High School Educator Training by Simulation to Address Emotional and Behavioral Concerns in School Settings: A Randomized Study

Abstract

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.

Postvention as Prevention: Coping with Loss at School

“…Quantitative results demonstrated that Resilient Together: Coping with Loss at School was an effective tool for teaching learners how to recognize signs of psychological distress, and improved learners’ preparedness and self-confidence in their ability to engage in conversations with students and colleagues regarding support services. These findings align with findings from similar studies that assess the efficacy of simulated virtual role-play programs, specifically in significantly increasing attitudes regarding recognition, approach, and referral behaviors [ 34 , 35 , 36 , 37 , 38 , 39 ]. However, this study differs in that it also incorporates the importance of identifying the impact of loss and grief on school communities, differing from typical interventions that aim to improve mental health awareness.…”

“…In this same study, educators reported a 36% increase in the number of students recognized as being in distress, a 54% in number of students with whom they had discussions about concerns, and a 72% increase in the number of parents with whom they had discussions about referrals to support for their children. Additional studies demonstrate similar findings for training via virtual role-play simulators [ 35 , 36 , 37 ]. In the Resilient Together: Coping with Loss at School simulation, participants enter an online environment where they practice role-playing with emotionally responsive intelligent virtual students coded with memory, personality, and will respond like real students who have experienced a loss.…”

“…A virtual coach provides ongoing feedback on effective and ineffective communication strategies and though practicing the role-plays, participants learn how to support students impacted by a death and support their colleagues experiencing compassion fatigue. Several studies have demonstrated the efficacious impact of role-play simulations that have implemented similar learning models as the one examined in this study [ 34 , 35 , 36 , 37 ]. A more detailed description of simulation design and learning methodology can be found in Albright et al [ 38 ] as well as an overview on simulations in PK-12 [ 39 ].…”

Digital mental health interventions for school teachers – A narrative review

“…Three randomized clinical trials conducted in the USA evaluated similar interventions using teacher training through brief online simulations (role play) lasting between one and 2 hours to address student mental health in general (Albright et al, 2022; Greif Green et al, 2020; Long et al, 2018). One of the studies was conducted with elementary school teachers and was found to be an effective strategy for improving teacher preparedness ( t (18651) = 81.01, p < .001), likelihood ( t (18568) = 39.62, p < .001), and self‐efficacy ( t (18511) = 56.62, p < .001) needed to perform a positive mental health gatekeeper role in schools measured through post‐simulation survey (Long et al, 2018).…”

“…Four studies involving brief role play online simulations showed that this kind of intervention was well received (Albright et al, 2022;Bradley & Kendall, 2019;Greif Green et al, 2020;Long et al, 2018).…”