental health by empowering them to identify students in psychological distress, engage them in effective conversations about their concerns, and if necessary, make a referral to behavioral health support services. Future studies need to implement measures that document students entering counseling as a result of self-reported referrals and examine the impact of the training on the overall mental health culture within schools. Such studies could lead to simulations being widely adopted to support public health initiatives that address student mental health and wellness.

Background: Technology has become increasingly prominent in nursing education. Online learning platforms may be more useful than traditional textbooks in promoting active learning, engagement, and satisfaction. Purpose: The purpose was to evaluate a new online interactive education program (OIEP) that replaces traditional textbooks and to understand student and faculty satisfaction, perceived efficacy of the program, student engagement, and whether the OIEP can help NCLEX preparation and reduce burnout. Method: This retrospective study assessed student and faculty perceptions of the constructs using quantitative and qualitative measures. Perceptions were measured at 2 time points each: halfway through the semester and again at its conclusion. Results: Mean efficacy scores of groups were high at both time points. Students showed significant increases in content constructs, which were supported by faculty perceptions of students. Students agreed that using the OIEP throughout their program would significantly increase preparedness for NCLEX. Conclusion:The OIEP may better support nursing students throughout school and on NCLEX than traditional textbooks.

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